Blood seen within the urine by patient or doctor (VISIBLE or MACROSCOPIC) or identified on urine dipstick or MSU (NON-VISIBLE or MICROSCOPIC).
Risk of urothelial malignancy: visible haematuria ~20%, non-visible ~3%
- Aged 45 and over and have:
- Unexplained visible haematuria without urinary tract infection or
- Visible haematuria that persists or recurs after successful treatment of urinary tract infection, or
Management prior to referral:
**In all cases please request urgent/2WW renal tract USS at referral**
- Haematuria patients that do not fulfil 2WW criteria should be referred urgently, and will be booked a cystoscopy. Please do not make C&B outpatient referrals.
- Recurrent haematuria management is contentious, ongoing visible bleeding may need repeat investigation, discussion or re-referral is advised according to duration/severity etc.
- Recurrent non-visible haematuria with an apparent cause identified at initial assessment (eg. enlarged prostate, UTI, stone, warfarin use etc) need not be re-referred.
- Patients under 40 with non-visible haematuria and proteinuria should have albumin/creatinine ratio measured and initially be referred to a renal physician as per CKD guidelines.