Haematuria

Question 1

what is difference between visiblefrank vs non-visible haematuria

Answer 1

Visible (macroscopic) - blood visible in the urine (pink, red or dark brown)
Non visible (microscopic) - blood present in urine on urinalysis but cant be seen w visible eyes.

Question 2

Most common causes of haematuria (6)

Answer 2

1. UTI
2. Renal cancer
   3.Bladder cancer
3. Renal calculi
4. Prostate cancer
5. Benign prostatic hyperplasia.

Question 3

Medical causes of haematuria.

Falls under (non-urological causes category)

Answer 3

Falls under (non-urological causes category)

1. Glomerulonephritis
2. Thin basement membrane disease
3. Haemolytic uraemic syndrome
4. Henoch-schonlein purpura // Goodpasteur’s disease.

Question 4

Timing of the haemturia stream shows what?

Answer 4

Total haemturia = bladder/ upper tract source of problem

Terminal haematuria - severe bladder irritation

Question 5

Important history to remember in HAEMATURIA.

Answer 5

1. Drug history
2. Smoking history (malignances)
3. Industrial carcinogens (bladder cancer)
4. Foreign travel (schistomiasis)

Question 6

Gold standard IX for lower urinary tract

Answer 6

• Flexible cystoscopy

Question 7

Initial IX of haematuria

Answer 7

• Urinalysis - nitrites, leukocytes
• Baseline bloods (FBC, U&Es, clotting, PSA)
• ACR, renal function.

Question 8

Urological referral criteria for haematuria

Answer 8

Aged ≥45yrs with either:
*Unexplained visible haematuria w/o UTI.
*Visible haematuria that persists or recurs after successful treatment of UTI

Aged 60yrs with unexplained non‑visible haematuria and either dysuria or a raised WCC.

Question 9

Causes of persistent non-visible haemturia

Answer 9

Cancer
Stones
Benign prostatic hyperplasia
Prostatitis
Urethritis
Renal causes - IgA nephropathy, thin basement membrane disease.