Diagnosis In evaluating your condition, your doctor will perform the following: Medical history and physical exam Urinalysis (testing of a urine sample) to confirm that blood is present in the urine. If red blood cells are present, further testing of the urine (including a urine culture) may help pinpoint where the blood is coming from and why. White blood cells in the urine signals a possible urinary tract infection (UTI); red blood cells that clump together to form little tubes (called casts) may indicate kidney disease; and large amounts of protein in the urine may also indicate kidney disease. Cancer cells can also be detected. Urine cytology may be needed to look for cancer cells in the urine. Blood test. A blood test can help assess kidney function. High levels of creatinine (a waste product of normal muscle breakdown) in the blood may indicate kidney disease. Cystoscopy is a procedure that allows your doctor to use a small tube fitted with a camera to look inside the urethra and bladder. Cystoscopy can assist in detecting cancer in the bladder, especially if cancer cells are found in the urine. Imaging: CT scan, MRI or ultrasound – these different imaging studies may reveal a tumor, a kidney or bladder stone; an enlarged prostate; or other cause for hematuria.