• Confirm it is blood (dipstick then microscopy) and decide visible versus non-visible.
• Painless visible haematuria is a red flag for urinary tract malignancy and needs prompt investigation, though other causes should also be considered.
• Other causes: stones (painful), infection, and glomerular disease (with protein and red-cell casts).
• Investigate with cystoscopy and upper-tract imaging (CT urogram or ultrasound).
Memory trick
Painless visible haematuria is a red flag for cancer - investigate promptly.