Description

 

Abstract

Confirmed haematuria requires investigation. A full history

and examination is mandatory. Urine infection should be excluded

and renal function and urinary tract imaging obtained. Haematuria

should not be attributed to infection without this information.

For the surgeon, if urinary tract imaging, urine cytology

and cystoscopy are normal, referral to a nephrologist is advisable.

Hypertension, significant proteinuria or renal impairment

make a medical cause of haematuria more likely, and early

referral, e.g. avoiding cystoscopy/complex imaging, made.

Glomerulonephritis may be rapidly progressive, e.g. Goodpastures

syndrome, early treatment is then vital to prevent long-term

renal failure. Physicians investigating haematuria need to

pay attention to urinary tract imaging and refer to a urologist

if abnormal. Macroscopic haematuria, especially if not precipitated

e.g. by a non-urinary infection (as may be the case in various

glomerulopathies), and with normal imaging, should prompt

early urological referral.