Urology: Haematuria Flashcards
Outline the pathophysiology of haematuria
Gross = blood that you can see
- 10% chance of finding cancer
Microscopic = blood that can only be seen under the microscope
- 3% chance of finding cancer
Outline the aetiology of haematuria
UTI
Pyelonephritis
Bladder/kidney stone
BPH
Prostatitis
Glomerulonephritis – IgA nephropathy
Cancer
Sickle cell anaemia
Kidney injury
Medication = anti-cancer drug cyclophosphamide, penicillin, aspirin, heparin
Strenuous exercise
What are the symptoms of haematuria?
Pink/red coloured urine
Passing clots = pain
UTI = persistent urge to urinate, pain and burning with urination, and extremely strong-smelling urine, fever
Pyelonephritis = fever, flank pain
Anaemia = pallor
How is haematuria investigated?
Urine dipstick
Urine analysis
Urine culture = suspected infection
Bloods = FBC, U+Es, coag
Imaging = CT, MRI, US
Cystoscopy
Abdo exam = assess for palpable kidneys
Genitalia exam
Kidney biopsy = in cases of: significant haematuria, abnormal renal function, recurrent persistent haematuria, serologic abnormalities, recurrent gross haematuria, FH of end-stage renal disease
How would you manage haematuria?
Asymptomatic = generally doesn’t require treatment
Abx = UTI
Medication to shrink prostate
Shock wave therapy to break up stones
Tumour/cancer = surgery
