Haematuria

Question 1

Define haematuria

Answer 1

the presence of blood in the urine either visible or non-visible.

Question 2

Classification of haematuria

Answer 2

visible haematuria
-macroscopic or gross, blood can be seen, colour like pink, red or dark brown
non-visible haematuria
- microscopic or dipstick positive, blood is present in the urine on urinalysis but not visible

further categorised into
Symptomatic non-visible haematuria (S-NVH):
-haematuria ass with symptoms, such as suprapubic pain or renal colic
Asymptomatic non-visible haematuria (A-NVH):
- haematuria without any ass symptoms

Question 3

Causes of haematuria

Answer 3

Urological:

• Infection (pyelonephritis, cystitis or prostatitis)
• Malignancy: urothelial ca (bladder ca)
• renal calculi
• trauma
• radiation cystitis
• parasite: Schistosomiasis

Non-urological:

• medical
• pseudohaematuria

Question 4

Clinical features

Answer 4

Colour
Presence of clots?
Timing in the stream (total or terminal haematuria)
Ass. symptoms
- LUTS
- fever, rigors
- suprapubic pain
- flank pain
- LOW
- recent trauma
Drug hx
Travel hx
SMOKING

Question 5

Investigations

Answer 5

Urinalysis
-look for nitrites and leucocytes for infection
FBC
U&Es
Coagulation profile
Prostate specific antigen (PSA)
Urine cytology for malignancy
US KUB
CT Urogram