Macroscopic (Frank) haematuria

Question 1

What are the common causes of frank haematuria?

Answer 1

Upper tract:

• Kidney cancer (renal cell carcinoma)
• Stone in kidney or ureter
• Trauma

Lower tract:

• Bladder cancer
• BPH
• Infection (bacterial cystitis)

Question 2

What investigations should be considered when a patient present with frank haematuria?

Answer 2

1. Full history and exam
2. Investigations:
   - Mid-stream urine for MC +S
   - Urine cytology
   - Flexible cystoscopy +/- biopsy