Microscopic Haematuria

Microscopic haematuria involves the presence of blood in urine that is not visible to the naked eye but detected through a urine test. This test looks for red blood cells (RBCs), white blood cells (WBCs), epithelial cells (ECs) and bacteria under a microscope.

• Menstruation
• Urinary tract infections (UTI)
• Kidney or bladder stones
• Benign or malignant kidney or bladder tumours
• Foreign bodies in the bladder, like sutures, tape or mesh
• Radiation cystitis from bladder or pelvic radiation treatment
• Interstitial cystitis, also known as painful bladder syndrome
• Urogenital syndrome, postmenopausal changes in the urinary tract and genital organs
• Pyelonephritis (kidney inflammation)
  

• No symptoms, with haematuria discovered during routine medical checks.
• Burning sensation during urination, frequent urination in small amounts, and incomplete voiding (indicative of UTI).
• Severe pain starting from the to the groin (suggestive of kidney stones).
• History of pelvic radiation treatment (possible radiation cystitis)
• Recurrent UTIs or blood in urine post-pelvic surgery (possible foreign body in the bladder)
• Vaginal dryness and painful intercourse post-menopause (likely urogenital syndrome)

• No physical findings
• Tenderness in the bladder or urethra area
• Tenderness in the loin or groin
• Vaginal dryness, thinning and paleness

• Urine tests for pus cells, red blood cells, bacteria and cancer cells
• Kidney and bladder ultrasound
• Cystoscopy: A procedure using a medical telescope to inspect the bladder and urethra. Typical features of Interstitial cystitis are shown in the bottom two photos during cystoscopy; when the bladder is drained of its filling fluid it starts to bleed. The top two photos show that during initial filling the bladder is normal.

UTI: Antibiotic treatment based on the specific infection.

Kidney/bladder stones, tumours, foreign bodies, radiation cystitis: Refer to the Department of Urology website for more information.

Painful bladder syndrome (Interstitial cystitis]: Consultation at the Urogynaecology clinic for cystoscopy, bladder biopsies and treatment.

Urogenital syndrome: Treat with topical Premarin cream amd Tab Vagifem.

Pyelonephritis: Referral to our Renal Physician colleagues.