haematuria causes ddx

Question 1

Trauma

Answer 1

Injury to renal tract
Renal trauma commonly due to blunt injury (others penetrating injuries)
Ureter trauma rare: iatrogenic
Bladder trauma: due to RTA or pelvic fractures

Question 2

Infection

Answer 2

Remember TB

Question 3

Malignancy

Answer 3

Renal cell carcinoma (remember paraneoplastic syndromes): painful or painless

Urothelial malignancies: 90% are transitional cell carcinoma, can occur anywhere along the urinary tract.

Painless haematuria.

Squamous cell carcinoma and adenocarcinoma: rare bladder tumours

Prostate cancer

Penile cancers: SCC

Question 4

Renal disease

Answer 4

Glomerulonephritis

Question 5

Stones

Answer 5

Microscopic haematuria common

Question 6

Structural abnormalities

Answer 6

Benign prostatic hyperplasia (BPH) causes haematuria due to hypervascularity of the prostate gland

Cystic renal lesions e.g. polycystic kidney disease

Vascular malformations

Renal vein thrombosis due to renal cell carcinoma

Question 7

Coagulopathy

Answer 7

Causes bleeding of underlying lesions

Question 8

Drugs

Answer 8

Cause tubular necrosis or interstitial nephritis: aminoglycosides, chemotherapy
Interstitial nephritis: penicillin, sulphonamides, and NSAIDs
Anticoagulants

Question 9

Benign

Answer 9

Exercise

Question 10

Gynaecological

Answer 10

Endometriosis: flank pain, dysuria, and haematuria that is cyclical

Question 11

Iatrogenic

Answer 11

Catheterisation

Radiotherapy; cystitis, severe haemorrhage, bladder necrosis

Question 12

Pseudohaematuria

Answer 12

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