By;Mr. Adeel ABBAS

Define Haematuria?

Haematuria is defined as Blood in the Urine.

Define Haemoglobinuria?

Haemoglobinuria is the Passage of Free

Haemoglobin in the Urine.

What are the Types of Haematuria?

1. Visible Haematuria (VH).

2. Non-Visible Haematuria (NVH).

1. Symptomatic Non-Visible Haematuria (s-

NVH).

2. Asymptomatic Non-Visible Haematuria (a-

NVH).

What Are The Causes Of Haematuria?

1. Renal Causes.2. Ureteric Causes.3. Bladder Causes.4. Urethral Causes.

Renal Causes;Calculus.RCC.Trauma.Pyelonephritis/Glomerulonephritis.T.B.Renal Adenoma.Renal Cyst.Renal Infarction.A/V Malformation.

Ureteral Causes;Stone.A. Appendicitis.TCC.

Bladder Causes;Calculus.TCC.Cystitis.Trauma.

Urethral Causes;BPH.Prostate Carcinoma.Stone.Trauma

Diagnostic Features

Diagnostic Features of Renal CausesCalculus;

Sever Loin Pain.Gross / Microscopic Haematuria.Associated Infection.

Diagnostic Features of Renal CausesRenal Cell Carcinoma;

Mass in Flank.Loin Pain.Haematuria / Clot.Fever.Para-Neoplastic Syndrome.

Diagnostic Features of Renal CausesTrauma;

Mild to Moderate Injury Renal Bleeding.

Sever Injury May NOT Bleed (Avulsed Kidney – Complete Disruption).

Diagnostic Features of Renal CausesGlomerulonephritis;

Microscopic Haematuria.Associated Systemic Disease (SLE).

Diagnostic Features of Ureteral CausesCalculus;

Sever Loin / Groin Pain.Gross / Microscopic Haematuria.Infection.

Diagnostic Features of Bladder CausesCalculus;

Sudden Cessation of Micturation.Gross / Microscopic Haematuria.Pain in Perineum.Pain in Tip of Penis.

Diagnostic Features of Bladder CausesCystitis;

Supra-Pubic Pain.Dysuria.Frequency.Bacteriuria.

Diagnostic Features of Bladder CausesTransitional Cell Carcinoma;

Painless, Intermittent Haematuria.Worker at Rubber or Dye Industry.

Diagnostic Features of Prostate CausesBPH;

Painless Haematuria.Obstructive Uropathy.Recurrent UTI.

Diagnostic Features of Urethral CausesTrauma;

Blood at Meatus.Blow to Perineum.

Key PointsHaematuria ALWAYS Requires Investigation

to Exclude an Underlying Cause.

Haematuria on Commencing Urination

Suggest a Urethral Cause.

Haematuria After Passing Urine Suggest a

Bladder or Prostatic Cause.

Key PointsPassage of Ribbon Clots Suggest a Pelvi-

Ureteric Cause.

Renal Bleeding Can Mimic Colic Due to Clots

Passing Down the Ureter.