Determining the cause of hematuria

Hematuria must always be regarded as a serious symptom. A careful history and physical examination are important in determining the source and cause of the bleeding. Procedures useful in evaluating hematuria include roentgenography, cystoscopy, angiography, ultrasound, and urinary cytology. Of these, cystoscopy is the most important, particularly during periods of active bleeding. Renal biopsy is not routinely advised but is useful in certain cases. A diagnosis of idiopathic hematuria, or hematuria of unknown origin, is warranted only after careful, complete, and repeated examinations.