[Radiological exploration of hematuria]

Hematuria is defined as the presence of blood in urine. Its site of origin can be in any point of the urinary tract. Its discovery leads to clinical, biological and radiological investigations. The causes of hematuria are dominated, in terms of frequency, by urinary infection and lithiasis. The risk of associated lesions, especially of a tumor, must lead to regarding them as excluding diagnoses. Besides the so-called "medical" hematurias of glomerular origin (hematuria with proteinuria and cylinder casts) and hematurias occurring during a first episode of cystitis in women, the radiological exploration of "surgical" hematuria is systematic and always begins with an IVP. When the IVP is normal, a cystoscopy is most often made. The other radiological examinations (CT, Doppler ultrasound) are performed only according to the findings of IVP and cystoscopy. Arteriography combined with renal phlebography is indicated if the assessment is negative in case of recurrent hematuria or of massive hematuria. It is mainly aimed at detecting a vascular malformation. When this exploration is completed, an etiology is found is about 90% of all cases.