Haematuria

What is haematuria?

Haematuria refers to blood in the urine. This may be visible to the patient (macroscopic haematuria) or non-visible (microscopic haematuria).

Who needs to be investigated?

Microscopic haematuria is often found incidentally and further investigations depend on the amount of blood detected in the urine and the patients age. Macroscopic haematuria does need investigation of the renal tract by performing either an ultrasound scan of the renal tract or a CT scan. Again depending on the pattern of haematuria and the age of the patient a camera test (cystoscopy) is also required to assess the bladder.

Causes of haematuria

Blood in the urine can arise from anywhere within the renal tract. This can be due to benign lesions such as kidney stones or infection or due to malignant lesions eg kidney tumours or bladder tumours. Cross sectional imaging using high resolution CT scanning can detect malignant lesion sin the kidneys as well as kidney stones. Cystoscopy can visualise the internal lining of the bladder.

Add figure showing kidney stone on CT

Treatment of haematuria

The treatment will depend on the cause of the bleeding. Any malignancy that is detected will be dealt with by a specialist in that particular area. The majority of malignant lesions can now be treated using laparoscopic or robot assisted techniques.

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