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Urology 2020

Blood in urine/haematuria

photo credit: Getty / digitalskillet

Mr Ben Challacombe

Consultant Urologist Guy’s and St Thomas’ Hospitals, Chair, BAUS Section of Oncology

As COVID-19 continues to dominate most of our lives, and hospitals are caught between preparing for a second wave and getting back to their new normal existence, it is an important time to highlight some of the issues that have been pushed out of the way by coronavirus.

The pandemic, while incredibly serious, hasn’t made urological and other cancers disappear or slowed their growth, but the numbers of patients presenting to primary care remain significantly down on normal across the UK. This means there is a group of patients potentially sitting on a cancer time bomb due to either ignoring their symptoms or feeling too anxious to discuss them, or come to hospital or a GP practice at the current time.

Painless visible blood in the urine leads to about a 30% chance of identifying a cancerous cause

Know the symptoms for cancer

There are some key urological symptoms that could signify important life-threatening cancers and other serious diseases. Perhaps the most obvious of these is visible blood in the urine, medically known as haematuria. This is a particularly significant event if it occurs without other urinary symptoms, which might indicate a urinary infection (burning, stinging and frequent urgent urination); often referred to as painless haematuria.

Painless visible blood in the urine leads to about a 30% chance of identifying a cancerous cause. Painful or symptomatic haematuria can also be a sign of significant issues including cancer as well but is more likely due to a urinary tract infection.

Most commonly painless haematuria can be a sign of bladder or kidney tumours, which are usually curable with early surgery. But, given enough time, these tumours can grow and spread outside their place of origin, so time is critical to ensuring the best outcomes. With this is mind it is vital that people tell their doctors if they experience blood in their urine and get an urgent referral to a urologist on a rapid access pathway.

Safety precautions to encourage hospital visits

To reassure those concerned about coming into hospitals at the current time, there are many precautions in place to ensure the safety of our patients with special precautions in both the diagnostic and treatment protocols for these conditions. In addition, the risks of the underlying problems causing the blood are likely to be far higher than the risk of potentially contracting COVID-19.

After fighting a challenging battle with coronavirus, let’s not lose the war on urological cancer.

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