Haematuria

Question 1

What are the types of haematuria?

Answer 1

1. Visible (microscopic)

2. Non-visible (macroscopic)

Question 2

What are the causes of visible haematuria?

Answer 2

cancer - bladder, renal, prostate
Stones
BPH
prostatitis
Urethritis e.g. chlamydia 
Renal: IgA nephropathy, thin BM disease

Question 3

What are the causes of non-visible haematuria?

Answer 3

UTI
menstruation
vigorous exercise
sex

Question 4

What are the causes of spurious haematuria?

Answer 4

food: beetroot, rhubarb
drugs: rifampicin, doxorubicin (chemo)

Question 5

What tests would you do in haematuria?

Answer 5

1. urine dipstick
2. Renal function, ACR/PCR + BP
3. Urine microscopy + culture

Question 6

What patients require an urgent referral

Answer 6

• ≥45yrs + unexplained visible haematuria w/o UTI
  or
• visible haematuria that persists after successful rx of UTI
• ≥60yrs + unexplained non-visible haematuria + either dysuria or raised WBC on FBC

Question 7

What pts require non-urgent referral ?

Answer 7

≥60yrs w recurrent or persistent UTIs

Question 8

What pts don’t require a referral?

Answer 8

<40yrs w normal renal function, no proteinuria and normal BP