Macroscopic hematuria – the presence of bloody urine – especially when it colours the end of urination, suggests until proven otherwise the existence of a bladder tumour.
In many cases, the presence of blood in the urine, hematuria is the first sign of bladder cancer.
Bleeding is usually large enough to change the usual colour of the urine. The urine is pink or red. These red urine are a reflection of macroscopic hematuria.
There are often clots in these bloody urine, which eliminates a nephrological cause of bleeding.
Terminal hematuria, when only the end of urination is bloody, are of bladder origin but if bleeding is abundant, hematuria becomes total and urination is red from start to finish.
Total hematuria can result from localized bleeding at any part of the urinary tract, from the renal cavities to the urethra.
Sometimes the urine retains a normal colour, but there are abnormal amounts of red blood cells in the urine at microscopic analysis.
This is called microscopic hematuria.
This hematuria is often capricious. There may be a free interval of several weeks or months during which the urine becomes clear again.
However, as the tumour progresses, these haematurias reappear inexorably.
These hematurias in early-stage bladder cancer are often isolated, with no further urinary discomfort and often without pain.
Other causes of hematuria include kidney or bladder stones, other kidney diseases, or infectious diseases of the kidneys or bladder, but it is important to keep in mind that bloody urine should be tested for tumours in the bloodstream until there is evidence to the contrary.
Bladder cancer can sometimes result in urinary problems, including irritating symptoms such as having bladder cancer:
- Abnormally frequent urination: pollakiuria, diurnal and/or nocturnal urination
- Burns or pain at the time of urination;
- Constant, urgent and persistent urge to urinate, even after urination;
- Urgent needs or even leaks if access to the toilets is not fast enough;
- A weakened jet.
This type of symptoms is more common during lower urinary tract infections, or when stones are present in the bladder or in overactive bladder, or in men when there is benign prostatic hypertrophy.
However, it is important that a check-up be carried out by a doctor as they can also reflect the existence of bladder cancer.
Symptoms of Advanced Bladder Cancer
Bulky bladder tumours or metastatic bladder cancers can also cause other symptoms such as
- The impossibility of urinating;
- Unilateral lumbar pains;
- Loss of appetite or weight loss;
- A feeling of fatigue or permanent weakness;
- Bone pain;
- A sensation of dizziness.
Again, many of these symptoms are more likely to be related to causes other than bladder cancer, but it is important to consult with them.