Haematuria

Last updated 20.09.12

 

Definition

-  Presence of blood in urine

-  Macroscopic: detected on urinalysis/dipstick

-  Microscopic: frank blood, rose

 

Features

-  May vary in colour from frank red, rose, Coke

 

Causes

-  Anti-coagulants

-  Prostate Ca

-  TCC

-  Urotrauma: cystoscopy, IDC, TURP

-  Urolithiasis

-  Obstructed labour

- Pelvic trauma

 

DDx

-  Beeturia

-  Red urine after beetroot ingestion

-  14% population

-  May be precipitated by iron def

 

Complications

-  Clot retention

 

Ix

-  Vitals: shock

-  FBE: WBC, Hb

-  U&E: ARF, ATN

-  Urinalysis: RBC, Casts, protein

-  Centrifuge: colour in sediment vs fluid

-   Red sediment, clear fluid: haematuria

-   Red/brown fluid --> urine dipstick

-   Haem + = myoglobinuria or haemoglobinuria

-   Haem - = meds, dyes, beetroot ingestion, porphyria

-  X-ray KUB: urolithiasis

-  CT – KUB: urolithiasis

 

Urine

 

Mx

-  IV access + fluids 

-  3 way catheter + bladder wash out

-  NS fluid until urine becomes clear 

-  +/- Cystoscopy & diathermy

 

 

 

 

References