In short
  • Early on, these cause no symptoms at all: Or one that stops on its own and gets ignored.
  • Painless blood in the urine is the main warning sign. Even once. Even if it clears.
  • Most such symptoms turn out to be something harmless. Finding that out takes one visit and usually one scan.
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Do Not Wait to See If It Settles

Blood in the urine without pain is the single most important warning sign in urology, and the one most often brushed aside. Also get seen for a painless lump in the testis, a lump felt in the belly or side, new bone pain with a known prostate problem, or weight loss you cannot explain alongside urinary symptoms.

Bladder

The usual sign is blood you can see, without pain, coming and going. Because it stops by itself, people decide it has settled.

  • Biggest risk is smoking, and the risk stays for years after stopping. Work with dyes, rubber, leather, paint or solvents also counts, as does a long-term catheter.
  • Other signs: Going often and urgently with no infection found, or an infection that keeps returning and never quite clears.
  • The check: Urine cytology, a CT urogram, and a telescope look inside the bladder. The telescope matters: small flat growths do not show reliably on any scan. If something is found, it is removed through the telescope, which also gives the tissue needed to plan everything else.

Kidney

Usually silent. Most are now found by chance on a scan done for something else — which is good, because chance usually means early.

  • Risks: Smoking, extra weight, long-standing high blood pressure, long-term kidney disease and dialysis, and some family conditions.
  • Signs when they come: Blood in urine, a constant dull ache in the side, or a lump you can feel. All three together is a late picture and uncommon now.
  • Less obvious clues: Weight loss, a low fever that will not go, anaemia with no cause, or new swollen veins on the right side of the scrotum that do not shrink lying down.
  • The check: A CT scan with dye, which identifies most kidney lumps without needing a biopsy. Chest imaging and blood tests complete it.

Prostate

Early prostate cancer causes nothing. Urinary symptoms in older men usually come from simple enlargement, not cancer — which is exactly why symptoms are a poor guide, and why the PSA conversation exists.

  • Who should discuss a PSA test: Men from about 50. From 40 to 45 if a father or brother had prostate cancer, or there is breast or ovarian cancer in the family with a known genetic link.
  • What PSA is: A prostate marker, not a cancer marker. It rises with simple enlargement, infection, a recent catheter, and after a biopsy. One raised reading means repeat and interpret, not panic. A normal PSA does not rule cancer out either, which is why examination is part of it.
  • Signs worth attention: New bone pain, especially in the back or hips, in a man with a known prostate problem. Blood in the semen. Urinary symptoms getting rapidly worse.
  • The check: PSA with an examination, then an MRI if needed, and a targeted biopsy only if the MRI shows something. Scanning before biopsy is now standard and spares some men a biopsy altogether.
Sensible Steps at Any Age
  • Never ignore blood in the urine, even once, even without pain.
  • Stopping smoking lowers bladder and kidney cancer risk. The benefit builds over years.
  • Men from 50 — or 45 with family history — should talk PSA through, rather than demanding or avoiding the test.
  • Young men should know a painless testicular lump is the classic sign of a very treatable cancer.
  • Keep your scans and reports. Comparing over time often says more than any single result.
A symptom that worries you is reason enough to come.

Most of these turn out to be harmless. Finding that out takes one consultation and usually one scan.

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What to Bring

  • All previous scans — CT, MRI or ultrasound — as images on CD, not just the reports.
  • All PSA results with dates. The trend says more than one number.
  • Urine reports, especially any that showed blood.
  • Any biopsy reports, and the slides if you have them.
  • Your smoking history and the work you have done, including years ago.
  • Family history of cancer — which relative, and at what age.
  • A list of your current medicines.

Related: blood in urine · prostate and urinary symptoms · scrotal lumps.

Dr. Azhar Anwar M.Ch. Urology (DMC Ludhiana) · DNB General Surgery · Consultant Urologist & Andrologist, Varanasi

This page provides general information only. It is not a substitute for medical advice, diagnosis or treatment. Consult a qualified urologist for assessment appropriate to your situation.