Haematuria

Haematuria

It is the presence of red blood cells in the urine.

Classification

Macroscopic Haematuria: A substantial haemorrhage imparting a reddish or brownish colour to the urine

Microscopic Haematuria: Hematuria detected by dipstick test.

Causes

Hematuria can either be:

Painless or painful

Macroscopic or microscopic

Intermittent or continuous

Initial or terminal or total

(Initial means only at the start of urination and it denotes Lower urinary tract cause. Terminal points to severe bladder irritation caused by stone or infection and total haematuria points to Upper urinary tract causes)

Investigations

Important Points

Haematuria is always abnormal whether microscopic or macroscopic

May be caused by lesion anywhere in the urinary tract

Is Investigated by :

                Examination of midstream specimen for infection

                Cytological examination of urine specimen

                Intravenous urogram and/or urinary tract ultrasound scan

                Flexible or rigid cystoscopy

It is commonly caused by urinary infection, especially in young women.

 Differential Diagnosis of red urine

•       Hematuria

•       Hemoglobinuria/myoglobinuria

•       Anthrocyanin in beets and blackberries

•       Chronic lead and mercury poisoning

•       Phenolphthalein (in bowel evacuants)

•       Phenothiazines (e.g., Compazine)

•       Rifampin