DR CHEW-LIN YIP | UROLOGIST

Dr Chew-Lin Yip investigates blood in the urine for patients across Mandurah, Rockingham, Murdoch and the wider Peel and southern Perth region. Blood in the urine needs to be explained even when it appears once, settles, or is painless.

Visible haematuria is blood that can be seen — urine may look pink, red, or the colour of tea or cola.

Non-visible haematuria is blood found on a urine test when the urine looks normal, often during testing for another reason.

Both require assessment. Visible haematuria is more urgent.

Common causes include urinary infection, kidney or bladder stones, and benign enlargement of the prostate.

Cancers of the bladder and kidney can also present with painless blood in the urine and no other symptom. The purpose of assessment is to identify or exclude serious causes. Bleeding that stops on its own has not been explained and still warrants investigation.

Assessment may include:

• consultation and examination, including smoking history and relevant occupational exposure

• urine tests for infection and, in selected cases, abnormal cells

• imaging of the kidneys and ureters, usually a contrast CT scan and sometimes ultrasound

• flexible cystoscopy, in which a fine telescope passes through the urethra to inspect the bladder lining directly

Dr Yip performs flexible cystoscopy under local anaesthetic at Peel Health Campus in Mandurah, St John of God Murdoch and Hollywood Private Hospital in Nedlands. It usually takes only a few minutes and the patient goes home afterwards. At Hollywood Private Hospital, self-administered Entonox may also be available during the procedure.

If a cause is found, treatment depends on that cause — for example antibiotics for infection, stone treatment, management of an enlarged prostate, or treatment of a bladder or kidney tumour.

In many patients no cause is found. This can be reassuring, and Dr Yip will explain whether follow-up is needed.