Abstract
Haematuria is a common urological presenting complaint. It can be classed as visible (VH) or non-visible (NVH), and symptomatic or asymptomatic. Approximately 40% of patients who present with haematuria have an underlying disease, including 8–25% of those with VH that have an underlying urological malignancy. Non-visible haematuria is present in about 2.5% of the general population. A focused history, physical examination, urinalysis, blood tests, imaging and cystoscopy form the initial evaluation of haematuria. International guidelines recommend urgent and non-urgent referral pathways, and subsequent targeted investigations depending upon the extent of haematuria and the patient. Non-urological causes may need referring to nephrology or haematology depending on the suspected cause. Patients with persistent asymptomatic NVH warrant monitoring with urinalysis since there is the uncertainty of an underlying and potential serious cause.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ritchie CD, Bevan EA, Collier SJ. Importance of occult haematuria found at screening. Br Med J (Clin Res Ed). 1986;292(6521):681–3.
Tan WS, Feber A, Sarpong R, Khetrapal P, Rodney S, Jalil R, et al. Who should be investigated for haematuria? Results of a contemporary prospective observational study of 3556 patients. Eur Urol. 2018;74(1):10–4.
Kelly JD, Fawcett DP, Goldberg LC. Assessment and management of non-visible haematuria in primary care. BMJ. 2009;338:a3021.
Linder BJ, Bass EJ, Mostafid H, Boorjian SA. Guideline of guidelines: asymptomatic microscopic haematuria. BJU Int. 2018 Feb;121(2):176–83.
National Institute for Health and Care Excellence. Urological cancers – recognition and referral [Internet]. 2015 [cited 2018 Jul 1]. https://cks.nice.org.uk/urological-cancers-recognition-and-referral#!topicsummary
Akiboye RD, Sharma DM. Haematuria in sport: a review. Eur Urol Focus. 2018; https://doi.org/10.1016/j.euf.2018.02.008.
British Association of Urological Surgeons. Consensus statement on the initial assessment of haematuria [Internet]. 2016 [cited 2018 Jul 1]. https://www.baus.org.uk/professionals/baus_business/publications/17/haematuria_guidelines
American Urological Association. Diagnosis, Evaluation and Follow-up of Asymptomatic Microhematuria (AMH) in Adults [Internet]. 2012 [cited 2018 Jul 1]. https://www.auanet.org/guidelines/asymptomatic-microhematuria-(2012-reviewed-for-currency-2016).
Canadian Urological Association. Recommendations for the improvement of bladder cancer quality of care in Canada: a consensus document reviewed and endorsed by bladder Cancer Canada (BCC), Canadian Urologic Oncology Group (CUOG), and Canadian Urological Association (CUA), December 2015. Can Urol Assoc J. 2016;10:E46–80.
Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Compérat EM, et al. EAU guidelines on non–muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol. 2017;71(3):447–61.
EAU. European Association of Urology Guidelines. EAU; 2018.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Pang, K.H., Catto, J.W.F. (2020). Haematuria: Evaluation and Management. In: Chapple, C., Steers, W., Evans, C. (eds) Urologic Principles and Practice. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-28599-9_16
Download citation
DOI: https://doi.org/10.1007/978-3-030-28599-9_16
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-28598-2
Online ISBN: 978-3-030-28599-9
eBook Packages: MedicineMedicine (R0)