Haematuria Flashcards
common cause of haematospermia?
prostate cancer
prostate enlargement
lower urinary tract symptoms?
hesitancy
frequency
urgency
dysuria
upper urinary tract symptoms?
renal colic
what is significant microscopic haematuria?
3+ RBCs per high power field on microscopic evaluation of urine in two out of 3 samples
risk factors?
analgesic abuse
exposure to chemicals or dyes
smoking
previous haematuria or urological disease
which is more likely to be a cancer, visible or microscopic haematuria?
visible
causes of haematuria?
benign (stones etc)
trauma
infection
malignancy
infection where in the urinary tract can cause haematuria?
anywhere
common presentations of renal cell cancer?
haematuria (50-60%)
pain (40%)
kidney mass (30-40%)
isreal triad (only present in <10%)
urinary tract tumours presentation?
haematuria (75-85%)
loin pain/colic
voiding problems
urinary irritative symptoms
which prostate conditions are more likely to cause haematuria?
BPH
post-radiation therapy (5-10 years after)
rarely causes by prostate cancer (<1%)
penile cancer symptoms?
itching/burning under foreskin
red/indurated/lesioned area
haematuria???
what is sport (joggers) haematuria?
renal/bladder trauma
can occur due to contact sports or in long distance runners
vasoconstriction of renal vessels
constriction of efferent arterioles
vascular responses to sports and trauma causing blood and muscle cell breakdown
what is loin pain haematuria syndrome?
on and off episodes of loin pain on one side
together with pain, dysuria, vomiting and low grade fever but not associated with a UTI
can have normal or abnormal glomeruli
what is decompression haematuria?
occurs when bladder is drained too quickly in urinary retention
drugs causing haematuria?
warfarin
heparin
aspirin
causes of deep pigmentation in urine?
menstrual food (beetroot, blackberries, rhubarb myoglobin in urine (rhabdomylolysis etc) drugs (hydroxychloroquine, metronidazole, nitrofurantoin, laxitives) toxins (lead, mercury)
causes of frank haematuria in kids?
UTI trauma perineal irritation sickle cell disease nephrolithiasis glomerulonephritis malignancies
what is red diaper syndrome?
serratia marcescens infection
common kidney tumour in kids?
nephroblastoma
features of UTI
loin pain frequency urgency dysuria feverish shivering etc
how can timing indicate source of bleeding
initial - urethra, prostate
terminal/total - bladder, upper urinary tract
veriform clots?
worm-like clots which indicate upper urinary tract source of bleeding
investigation of haematuria?
dipstick culture (if infection suspected) cytology imaging - MRI/CT/IV urogram to see collecting ducts - US/CT/MRI scan to see internal kidney - US/CT/MRI scan or IVU to see bladder
what can CT show which indicates bladder cancer?
filling defects
most sensitive test for bladder investigation?
cystoscopy or urethrocystoscopy
who should be investigated?
> 45 yrs old with visible haematuria
>60 yrs with symptomatic non-visible haematuria
who should be referred to urology?
all visible haematuria
symptomatic haematuria any age
asymptomatic haematuria >40 yrs old
referral to nephrology
declining eGFR
significant proteinuria
isolated haematuria with hypertension
