'Haematuria' is the medical term for blood in the urine. The blood may be visible to the naked eye or may only be picked up on testing your urine. A minority of patients have a serious cause for the blood it is important to investigate all patients thoroughly to exclude a serious cause such as infection, a kidney or bladder stone, and cancer. As in the case of skin cancer, bladder cancer is not a serious threat to your health provided it is picked up early and not allowed to invade the underlying tissues.
You will be asked to provide a sample or urine into a special container when you arrive. You will then see a doctor, who will ask you about the haematuria and about your general health before examining you. As part of the examination, the doctor will use a flexible plastic telescope to examine the lining of your bladder. This procedure is called 'flexible cystoscopy', takes 2-3 minutes to perform and is no more uncomfortable than a visit to the dentist, although it is a little undignified.
The area around the end of the tube you pass urine through (the urethra) is cleaned with an antiseptic solution. In men, local anaesthetic lubricant gel is inserted into the urethra and in women the telescope is coated with gel instead. The flexible telescope, with irrigation fluid running to ensure a clear view, is then gently inserted and the urethra and bladder lining inspected. It is common to have the feeling of wanting to pass water during the examination - if this becomes very uncomfortable tell the surgeon. After the examination, the surgeon will tell you the result immediately and will arrange for you to have the remaining tests to examine the kidneys (an ultrasound scan and/or an X-ray) as an outpatient.
Discomfort when you pass water, and occasionally some bleeding, is common after cystoscopy. This will pass within 24-48 hours and will be helped by drinking plenty of fluids. If it persists, consult your GP. If you feel unwell or have a temperature you should contact your GP or attend the Accident & Emergency Department of the hospital, promptly.
Once the results of the remaining tests are available, the Consultant will write to you and your GP and arrange any necessary follow-up. Commonly, the results of all of the tests ordered to investigate haematuria are normal, in which case the Consultant will be able to reassure you that all is well and discharge you back to your GP.