Specialist Urology · Haematuria Clinic
Haematuria Clinic London — Blood in Urine Assessment
Visible or microscopic blood in the urine is always a red flag that requires expert investigation. Mr Torath Ameen FRCS offers rapid haematuria assessment with same-week cystoscopy and CT urogram available.
What Haematuria Assessment Involves
- Flexible cystoscopy under local anaesthetic — direct visualisation of the urethra and bladder
- CT urogram — imaging of the kidneys, ureters and bladder (upper tract assessment)
- Urine cytology — cells in the urine examined for cancer markers
- Urine culture — to exclude infection as a cause
- Blood tests — renal function, FBC
- Risk stratification for bladder, kidney and ureteric causes
Visible haematuria should never be assumed to be benign without a proper investigation. Even a single episode warrants urgent cystoscopy and imaging.
— Mr Torath Ameen, FRCS (Urol)What Can Cause Blood in the Urine
Bladder cancer
Most important diagnosis to exclude — even a single episode of haematuria warrants investigation.
Kidney cancer
Painless haematuria can be the only early sign of a renal tumour.
Ureteric or renal stones
Often with flank pain, but haematuria can occur without pain.
Urinary tract infection
Usually with symptoms, but haematuria can occur without overt infection signs.
BPH and prostatitis
Benign prostatic enlargement and prostate inflammation are common causes in older men.
Glomerulonephritis
Kidney inflammation — usually presents as microscopic haematuria.
Visible vs Microscopic Haematuria
Visible (Frank) Haematuria
Urine visibly pink, red or brown. Always requires urgent investigation — do not wait for a repeat episode. Referred by NICE guidance as a 2-week-wait pathway in the NHS. In the private sector, Mr Ameen offers same-week assessment.
Risk of significant underlying pathology (cancer) is approximately 10–15%. A single episode is sufficient to warrant a full workup — intermittent bleeding does not reduce the urgency of investigation.
Microscopic Haematuria
Blood visible only on dipstick or laboratory urinalysis. Must first exclude infection — send an MSU (mid-stream urine) before acting on a positive dipstick. If no infection, formal investigation with cystoscopy and imaging is indicated in adults over 40.
More commonly a benign cause, but cancer can present this way. False negatives are possible — a negative dipstick does not fully exclude microscopic haematuria in all cases.
Tests & What to Expect
Flexible Cystoscopy
Performed under local anaesthetic gel. A fine telescope (flexiscope) is passed through the urethra. The bladder lining is directly visualised for any tumours, inflammation or abnormalities. Takes approximately 5–10 minutes. Most patients describe mild discomfort rather than pain. Results discussed immediately.
CT Urogram
CT scan of the whole urinary tract — kidneys, ureters and bladder — with contrast dye. Assesses the upper tract for tumour, stones and structural causes of haematuria. Can usually be arranged the same week. Results reviewed by Mr Ameen personally.
After the Workup
If investigations are normal: formal discharge with safety-netting advice and repeat testing plan. If an abnormality is found: Mr Ameen discusses findings and management options at the same appointment or arranges urgent follow-up. Written summary provided for your GP.
Haematuria Clinic FAQs
Act on visible haematuria — don't wait.
Blood in the urine always warrants expert investigation. Mr Ameen offers same-week haematuria assessment across his London clinics.