HAEMATURIA Whistlestop tour Sarahjayne Pollock GPST 1 04092019

HAEMATURIA (Whistle-stop tour) Sarah-jayne Pollock GPST 1 04/09/2019

Objectives o Definition o Causes o Assessment o Referral guidelines

Haematuria o Haematuria is the presence of red blood cells in the urine. It can either be: n Macroscopic o (Visible / gross haematuria ) n Microscopic o (Non-visible / dipstick positive haematuria)

Location! Location o o o o o Pyelonephritis Glomerulonephritis Lithiasis Acute Cystitis Prostate: Ca / BPH Inherited diseases (SCD, Polycystic Kidney Disease) Medications Tumors Injury Exercise o [Beeturia]

Assessment o History n Smoking; Occupation o Examination n BP o Urinalysis o Routine Bloods n PCR o Investigate n USS KUB n CT KUB n Cystoscopy

Significant Haematuria o Any single episode of macroscopic haematuria o Any single episode of microscopic haematuria in the absence of a UTI or other transient cause o Persistent asymptomatic microscopic haematuria

When to Refer o According to the BAUS website… n Your GP will arrange urgent referral to the Haematuria Clinic of your local urology unit if: o you are over the age of 45 years, and have visible blood in the urine in the absence of infection o the blood fails to clear following antibiotic treatment for urinary infection o you have non-visible bleeding but significant urinary symptoms o you have non-visible bleeding, and you are over the age of 60 years with a high white blood count on a blood sample or discomfort when you are passing urine