Haematuria and urinary history

Question 1

If someone presents with urinary symptoms, what questions would you specifically ask?

Answer 1

1. Onset - how long has this been going on for
2. Character - ask for colour and clots
3. Associated features - fevers, flank pain, urinary hesitancy, bowel movements, vaginal discharge, menopausal status, weight loss, fatigue
4. Timing - urinary frequency
5. Severity - ask about pain

Question 2

What would you ask about past medical history for urinary symptoms?

And social history

Answer 2

Asks about past medical history

Asks specifically about previous urinary tract pathology

Specifically ask about occupation

Question 3

How does bladder cancer often present?

Answer 3

Painless, macroscopic haematuria in those aged 50-80 years

More common in men

Question 4

What are risk factors for bladder cancers?

Answer 4

The biggest risk factors for bladder cancer is smoking, but other risk factors include exposure to dyes e.g. by hair-dressers or those working within the textile industry

Question 5

What is the management for suspected bladder cancer?

Answer 5

There is a 2 week wait referral system in place as urgent referrals for potential new cancer diagnoses, and also that a flexible cystoscopy is the diagnostic test for bladder cancer

You should reassure the patient that they will receive more information in their specialist appointment, as well as an opportunity to ask more about any tests and procedures they may require, so that they understand that if they think of more questions once they get home they will have a chance to ask them.