HAEMATURIA

Definition  Blood in the urine  Presence of ≥3 erythrocytes per high power field (HPF) under a microscope  Microscopic or frank/gross

Causes AcquiredCongenital LocalGeneral 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