HAEMATURIA

Definition

Blood in the urine

Presence of ≥3 erythrocytes per high power field (HPF) under a microscope

Microscopic or frank/gross

Causes

Causes

Acquired

Congenital

Local General

Surgical sieve!

Surgical Sieve – VITAMIN D

Vascular Infection/inflammation Traumatic Autoimmune Metabolic Idiopathic Neoplastic Degenerative

Causes

Infective cystitis, prostatitis, urethritis

Inflammation glomerulonephritis, IgA nephropathy

Traumatic accidents, catheter (iatrogenic)

Neoplastic renal, prostate/BPH, ureters, bladder

Structural stones, polycystic kidney disease

General bleeding disorders, sickle cell disease

False Readings

False + Haemoglobinuria/myoglobinuria Betanin (beetroot) Porphyria

False – Highly dilute urine

History - HPC

Pain Onset

Time

When during the stream?

Associated factors

Frequency

Chemicals

Red flags!

True haematuria?

Definitely haematuria?

Investigations

MSU: dipstick, MCS & cytology (TCC)

Bloods: FBC, U/E, CRP, ESR

Imaging: US, contrast CT, XR-KUB, intravenous urogram (IVU)

Flexible cystoscopy