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Related Experiment Videos

Unexplained hematuria.

M Barkin, W Lopatin, S Herschorn

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |November 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

    Evaluating hematuria (blood in urine) is crucial. Most cases have a cause found by urography and cystoscopy, but some require repeat evaluation or advanced imaging for diagnosis.

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    Area of Science:

    • Urology
    • Diagnostic Imaging
    • Nephrology

    Background:

    • Hematuria, or blood in urine, is a common presenting symptom requiring thorough investigation.
    • Identifying the underlying cause of hematuria is essential for appropriate patient management and prognosis.

    Purpose of the Study:

    • To assess the diagnostic yield of initial and repeat investigations for hematuria.
    • To determine the incidence of unexplained hematuria and identify associated clinical features.
    • To evaluate the efficacy of epsilon aminocaproic acid in specific cases of unexplained hematuria.

    Main Methods:

    • Prospective study of 270 consecutive patients presenting with hematuria.
    • Utilized urography and cystoscopy for initial urinary tract visualization.
    • Repeated evaluations and advanced imaging (angiography, CT, ultrasound) for persistent or unclear cases.

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  • Retrospective analysis of 159 patients with unexplained hematuria.

    • Main Results:

    • Over 90% of hematuria cases had a causative lesion identified by initial urography and cystoscopy.
    • Repeat evaluation within 4 months diagnosed previously missed lesions in 4 patients.
    • 17% of patients on anticoagulants had an underlying cause for hematuria unrelated to their medication.
    • 6% of all patients (12% with microscopic, 4% with gross hematuria) remained undiagnosed despite extensive investigation.
    • The triad of gross, total, and painless hematuria was present in 15% of unexplained cases.
    • Orally administered epsilon aminocaproic acid benefited patients with heavy unilateral renal bleeding.

    Conclusions:

    • Initial urography and cystoscopy are highly effective in diagnosing the cause of most hematuria presentations.
    • A subset of patients requires repeat or advanced imaging to identify the source of bleeding.
    • Unexplained hematuria, though uncommon, necessitates comprehensive diagnostic approaches.
    • Epsilon aminocaproic acid may offer a therapeutic option for specific scenarios of unexplained renal hematuria.