Haematuria

Question 1

What are the types of haematuria?

Answer 1

1. visible - macroscopic

2. non-visible - microscopic

Question 2

What are 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 causes of non-visible haematuria?

Answer 3

• UTI
• Vigorous exercise
• Sex

Question 4

what are causes of spurious haematuria?

Answer 4

Food - beetroot, rhubarb

Drugs - rifampicin, doxorubicin (chemo)

Question 5

What tests should be done?

Answer 5

1. urine dipstick - persistent non-visible haematuria - present in 2/3 samples tested 2/3 weeks apart
2. Renal function - ACR/PCR + BP
3. Urine microscopy

Question 6

What should prompt urgent referral?

Answer 6

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

Question 7

what should prompt a non-urgent referral?

Answer 7

≥60yrs w current or persistent UTIs