Haematuria

Question 1

What is haematuria?

Answer 1

The presence of blood in the urine

Question 2

How is non visible haematuria detected?

Answer 2

Urine dipstick

Urine microscopy

Question 3

What is pseudohaematuria?

Answer 3

Red or brown urine that is not due to haemoglobin

e.g. medication, hyperbilirubinaemia, certain foods (rhubarb)

Question 4

What are some urological causes of haematuria?

Answer 4

Infections - pyelonephritis, cystitis or prostatitis
Malignancies
Renal calculi
Trauma / recent surgery
Radiation cystitis
Parasitic - e.g. schistosomiasis

Question 5

What investigations are done for haematuria?

Answer 5

Urinalysis - dipstick
Bloods - FBCs, U+Es and clotting
- PSA testing may also be done
- Albumin : creatinine ratio
Flexible cystoscopy (lower urinary tract)
Imagine - ultrasound or CT (upper urinary tract)

Question 6

When is someone with haematuria referred?

Answer 6

Aged >45 with unexplained visible haematuria without UTI
Aged > 45 with visible haematuria that persists or recurs after sucessful treatment of a UTI

Age >60 with unexplained non visible haematuria + either dysuria or raised WCC

Asymptomatic non-visibile haematuria on 2/3 occasions

Or if patient has co-morbidities such as declining GFR

Question 7

What is the gold standard investigation for assessing the lower urinary tract?

Answer 7

Flexible cystoscopy