Haematuria

Question 1

Define Haematuria

Answer 1

Haematuria is the presence of blood in the urine, either visible or non-visible

Question 2

Urological causes of haematuria

Answer 2

• UTI
• renal cancer
• bladder cancer
• renal tract calculi
• prostate cancer

Question 3

Non-urological causes of haematuria

Answer 3

1. Pseudohaematuria
2. Medical

Question 4

Define Pseudohaematuria

Answer 4

Red or Brown urine that is NOT secondary to the presence of haemoglobin.

Question 5

Pseudohaematuria causes

Answer 5

• Foods (beetroots, rhubard)
• Meds (rifampicin or methyldopa)
• hyperbilirubinuria
• myoglobinuria

Question 6

Medical causes of haematuria

Answer 6

• glomerulonephritis
• haemolytic uraemic syndrome
• Henoch-Schönlein Purpura
• Goodpasteur’s disease

Question 7

Define Microscopic haematuria

Answer 7

• blood is present on urine dip
• NOT visible

Question 8

Define macroscopic haematuria

Answer 8

blood is visible in the urine, colouring it pink, red, or dark brown

Question 9

NICE urgent referral guidelines for
haematuria

Answer 9

1. Aged ≥45yrs with either:
   - Unexplained visible haematuria without UTI
   - Visible haematuria that persists or recurs after successful treatment of UTI
2. Aged 60yrs with
   - unexplained non‑visible haematuria and either dysuria or a raised white cell count on a blood test

Question 10

gold standard Ix for haematuria

Answer 10

Flexible cystoscopy - to assess the LUT

Question 11

Initial Investigations for haematuria

Answer 11

1. Urinalysis: nitrites +/-leukocytes
2. Bloods: FBC (Hb, WCC), UEs (egfr, Cr), clotting screening, PSA
3. Urine ACR: if deranged egfr

Question 12

USS KUB indications in haematuria

Answer 12

For microscopic (non-visible) haematuria

Question 13

CT Urogram indications for haematuria

Answer 13

For macroscopic (visible) haematuria

Question 14

Management of haematuria

Answer 14

• Mx of underlying issue
• Review medications