You Ask , They Answer
Q
: Is blood in urine a sign of a serious condition ?
A
: Blood in the urine is never a pleasant experience . Visible painless blood in the urine is usually considered a serious medical condition , especially in males as we need to exclude conditions like cancer or urinary stones . This is very important if there ’ s a history of smoking as it ’ s linked to bladder cancer . For women , visible blood in the urine is often due to a urinary tract infection , but more serious conditions like urethral stricture or narrowing , stones , or cancer still need to be ruled out , especially if the blood recurs . In general , a visit to a urologist is warranted .
Q
: What are the main diagnostic examinations for blood in urine ?
A
: One of the initial investigations for blood in the urine is a urine test to exclude a urinary infection . Imaging using a CT scan or ultrasound of the urinary tract is helpful to exclude cancer , stones , and obstructions . In selected cases , an endoscopy is indicated to rule out and treat bladder issues like cancer and urethral strictures .
Q
: What are the most common treatment options ?
A
: Treatment depends on the diagnosis . In the event a urinary stone is found , the plan is to remove the stone via non-invasive or minimally invasive modalities after which we
will need to ascertain the cause of the urinary stones , which may be genetic , so we can find ways to reduce stone recurrence . If a urinary tract infection is the cause of the blood in the urine , the attending urologist will have to firstly treat the infection with culture-directed antibiotics and then ascertain the cause of the infection to prevent future recurrences . If bladder cancer is detected , the next step is usually endoscopic surgery to remove the cancer and biopsy it in order to decide on subsequent treatments .
Q
: What ’ s the take-away message for people who experience blood in urine ?
A
: The message is that visible blood in the urine is a red flag that cannot be ignored . Please see your urologist soon for treatment .
Dr Michael Wong Yuet Chen
Dr Michael Wong Yuet Chen is medical director and senior consultant urologist at the Urology , Fertility & Gynaecology Centre in Singapore . He is currently Associate Editor at the British Journal of Urology International .
14 ISSUE 5 | 2023 GlobalHealthAsiaPacific . com