Hematuria Treatment in Singapore

• Individuals with visible blood in urine (gross hematuria)
• Patients with microscopic hematuria detected on urinalysis
• Those experiencing accompanying symptoms like pain, burning, or urgency
• Adults over 40 with unexplained hematuria
• Individuals with risk factors for bladder or kidney cancer
• Patients with recurrent urinary tract infections
• Those with family history of kidney disease or urological cancers
• Individuals exposed to occupational bladder carcinogens

• Patients on anticoagulation therapy requiring careful management
• Individuals with bleeding disorders needing specialised approaches
• Those with chronic kidney disease requiring nephrology coordination
• Pregnant women needing modified diagnostic protocols
• Children with hematuria requiring paediatric urology expertise

• Transient hematuria from vigorous exercise
• Menstruating women (requires retesting after menstruation)
• Recent urological procedures causing expected bleeding
• Documented benign causes requiring only monitoring

Professional assessment remains crucial for all cases of hematuria, as even asymptomatic microscopic bleeding may indicate significant underlying pathology requiring treatment.

Medical therapy forms the foundation for many hematuria cases, particularly those caused by infections or inflammatory conditions. Antibiotics treat urinary tract infections causing hematuria, with culture-guided therapy ensuring appropriate medication selection. Anti-inflammatory medications may address conditions like interstitial cystitis or prostatitis contributing to bleeding.

Cystoscopy with therapeutic capability allows simultaneous diagnosis and treatment of bladder lesions causing hematuria. During the procedure, bleeding vessels can be cauterised, small tumours removed, and stones fragmented. Ureteroscopy extends this capability to the upper urinary tract, treating ureteral stones or lesions causing bleeding.

Surgical intervention becomes necessary for structural abnormalities, large stones, or tumours causing persistent hematuria. Minimally invasive techniques like percutaneous nephrolithotomy address large kidney stones, while transurethral resection manages bladder tumours. Open or laparoscopic surgery may be required for complex cases involving kidney tumours or severe anatomical abnormalities.

Modern diagnostic technology includes flexible cystoscopes with high-definition imaging, CT urography for comprehensive urinary tract visualisation, and ultrasound for non-invasive assessment. Treatment technologies encompass laser lithotripsy for stone fragmentation, electrocautery for bleeding control, and robotic-assisted systems for complex surgical procedures.

Initial evaluation begins with comprehensive medical history and physical examination. Laboratory tests include urinalysis, urine culture, and cytology to check for abnormal cells. Blood tests assess kidney function and coagulation status. Imaging studies such as ultrasound, CT urography, or MRI provide anatomical detail of the urinary system.

Patients may need to discontinue certain medications temporarily, particularly anticoagulants or anti-platelet drugs, under medical supervision. Dietary modifications might include increased hydration or temporary dietary restrictions before specific procedures. Pre-procedure antibiotics may be prescribed to prevent infection.

Diagnostic cystoscopy typically takes 15-30 minutes under local anaesthesia with urethral numbing gel. Patients remain awake but comfortable throughout the examination. For therapeutic procedures, sedation or general anaesthesia may be administered based on complexity and patient preference.

The urologist examines the urethra, bladder, and ureteral openings using a thin, flexible scope. Any abnormalities are documented, biopsied if necessary, and treated when appropriate. Patients may feel mild pressure or urgency during bladder filling but should experience minimal discomfort with proper anaesthesia.

Following diagnostic procedures, patients typically rest briefly before discharge. Mild burning during urination and light bleeding may occur for 24-48 hours. Increased fluid intake helps flush the urinary system and reduce discomfort. Prophylactic antibiotics may be prescribed to prevent infection.

After therapeutic interventions, monitoring duration depends on procedure complexity. Catheter placement may be necessary temporarily for certain treatments. Pain medication and bladder antispasmodics provide comfort during initial recovery. Clear discharge instructions include warning signs requiring immediate medical attention.

Initial recovery focuses on monitoring for complications and managing discomfort. Patients should drink plenty of water to maintain good urine flow and prevent clot formation. Mild hematuria may persist but should gradually improve. Rest is recommended, avoiding strenuous activities that might provoke bleeding.

Pain management typically involves over-the-counter analgesics, though prescription medications may be needed after surgical procedures. Patients should monitor urine colour, noting any increase in bleeding intensity. Temperature monitoring helps detect early infection signs.

Gradual return to normal activities occurs as symptoms resolve. Most patients resume work within 2-3 days after diagnostic procedures, though surgical interventions may require longer recovery. Follow-up appointments assess treatment effectiveness and address any concerns.

Continued hydration remains important for optimal healing. Dietary modifications may include avoiding irritants like caffeine, alcohol, and spicy foods. Patients complete prescribed antibiotic courses even if symptoms resolve early.

Complete resolution timeline varies based on underlying cause and treatment type. Infection-related hematuria typically resolves within days of antibiotic therapy. Stone-related bleeding stops once fragments pass completely. Tumour-related hematuria requires ongoing surveillance after initial treatment.

Regular follow-up ensures treatment success and monitors for recurrence. Surveillance protocols may include periodic urinalysis, imaging studies, and cystoscopy based on initial diagnosis. Lifestyle modifications to prevent recurrence include adequate hydration, dietary adjustments, and smoking cessation when applicable.

Diagnostic procedures like cystoscopy may cause temporary urethral discomfort and mild bleeding for 1-2 days. Urinary frequency and urgency often occur but resolve quickly. Some patients experience bladder spasms, particularly after therapeutic procedures.

Antibiotic therapy may cause gastrointestinal upset, though this typically improves with food intake. Temporary changes in urine colour from medications or procedure-related bleeding are expected. Mild pelvic discomfort may persist for several days after invasive procedures.

Urinary tract infection occurs in less than 5% of cases despite preventive measures. Significant bleeding requiring intervention is uncommon but may occur with certain treatments. Urethral stricture or bladder perforation represents rare but serious complications of invasive procedures.

Allergic reactions to contrast media or medications require immediate management. Stone fragment impaction during lithotripsy may necessitate additional procedures. Incomplete treatment may result in persistent or recurrent hematuria requiring further intervention.

Our experienced urologists minimise risks through careful patient selection, meticulous technique, and appropriate prophylactic measures. Comprehensive pre-procedure assessment identifies patients at higher risk, allowing for modified approaches when necessary.