Macrohaematuria means that blood is visible in the urine. The word comes from Greek: "macro" means "large" or "visible to the naked eye", and "haematuria" describes the presence of blood in the urine. With macrohaematuria, the urine turns reddish, brownish, or sometimes even dark red, so the blood can clearly be seen.
Blood in the urine – what is behind it?
When urine suddenly changes colour, it can be quite a shock. The cause can vary a great deal. Sometimes it is something harmless, such as irritation after heavy physical exercise or a mild bladder infection. In other cases, more serious conditions may be responsible, such as urinary tract infections, kidney stones, or injuries to the urinary tract. Tumours, for example of the bladder or kidney, are also among the possible causes.
The urine does not need to contain a large amount of blood for the discolouration to be visible. Even small amounts of blood are enough to change the colour noticeably. Macrohaematuria is different from what is called microhaematuria, where blood in the urine can only be detected under a microscope.
Is it dangerous?
The sight of bloody urine can be worrying, and that is completely understandable. The cause is often harmless, but because serious conditions can also be behind it, macrohaematuria should always be checked by a doctor. This is especially important if other symptoms appear at the same time, such as pain when urinating, fever, a strong urge to urinate, or pain in the side. If blood clots are visible in the urine or the bleeding continues for a longer time, a prompt examination is advisable.
Many people wonder at this point: do I need to go to hospital straight away? Am I at risk of serious blood loss? In most cases, the amount of blood is actually small and not life-threatening. Even so, macrohaematuria can be a warning sign that should not be ignored. A timely medical examination is particularly important for older people or those with existing health conditions.
How is it diagnosed?
To find the cause, the doctor will usually begin with a conversation about the symptoms and medical history. Questions about pain, fever, medication, or known health conditions help to narrow things down. A physical examination follows.
A urine sample gives information about how much blood is present and whether there are other signs such as bacteria, protein, or crystals. An ultrasound of the kidneys and bladder is often carried out to identify stones, tumours, or other changes. If the findings are unclear, a cystoscopy may be needed to look inside the urinary tract.
Certain medicines can also play a role, as some affect blood clotting and may lead to macrohaematuria. It is therefore important to mention all medicines being taken.
Treatment options and next steps
Treatment always depends on the cause. A simple bladder infection is usually treated with antibiotics and plenty of fluids. Kidney or bladder stones are either left to pass on their own, broken up, or surgically removed, depending on their size and position. If a tumour is found, the exact diagnosis determines the next steps, which may include surgery, radiotherapy, or medication.
Importantly, in the vast majority of cases, the cause of macrohaematuria can be treated effectively. It is only very rarely that blood loss is severe enough to require a blood transfusion or surgical intervention. Anyone who notices blood in their urine should not panic, but should not delay getting it checked either.
What to do when urine is bloody
As soon as a change in urine colour is noticed, it is a good idea to pay attention to any other symptoms. If pain, fever, or circulation problems occur, a quick visit to the doctor makes sense. If the bleeding does not go away on its own within a few hours, or if it keeps coming back, a thorough examination should take place.
Sometimes harmless causes such as certain foods (for example beetroot) or medicines (such as some antibiotics) can also discolour the urine. But as soon as there is any uncertainty, getting a medical opinion is the best decision.
Macrohaematuria is always a signal that deserves a closer look. Most causes can be treated well when they are identified in time.
