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Macroscopic haematuria--a urological approach
Melissa Yeoh1, Nai Kid Lai, Daniel Anderson
1Department of Urology, Nambour General Hospital, Queensland, Australia. melissa_yeoh@health.qld.gov.au
Australian Family Physician
|March 27, 2013
Summary
Macroscopic haematuria requires prompt investigation by general practitioners. Persistent or significant cases may indicate serious underlying conditions, including genitourinary malignancy, necessitating further urological assessment.
Area of Science:
- Urology
- General Practice
- Diagnostic Medicine
Background:
- Haematuria presents a common yet diagnostically challenging symptom.
- A wide range of potential causes exists for haematuria.
Purpose of the Study:
- To define the general practitioner's role in managing macroscopic haematuria.
- To outline initial diagnostic and management strategies for GPs.
Main Methods:
- Review of common causes and diagnostic pathways for haematuria.
- Emphasis on initial investigations and referral criteria.
Main Results:
- Urinary tract infections, ureteric, and renal stones are frequent causes.
- Significant or persistent haematuria warrants suspicion of concurrent pathology or malignancy.
- Recommended investigations include imaging (CT IVP), cytology, microscopy, urine culture, and blood tests.
Conclusions:
- Early and thorough investigation is crucial for haematuria.
- Referral to urology is advised for high-risk patients, persistent cases, or those with suspected malignancy.
- Acute urinary retention may complicate haematuria, typically managed conservatively.
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