Blood in the urine can originate from anywhere in the urinary tract from the kidneys to the urethra (water pipe draining urine from the bladder).
The aim of investigation of haematuria is to identify its cause and particularly to distinguish those causes that require treatment from those that can be safely observed or monitored.
The most common causes of haematuria include:
- Urinary tract infection
- Bladder tumours or cancers
- Urinary tract stones (calculi)
- Benign prostatic enlargement in men
- Prostate cancer in men
Potential causes of haematuria
Potential causes of haematuria include:
- Cancers within the urinary tract including:
- Kidney cancer
- Renal pelvic or ureteric cancers (cancers of the lining of the drainage system of the urinary tract)
- Bladder cancer
- Prostate cancer
- Urethral cancer
- Infection or inflammation within the urinary tract due to:
- Urinary tract infections including:
- Cystitis – bladder infection
- Pyelonephritis- kidney infection
- Urethritis – including sexually transmitted infections
- Uncommon urinary tract infections in the Western world such as:
- Tuberculosis
- Schistosomiasis
- Benign inflammatory conditions within the urinary tract such as:
- Interstitial cystitis
- Haemorrhagic cystitis – which may be associated with past radiation or therapy with drugs such as cyclophosphamide
- Medical renal disease such as:
- Glomerulonephritis including hereditary nephritis
- IgA nephropathy
- Thin basement membrane disease
- Medullary sponge kidney
- Urinary tract infections including:
-
Calculus or stone disease anywhere within the urinary tract including:
- Renal (kidney) stones
- Ureteric stones (in the tube draining the urine from the kidney to the bladder)
- Bladder stones
- Anatomical abnormalities of the kidneys which can be either congenital or developmental/ acquired such as:
- Polycystic kidney disease
- Pelviureteric junction (PUJ) obstruction
- Benign renal tumours such as angiomyolipoma
- Anatomical abnormalities of the urinary tract such as:
- Benign prostate enlargement (also known as BPH – benign prostate hypertrophy)
- Abnormal connections between the urinary tract and adjacent organs known as fistula (caused by conditions such as diverticulitis and colon cancer)
- Urethral diverticulum
- Urethral stricture – scar or narrowing in the urethra (water pipe draining urine from the bladder)
- Other conditions such as:
- Trauma affecting the urinary tract
- Recent urinary tract surgery or instrumentation (such as urinary catheter insertion)
- Abnormalities of blood vessels in the urinary tract e.g:
- Arteriovenous malformation (blood vessel malformation)
- Renal vein thrombosis (clot formation)
- Endometriosis within the urinary tract
- Papillary necrosis
- Blood abnormalities such as disorders of blood clotting, sickle cell disease