Haematuria

Haematuria is the presence of red blood cells in the urine. It can either be:

• Visible haematuria (VH) - also referred to as macroscopic haematuria or gross haematuria
• Non visible haematuria (NVH) - also known as microscopic haematuria or ‘dipstick positive haematuria’ (1)

Significant haematuria is defined as:

• Any single episode of VH
• Any single episode of symptomatic -NVH (in absence of UTI or other transient causes).
• Persistent asymptomatic -NVH (in absence of UTI or other transient causes). Persistence is defined as 2 out of 3 dipsticks positive for NVH(1)

NICE state (3)

• Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for bladder cancer if they are:
  • 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
    • aged 60 and over and have unexplained non-visible haematuria and either dysuria or a raised white cell count on a blood test
      
      
  • Consider non-urgent referral for bladder cancer in people aged 60 and over with recurrent or persistent unexplained urinary tract infection