Hematuria (blood in urine) is a common symptom of urinary tract infection. Usually it is accompanied by dysuria, and sometimes lower abdominal pain and fever. However, hematuria without any pain is actually a very alarming symptom. It can be a warning sign for underlying bladder cancer. In fact, bladder tumours are very fragile and tend to bleed without causing any pain. Just a few drops of blood may turn your urine pinkish or red in colour. Therefore, hematuria can represent something serious and it should never be neglected.
Patients with painless hematuria would require further investigations including flexible cystoscopy and upper tract imaging. Flexible cystoscopy is a relatively simple out-patient procedure for diagnosing bladder cancer. In 2018, there were 475 cases of bladder cancer being diagnosed in Hong Kong. Most of the time, bladder cancers can be detected early and are amendable to cure upon transurethral resection surgery. Some patients may require more radical surgery by removing the whole bladder. A small proportion of patients may present with late-stage bladder cancer and may require systematic treatment such as chemotherapy.
Early detection and treatment of bladder cancer is very important for optimising oncological outcomes. If you have hematuria (blood in urine), please do not neglect it and seek timely medical attention!