Blood In Your Urine: What Does It Mean And What Should I Do About It?

Seeing blood when you pee is frightening, and most of the time it is not caused by anything serious. It still has to be looked at. The NHS puts it plainly: blood in urine (pee) is not usually caused by anything serious, but you must get it checked out by a GP [1]. Here is what the common causes look like, and when to ask for an urgent appointment.

The reason that advice is so firm is simple. Blood in pee must be checked out because it can be a sign of cancer [1]. Bladder cancer is the 11th most common cancer in the UK [2], with around 10,900 new cases every year - that is 30 every day [3]. Most people who notice blood will have a different explanation, and the only way to know is to be seen.

What Does Blood In Your Urine Look Like?

It varies more than people expect. The NHS says blood in your pee may be bright pink, red or dark brown [1].

It can also behave in ways that make it easy to talk yourself out of acting. It might happen once and not come back. You might have no pain and no other symptoms at all. None of that makes it less worth checking.

What Causes Blood In Your Urine?

Several things can, and most of them are treatable. These are the causes the NHS lists, with the symptoms that usually sit alongside them.

• A urinary tract infection (UTI). Burning pain when you pee, needing to pee often, smelly or cloudy pee, a high temperature, or pain in your sides or lower back [1].
• Kidney stones. Bad pain in your sides, lower back or groin that comes and goes, being unable to lie still, and feeling sick [1].
• Bladder cancer. Blood in your pee is the main symptom [4]. Others can include pain or burning when you pee, needing to pee more often or very suddenly, getting lots of urinary tract infections, and losing weight without trying to [4].
• Kidney cancer. Blood in your pee is the first symptom the NHS lists [5], alongside a lump or swelling in your back, under your ribs or in your neck, pain between your ribs and waist that does not go away, weight loss, and a high temperature that does not go away [5].
• An enlarged prostate. Another common cause in men over 50 - the NHS lists difficulty peeing, needing to pee suddenly and often, and waking up in the night [1]. We cover prostate health separately, including Prostate Screening.

Could It Be Something Other Than Blood?

Sometimes, yes. The NHS notes that what looks like blood in your pee may not be blood at all - recent beetroot, certain medicines, bleeding from your bottom, or period bleeding can each explain it [1].

That is useful to know, and it is not a reason to wait and see. If you are not sure whether it is blood, the advice does not change: get it checked [1]. If it turns out to be bleeding from your bottom, our article on blood in your poo covers what that can mean.

When Should You Get Blood In Your Urine Checked?

Straight away. The NHS advice is deliberately broad, and the "even if" clauses are the important part.

Ask for an urgent GP appointment or get help from NHS 111 if you have blood in your pee, even if [1]:

• you do not have any other symptoms
• it's the first time it's happened
• there's only a small amount of blood
• you're not sure it's blood

Blood that stops on its own has not been explained. It has just stopped.

Book an appointment if you notice:

• repeated urine infections - the NHS counts these as 2 within 6 months, or 3 within 12 months [6]
• infection symptoms that get worse quickly, or do not improve within 48 hours (2 days) of starting treatment [6]

LivingCare's cystoscopy service also investigates bladder pain or discomfort that keeps returning, and persistent changes in how you pee - urgency, frequency, difficulty, or a feeling that your bladder is not emptying.

What Happens When You Get It Checked?

Your GP will want to know what you saw and when. They might ask for a pee sample or arrange a blood test, prescribe antibiotics if they think you have an infection, or refer you to a specialist for tests [1].

That specialist is a urologist [7]. There may be another urine test, and the main look-inside test is a cystoscopy, which the NHS describes as a thin camera passed through the tube that carries pee out of your body (the urethra) to see inside your bladder [7]. The NHS says it may be uncomfortable, but it should not be painful [7]. A small sample of the bladder lining is sometimes taken at the same time for testing, called a biopsy [7]. Further tests may include an ultrasound, MRI or CT scan - and, in the NHS's own words, you may not have all of these tests [7].

At LivingCare, our Cystoscopy service investigates visible or microscopic blood in urine to identify causes such as bladder tumours, stones, inflammation or infection. We perform flexible cystoscopy at both our Leeds and Sheffield clinics.

Frequently Asked Questions

Can a urine infection cause blood in your pee?

Yes - blood in your pee is one of the symptoms the NHS lists for a urinary tract infection [6]. The NHS also flags situations where a UTI needs urgent advice rather than watchful waiting: if you are aged 65 or older, if you are a man or are trans or non-binary and were assigned male at birth, if you have diabetes, if you are pregnant, if you use a catheter, or if you keep getting UTIs [6].

My GP found blood on a urine test but I cannot see anything. Does that count?

It is still worth following up. Blood you can see is described as visible, frank or macroscopic; blood found only when the urine is examined is described as non-visible, invisible or microscopic [8]. A cystoscopy can be used to investigate either. Follow the advice your GP gives you about what happens next.

Does blood in your urine always mean cancer?

No. The NHS holds both halves at once: it is not usually caused by anything serious, and it must be checked out by a GP because it can be a sign of cancer [1]. Bladder cancer is more common if you are over the age of 60 [9], and it is one of several possible causes rather than the expected one.

Book A Urology Appointment In Leeds Or Sheffield

September is Urology Awareness Month - a reasonable prompt to stop putting off the thing you noticed a fortnight ago.

If you have blood in your pee, ask for an urgent GP appointment or get help from NHS 111 first [1]. When you want the investigation itself done quickly, LivingCare's consultant urologists can see you at Thorpe Park Clinic in Leeds and Canon Medical Arena in Sheffield. Self-pay, with no GP referral needed. If you are using medical insurance, your insurer may ask for a GP referral letter.

Book a Urology Consultation, or read more about our urology service. Exceptional care, without the wait.

References

1. NHS - Blood in urine
2. Cancer Research UK - Bladder cancer statistics
3. Cancer Research UK - Bladder cancer incidence
4. NHS - Bladder cancer: symptoms
5. NHS - Kidney cancer: symptoms
6. NHS - Urinary tract infections (UTIs)
7. NHS - Bladder cancer: tests and next steps
8. Price SJ, Shephard EA, Stapley SA, Barraclough K, Hamilton WT. Non-visible versus visible haematuria and bladder cancer risk: a study of electronic records in primary care. British Journal of General Practice 2014;64(626):e584-e589
9. NHS - Bladder cancer

This article is for general information and is not sponsored content.