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Haematuria Clinic
On arrival at hospital please go directly to the Radiology
Department and book in at Radiology Reception Desk 2 at the
time shown on your appointment letter. After you have the scan
of your kidneys please come to the Urology Investigation Suite.
What is haematuria?
'Haematuria' means blood in your urine.
Why are you being seen in this clinic?
The blood maybe visible (macroscopic) or non-visible (microscopic). You may have observed
the blood yourself if it was visible. If the blood was non-visible, you have probably been referred
to this clinic because your general practitioner (GP) has detected blood in your urine on a
routine urine test.
At this clinic tests will be organised to try to find the cause for the blood in your urine.
Please bring a mid-stream sample of urine in a sterile container (available
from your GP surgery, a pharmacy or from the Urology Investigation Suite)
with you to the appointment.
What can cause blood in your urine?
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Infection in the urine.
An enlarged prostate gland in men.
Vaginal bleeding in women.
Certain medicines e.g.: Warfarin or Aspirin can make blood in the urine more likely.
Stones in the kidneys, ureters (tubes from the kidneys) or bladder.
Kidney problems.
Excessive exercise.
Cancer in the kidney, bladder or prostate.
In persons under the age of 50 a common cause of microscopic haematuria is 'leaky'
kidneys and the traces of blood in the urine are often persistent, but not serious.
What will happen in the clinic?
We generally perform several investigations in this clinic so you should be prepared to be in the
hospital for a total of three to four hours. You may eat and drink as normal and take your
usual medication prior to the appointment.
The usual investigations include:
An ultrasound scan of the kidneys.
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Followed by:
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Consultation and examination.
Urine samples.
An examination of your bladder under local anaesthetic (a flexible cystoscopy).
Blood tests (if required).
Ultrasound scan of the kidneys
This is performed in the radiology (x-ray) department on arrival. The ultrasound scan is a totally
painless procedure and involves a small probe being gently moved over your kidneys, after first
putting a special gel on the skin over these areas.
This scan only takes five to ten minutes but is able to detect kidney abnormalities that may be
the cause of the bleeding.
The consultation and Flexible cystoscopy
There will be other patients having these investigations performed, so you may have a short
wait, but there is a waiting area with comfortable chairs. Pagers are available enabling you to go
to the canteen for a hot drink.
A doctor or specialist nurse will take details as to when and for how long you have had the
blood in your urine. Your past medical history and any medications you may be taking will also
be noted. Your abdomen will be examined and your prostate (if appropriate) will be assessed.
Arrangements will be made for blood tests if these are thought necessary.
You will then have an examination of your bladder under local anaesthetic. The procedure is
performed with you lying on your back. Your genital area will be cleaned to reduce risk of
infection. A local anaesthetic gel called 'lidocaine' is then inserted into the urethra (water pipe),
this may sting for a few moments. The cystoscope (flexible telescope) is then passed up the
urethra This can be a little uncomfortable.
You may be asked to cough or try to pass urine as this relaxes the muscle on the outside of the
bladder and allows the instrument to enter the bladder. The bladder is then filled with water to
allow your doctor or nurse to examine the bladder more easily.
You will feel your bladder filling up. Do let us know if it becomes uncomfortable. Once the
bladder inspection is completed the cystoscope is removed. The procedure will only take
around one to two minutes to complete.
The cystoscope may be linked to a television monitor. This allows you (if you wish) and the
doctor or nurse to view the procedure on the screen.
What are the risks of flexible cystoscopy?
Flexible cystoscopy is a safe and very common procedure. However, this procedure may cause:
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A urinary tract infection occurs in about 3% of people who have a flexible cystoscopy. You
may be given an antibiotic to reduce this risk if you are a high risk patient. Please let the
doctor know if you are allergic to antibiotics. An infection may cause you to have a fever and
cystitis symptoms in the 48 hours following the procedure.
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It may sting or burn when you pass water the first few times.
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Blood in the urine, (you may pass some blood in your urine over the next two to three days.)
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Inability to pass urine after the procedure occurs in about 1% of people who have a flexible
cystoscopy. This requires a catheter (drainage tube) to be inserted in the bladder. This
problem would usually be identified before you leave the department.
After the investigations
The results of the tests will be discussed with you at the consultation. If no cause for the blood
in the urine has been found you may not need any further investigation and may be discharged
back to your GP. If any further investigations are required we will discuss this with you before
you leave the hospital.
If a cause for the blood in the urine is found, you may need to come into hospital within a few
weeks for a short stay for further investigation or treatment under general anaesthetic. This will
be fully explained to you by a specialist nurse if an admission to hospital is required.
At home after the flexible cystoscopy
You are advised to drink an extra four to five cups of fluid today. For the first two to three days
at home you may experience some bleeding and slight discomfort when passing urine. If you
develop:
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Smelly, cloudy urine.
Bothersome frequency.
Burning sensation when passing urine.
Feeling unwell or flu-like symptoms.
It is important to be seen by your own GP without delay as you may have a urinary tract
infection that requires antibiotic treatment. Take this leaflet with you so that your GP will be
aware of the procedure you have undergone.
The information in this leaflet is in addition to any verbal advice and information you may
receive from medical and nursing staff.
Please feel free to ask any additional questions before, during or after your appointment.
Sources of information
Conquest Hospital - Tel: (01424) 755255
Sarah Aylett, Urology Nurse Specialist
- Tel: (01424) 755255 Ext 7229 (answer phone) or ask for bleep 0854
Eastbourne District General Hospital - Tel: (01323) 417400
Alison Gidlow, Tessa Rodgers, Jo Gainsford or Jocelyn Jaun, Urology Nurse Specialists
- Tel: (01323) 438246 (answer phone) or (01323) 417400 ask for bleep 8246
Urology Investigation Suite (Eastbourne) - Tel: (01323) 435887
Important information
The information in this leaflet is for guidance purposes only and is not provided to replace
professional clinical advice from a qualified practitioner.
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Your comments
We are always interested to hear your views about our leaflets. If you have any comments
please contact our Patient Advice and Liaison Service (PALS) – details below.
Hand hygiene
The trust is committed to maintaining a clean, safe environment. Hand hygiene is very important
in controlling infection. Alcohol gel is widely available at the patient bedside for staff use and at
the entrance of each clinical area for visitors to clean their hands before and after entering.
Other formats
This information is available in alternative formats such as large print or
electronically on request. Interpreters can also be booked. Please
contact the Patient Advice and Liaison Service (PALS) offices, found in
the main reception areas:
Conquest Hospital
Email: [email protected] - Telephone: 01424 758090
Eastbourne District General Hospital
Email: [email protected] - Telephone: 01323 435886
After reading this information are there any questions you would like to ask? Please list below
and ask your nurse or doctor.
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Reference
Reference
The following clinicians have been consulted and agreed this patient information:
Consultant Urologists: Mr S Garnett, Mr R O Plail, Mr P Rimington
Ms Alison Gidlow - Urology Nurse Specialist, Susan Crosby-Jones – Matron, Urology
Investigation Suite
Next review date:
Responsible clinician:
August 2016
Ms Alison Gidlow, Urology Nurse Specialist
© East Sussex Healthcare NHS Trust – www.esht.nhs.uk
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