Haematuria Flashcards
What is haematuria?
Presence of blood in the urine
What is the difference between visible and non visible haematuria?
Visible can be seen with the naked eye and non-visible is confirmed by urine dipstick or urine microscopy
What is pseudohaematuria?
Red or brown urine that is not secondary to the presence of haemoglobin, causes include medication, hyperbilirubinuria, myoglobinuria and certain foods
What can cause haematuria?
UTI, Urothelial carcinoma, stone disease, adenocarcinoma of the prostate, BPH, Trauma, radiation cystitis, parasite
What is the degree of haematuria?
Pink vs dark red and the presence of clots
What colours of urine would suggest a non-urological cause of haematuria?
Bright pink, orange or dark brown
What does the timing of the stream show in haematuria?
Total- bladder or upper tract source
Terminal- severe bladder irritation
What are the associated symptoms to ask about with haematuria?
LUTS
Fever, rigors
Suprapubic pain, flank pain, weight loss, trauma
What is smoking strongly associated to urologically?
malignancy
What increases risks of bladder cancer?
Industrial carcinogens
Why is foreign travel important with haematuria?
Schistosomiasis
What drugs can cause haematuria?
antiplatelets or antithrombotics
What examinations would you do for someone with haematuria?
Abdominal exam and a DRE and external genitalia
What investigations should you do for haematuria?
Urinalysis- nitrites or leukocytes may suggest UTI
Baseline bloods and PSA
Urinary protein levels (albumin:creatinine ratio or protein:creatinine ratio)
What is the urological referral criteria for someone over 45 with visible haematuria?
If unexplained without UTI or if persists or recurs after successful treatment or UTI
