Haematuria

Question 1

What is Haematuria?

Answer 1

Blood in the urine

Question 2

What are the different categories of Haematuria?

Answer 2

=> Visible:
- Also known as macroscopic or flank

=> Non-visible:

• Also known as microscopic
• Further subdivided as symptomatic or asymptomatic

Persistent non visible haematuria is defined as blood being detected in 2 out of 3 samples tested 2-3 weeks apart

Question 3

What are the common causes of Haematuria?

Answer 3

• Malignancies
• Stones
• Trauma
• Structural abnormalities
• Exercise
• Drugs
• Iatrogenic

Question 4

What common malignancies may present with Haematuria?

Answer 4

• Renal Cell Carcinoma
• Urothelial Carcinoma
• Prostate Cancer
• Penile Cancer

Question 5

What infection may present with Haematuria?

Answer 5

TB

Question 6

What drugs may cause Haematuria?

Answer 6

• Aminoglycosides
• Penicillin
• Sulphonamides
• NSAIDs

Question 7

What structural abnormalities may cause Haematuria?

Answer 7

• BPH
• Cystic Renal lesions
• Renal vein thrombosis

Question 8

What are the investigations in suspected Haematuria cases?

Answer 8

• Urine MC&S
• Urinanalysis
• Flexible cystoscopy
• Biopsy

Question 9

What is the management of Haematuria?

Answer 9

=> Criteria for urgent referral:

45 ≤ Age < 60 and:
- unexplained haematuria without UTI
OR
- visible haematuria after treatment

=> Criteria for non-urgent referral:

Age ≥ 60 with recurrent or persistent unexplained UTIs

• Patients < 40 who are normotensive, with normal renal function and no proteinuria can be managed with GP