The London Clinic, 120 Harley Street, London, W1G 7JW

Visible blood in the urine is abnormal, and needs urgent urological investigation. This key message is simple, but extremely important. If it is ignored, serious underlying urological disease can be missed, and delay in diagnosis can have a very significant impact on treatment.

People unfortunately delay seeing their doctor for many reasons. It is quite understandable that the first sight of blood in the urine can be worrying and frightening. Staying quiet about the problem, hoping the bleeding will settle, is a big mistake . The underlying cause will persist even if the bleeding seems to settle, and often the bleeding will recur later. Without prompt diagnosis and the right treatment, underlying disease can become more serious.

It is equally important for women and men present to their doctor for advice after seeing blood in the urine. Women in their perimenopausal years may mistakenly attribute bladder symptoms and occasional bleeding to their “time of life”. It is not sufficiently appreciated that women of this age with cancer have a higher risk of more advanced urological disease than men.

The risk of cancer increases with age, and is unusual before the age of 40, unless there are genetic or environmental predisposing factors. Bleeding can be due to causes other than cancer, such as stones and urinary infection, which also need to be evaluated to prevent complications or deterioration.

The message is clear: visible blood in the urine always needs urological investigation. Your urologist will be sympathetic, and in many cases serious disease will be ruled out. But, if there is an underlying condition, delay in coming forward can sadly have serious consequences that might otherwise be avoided.