Haematuria

Question 1

What is Haematuria?

Answer 1

The presence of blood in the urine.

Question 2

What is Microscopic Haematuria?

Answer 2

Non-visible haematuria - dipstick-positive cases.

Question 3

What is Macroscopic Haematuria?

Answer 3

Visible frank haematuria.

Question 4

What is Pseudohaematuria?

Answer 4

Red/Brown urine that is not secondary to the presence of Haemoglobin.

Question 5

Give 4 causes of transient/spurious Microscopic Haematuria.

Answer 5

1. UTIs - especially Cystitis.
2. Menstruation.
3. Vigorous Exercise (settles after 3 days).
4. Sexual Intercourse.

Question 6

Give 6 causes of persistent Microscopic Haematuria.

Answer 6

1. Cancer - Renal, Bladder, Prostate.
2. Stones.
3. Benign Prostatic Hyperplasia - hypervascularity.
4. Prostatitis.
5. Urethritis - Chlamydia.
6. Renal Causes : IgA Nephropathy, Thin Basement Membrane Disease.

Question 7

Give 4 causes of pseudohaematuria.

Answer 7

1. Foods e.g. Beetroot, Rhubarb.
2. Drugs : Rifampicin, Doxorubicin, Drugs that start with Phen.
3. Myoglobinuria.
4. Menstruation.

Question 8

What is the investigation of choice in assessing Haematuria?

Answer 8

Urine Dipstick.

Question 9

What is Persistent Non-Visible Haematuria?

Answer 9

Blood being present in 2/3 samples tested 2-3 weeks apart.

Question 10

Investigations of Macroscopic Haematuria (3).

Answer 10

1. Urine Cytology.
2. Urinary Tract US.
3. Flexible Cystoscopy and Biopsy.

Question 11

What are the gold-standard investigations to assess the upper and lower urinary tracts? (3)

Answer 11

Upper - Macroscopic : CT Urogram.
Upper - Microscopic : US KUB.
Lower - Flexible Cystoscopy (LA).