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Haematuria Treatment & Diagnosis

Discovering blood in your urine can be alarming. Haematuria, the medical term for blood in the urine, affects many individuals and can range from a minor issue to a sign requiring prompt medical attention. At TTW Urology clinic in Singapore, we understand the anxiety this symptom can cause and provide comprehensive evaluation and treatment to identify the underlying cause. Dr Tan Teck Wei uses established diagnostic techniques to determine the source of bleeding and develops personalised treatment plans that address your specific condition.

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Dr Tan Teck Wei

MBBS|DFD (CAW)|MRCS|MMed (Surgery)|FAMS (Urology)

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FAQ

What is Haematuria?

Haematuria refers to the presence of red blood cells in urine, which can manifest in two forms. Gross haematuria is visible blood that turns urine pink, red, or cola-coloured, while microscopic haematuria is only detectable through laboratory testing. This condition occurs when blood enters the urinary tract anywhere from the kidneys to the urethra.

The urinary system includes the kidneys, ureters, bladder, and urethra (and prostate as well in men), and bleeding can originate from any of these structures. While haematuria itself is a symptom rather than a disease, it serves as an indicator that requires medical evaluation. The amount of blood present doesn’t necessarily correlate with the severity of the underlying condition – even small amounts warrant investigation.

Many conditions can cause haematuria, ranging from urinary tract infections and kidney stones to more serious conditions (such as cancer) requiring prompt treatment. The key lies in accurate diagnosis through systematic evaluation by an experienced urologist who can differentiate between various causes and recommend appropriate management.

Who Requires Haematuria Evaluation?

Immediate Evaluation Needed
  • Anyone with visible blood in the urine (gross haematuria)
  • Individuals over 40 with any degree of haematuria
  • Presence of additional symptoms like pain, fever, or urinary difficulties
  • History of smoking or occupational chemical exposure
  • Family history of kidney disease or urinary cancers
  • Previous urological conditions or treatments
Routine Evaluation Recommended
  • Microscopic haematuria discovered during health screening
  • Recurrent urinary tract infections with presence of blood in urine
  • Athletes experiencing haematuria after exercise
  • Individuals on blood-thinning medications
  • Patients with systemic conditions affecting the kidneys
Special Considerations
  • Pregnant women with haematuria require immediate assessment
  • Children with haematuria need paediatric urology evaluation
  • Immunocompromised patients need urgent investigation
  • Recent urological procedure patients should report any bleeding

Professional evaluation becomes crucial because haematuria can indicate various conditions with different treatment requirements. Dr Tan conducts thorough assessments considering your medical history, risk factors, and presenting symptoms to determine the appropriate diagnostic approach.

Diagnostic Techniques & Approaches

  • Initial Clinical Assessment

    The diagnostic journey begins with a detailed medical history and physical examination. Dr Tan will evaluate your symptoms and associated complaints, medication use, and relevant risk factors. This comprehensive approach helps narrow potential causes and guides subsequent testing.

  • Laboratory Investigations

    Urinalysis forms the cornerstone of haematuria evaluation, confirming the presence of blood and identifying other abnormalities. Urine culture detects infections, while cytology examines cells for abnormalities. Blood tests assess kidney function and check for systemic conditions affecting the urinary tract.

  • Imaging Studies

    Modern imaging provides detailed visualisation of the urinary system. A simple bedside ultrasound scan in the clinic can evaluate the kidneys, bladder and prostate for obvious abnormalities. CT urogram scan offers comprehensive evaluation of the kidneys, ureters, and bladder in a single examination. MRI urogram serves as an alternative for patients unable to undergo CT scanning.

  • Cystoscopy

    This procedure involves inserting a thin, flexible telescope through the urethra to directly visualise the bladder lining. Flexible cystoscopy, performed under local anaesthesia or sedation, allows thorough bladder examination and identification of abnormalities not visible on imaging studies.

Wondering which diagnostic approach is right for you?

Dr Tan Teck Wei will evaluate your specific needs and recommend the suitable investigation plan.

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The Evaluation Process

Pre-Evaluation Preparation

Before your appointment, compile a list of current medications, including supplements and over-the-counter drugs. Document symptom patterns, including timing, frequency, and associated factors. Collect any previous test results or imaging studies. Prepare questions about your condition and potential diagnoses.

During Initial Consultation

Dr Tan will conduct a thorough interview exploring symptom details, medical history, and risk factors. Physical examination includes abdominal and genital assessment. A bedside ultrasound scan of the kidneys and bladder is usually done as well. Initial urine testing occurs during this visit. Based on these findings, Dr Tan will determine the necessary investigations and explain the diagnostic plan.

Diagnostic Testing Phase

Scheduled investigations proceed based on initial assessment findings. Most blood tests and urine studies are done on the day of initial consultation. Imaging studies, such as CT urogram scan, can often be done on the same day, but may sometimes require a separate appointment in some cases. Cystoscopy, if needed, is usually performed as an outpatient procedure on a separate day. All the results are usually available for review within days.

Results Discussion

Once all investigations are completed, you will meet Dr Tan to review the findings. He will explain the identified causes and their significance. Treatment options are discussed based on the diagnosis. A management plan is developed collaboratively, considering your preferences and circumstances.

Treatment Approaches

Managing Urinary Tract Infections

Bacterial infections causing haematuria typically respond well to targeted antibiotics. Treatment selection depends on culture results and sensitivity testing. Course duration varies from 3 to 14 days based on the severity of the infection. Follow-up testing confirms clearance of the infection and resolution of haematuria.

Kidney Stone Management

In cases where haematuria is found to be related to urinary tract stones, treatment depends on the stone(s) size, location, and composition. Small stones may pass with conservative management including hydration and pain relief. Larger stones might require shock wave treatment (extracorporeal shockwave lithotripsy, or ESWL) or endoscopic removal (ureterorenoscopy and fragmentation of stones with laser). Preventive measures address underlying metabolic causes and reduce the recurrence of stones.

Addressing Bladder Conditions

Bladder tumours require specialised treatment ranging from endoscopic resection to more extensive surgery. Bladder inflammation (cystitis) management targets underlying causes. Medications can help with specific bladder conditions. Regular surveillance monitors treatment effectiveness and disease status.

Kidney Disease Management

Glomerulonephritis and other kidney conditions require collaborative care with nephrologists. Treatment may include medications to reduce inflammation and protect kidney function. Blood pressure control becomes essential. Regular monitoring tracks disease progression and treatment response.

Medication Adjustments

Blood-thinning medications sometimes require modification or cessation. Alternative medications may be considered if current drugs cause persistent haematuria. Coordination with prescribing physicians ensures safe medication management. Risk-benefit analysis guides decision-making.

Schedule your consultation to learn more about management options.

Dr Tan Teck Wei provides comprehensive post-diagnosis support to ensure good treatment outcomes.

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Recovery & Follow-up Care

  • First Week After Diagnosis

    Following diagnosis, treatment initiation focuses on addressing identified causes. Symptom monitoring helps assess treatment effectiveness. Activity modifications may be necessary depending on the underlying condition. Communication with your healthcare team remains important for addressing concerns.

  • Ongoing Management

    Regular follow-up appointments monitor treatment response and resolution of haematuria. Repeat testing confirms improvement and rules out persistent issues. Lifestyle modifications support long-term urinary health. Preventive strategies reduce recurrence risk for applicable conditions.

  • Long-term Surveillance

    Certain diagnoses require extended monitoring protocols. Surveillance schedules vary based on initial findings and risk factors. Regular cystoscopy may be necessary for some patients. Imaging studies might be repeated at specified intervals. Continued vigilance ensures early detection of any changes.

Benefits of Prompt Haematuria Evaluation

Timely assessment enables early detection of treatable conditions before progression occurs. Identifying benign causes provides peace of mind and prevents unnecessary anxiety. Appropriate treatment prevents complications and preserves kidney function. Many conditions causing haematuria respond well to treatment when caught early.

Quality of life improves once underlying causes are addressed and symptoms resolve. Proper diagnosis guides targeted treatment rather than empirical approaches. Understanding your condition empowers informed healthcare decisions. Regular monitoring provides ongoing reassurance and maintains urinary tract health.

Risks of Delayed Evaluation

Immediate Risks

Untreated infections can progress to serious kidney infections or sepsis. Obstruction from stones or tumours may damage kidney function. Continued bleeding might lead to anaemia in severe cases. Pain and discomfort often worsen without treatment.

Long-term Complications

Delayed cancer diagnosis significantly impacts treatment options and outcomes. Chronic kidney disease may develop from untreated conditions. Bladder damage can occur from persistent inflammation. Some conditions become more complex to treat with delays.

Our experienced urologist minimises risks through prompt, thorough evaluation and evidence-based treatment approaches. Early intervention typically leads to better outcomes and simpler treatment requirements.

Cost Considerations

Haematuria evaluation costs vary based on required investigations and identified conditions. Initial consultation includes clinical assessment and basic urine testing. Additional investigations like imaging and cystoscopy incur separate charges. Treatment costs depend entirely on the underlying diagnosis.

Factors affecting overall expenses include diagnostic test complexity, whether procedures require day surgery facilities, medications prescribed, and follow-up requirements. Early evaluation often proves more cost-effective than delayed diagnosis requiring extensive treatment. Our clinic provides transparent pricing information during consultation, helping you understand anticipated costs. Investment in proper diagnosis prevents potentially higher costs from untreated conditions.

Dr Tan Scrubs Photo

Dr Tan Teck Wei

MBBS (S’pore)

DFD (CAW)

MRCS (Edin)

MMed (Surgery)

FAMS (Urology)

Dr Tan Teck Wei is a Senior Consultant Urologist in Singapore who specialises in the management of complex urological cancers, including those affecting the kidneys, prostate, and bladder.

He is fellowship-trained in open, laparoscopic and robotic surgery. He also specialises in the management of other urological conditions including:

  • Prostate Enlargement
  • Recurrent Urinary Tract Infections
  • Stones

To date, Dr Tan Teck Wei has been involved in more than 500 robot-assisted surgeries, building up his volume of cases from his fellowship training days and cementing his expertise in robotic surgery.

Dr Tan Teck Wei believes in the holistic management of his patients, and seeks to journey with them from diagnosis to cure.  Dr Tan is effectively bilingual in English and Mandarin, making him a popular choice with the young and old, as well as international patients.

Dr Tan Teck Wei possesses a wealth of specialist experience in the field of Urology. He has previously held positions as a Consultant Urologist and Director of Genitourinary Oncology at Tan Tock Seng Hospital.

Dr Tan’s expertise in conducting MRI-targeted Prostate Biopsies led to his advisory role with the Ministry of Health’s Agency for Care Effectiveness. Furthermore, he has served as an Adjunct Assistant Professor and Clinical Teacher at the National University of Singapore (NUS) Yong Loo Lin School of Medicine and the Nanyang Technological University-Imperial College London’s Lee Kong Chian School of Medicine respectively.

He has actively participated in humanitarian initiatives as a member of the Singapore Navy surgical team, collaborating with the Indonesian Navy to provide healthcare services to the communities in Padang and Ambon. It is his passion to improve the standards of healthcare to patients both in Singapore and overseas.

  • Former Consultant Urologist and Director of Genitourinary Oncology, Tan Tock Seng Hospital
  • Adjunct Assistant Professor, National University of Singapore (NUS) Yong Loo Lin School of Medicine
  • Clinical Teacher, Nanyang Technological University-Imperial College London’s Lee Kong Chian School of Medicine
  • Advisor, Ministry of Health’s Agency for Care Effectiveness
  • Surgical Team, Singapore Navy
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Ready to Take the Next Step?

If you’ve noticed blood in your urine or have been told you have microscopic haematuria, Dr Tan Teck Wei can help you understand the cause and develop an appropriate treatment plan. With considerable experience in haematuria evaluation and management, he provides personalised care throughout your diagnostic and treatment journey.

Book Your Consultation Today
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    Frequently Asked Questions

    Is blood in urine always serious?

    While haematuria can indicate serious conditions, many causes are benign and treatable. Common causes include urinary infections, kidney stones, and vigorous exercise. Because it can also signal more serious conditions like tumours or kidney disease, all haematuria requires medical evaluation. The key is determining the underlying cause through proper assessment by a urologist.

    What should I do if I notice blood in my urine?

    Seek medical attention promptly, especially for visible blood. Document when you noticed it, associated symptoms, and any potential triggers. Avoid strenuous activity until evaluated. Continue normal fluid intake unless advised otherwise. Bring a urine sample if possible. Contact our urology clinic immediately to schedule an urgent consultation.

    How long does haematuria evaluation take?

    Initial consultation typically takes about 30 minutes. Basic urine and blood tests results are available within 1-2 days. Imaging studies can usually be scheduled on the same day, or within 24 hours. Cystoscopy, if required, takes about 5 minutes and can be scheduled within a few days. Complete evaluation from first visit to final diagnosis generally occurs within a week, although urgent cases receive expedited assessment.

    Will I need a cystoscopy?

    Not everyone with haematuria requires cystoscopy. The decision depends on various factors including age, risk factors, and initial test results. Individuals over 40, those with risk factors for bladder cancer, or persistent unexplained haematuria typically need cystoscopic evaluation. Dr Tan will explain whether this procedure is necessary based on your specific circumstances.

    Can haematuria resolve on its own?

    Some causes of haematuria may resolve spontaneously, such as minor infections or exercise-induced bleeding. Assuming haematuria will disappear without investigation is risky. Even if bleeding stops, the underlying cause still requires identification and treatment. Intermittent haematuria can indicate serious conditions, making medical evaluation essential regardless of symptom resolution.

    What lifestyle changes help prevent haematuria?

    Staying well-hydrated helps prevent kidney stones and reduces infection risk. Avoiding smoking significantly lowers urinary cancer risk. Practising good hygiene prevents urinary infections. Managing chronic conditions like hypertension protects kidney health. Regular exercise maintains overall urinary system health. Your urologist can provide personalised prevention strategies based on your risk factors.

    Conclusion

    Haematuria serves as a warning sign that deserves prompt medical attention. Through comprehensive evaluation by Dr Tan, the underlying cause can be identified and appropriately treated. Modern diagnostic techniques enable accurate diagnosis while minimising discomfort, and most conditions causing haematuria respond well to treatment when detected early. Don’t let concerns about the evaluation process delay you seeking help – our urologist provides compassionate, professional care throughout your diagnostic journey.