Haematuria - ADULTS
Haematuria can either be
- visible haematuria (VH) – macroscopic haematuria or gross haemtauria
- non visible haematuria (NVH) – microscopic haematuria or ‘dipstick positive haematuria’
What if they are on anticoagulants or antiplatelet therapy?
- You should not assume the haematuria is because of anti-coagulant or anti-platelet therapy
- Patients should be evaluated regardless of these medications.
- Dipstick – any proteinuria as well?
- MSSU for MC&S – guides antibiotic selection if UTI
- 24h urine creatine clearance & urinary protein excretion – re: is there renal impairment?
- Bloods – U&E (for renal function), FBC (if any anaemia), clotting screen
- KUB x-ray vs IVU vs USS
Management: NICE says…
urgent 2ww suspected cancer referral if…
- aged 45 and over and have:
- unexplained visible haematuria (i.e. no UTI)
- visible haematuria that persists or recurs after successful treatment of urinary tract infection
- aged 60 and over and have unexplained non-visible haematuria and either dysuria or a raised white cell count on a blood test
- consider non-urgent referral for bladder cancer in people aged 60 and over with recurrent or persistent unexplained urinary tract infection (i.e. suspected bladder cancer)