Introduction

• Presence of blood in the urine.
• Hematuria is a sign NOT a diagnosis.
• Cause: urinary tract hemorrhage, manifestation of abnormal hemostasis.
• Signs: discoloration of urine.
• Diagnosis: detection of blood on dipstick and presence of red blood cells on cytological examination of urine.
• Treatment: depends on etiology.
• Prognosis: depends on etiology.

Pathogenesis

Etiology

Primary urinary tract hemorrhage

• Neoplasia:
  • Renal Kidney: neoplasia.
  • Ureteral Ureter: neoplasia.
  • Bladder Bladder: neoplasia.
  • Urethral Urethra: neoplasia.
• Inflammatory/infectious:
  • Urolithiasis Urolithiasis.
  • Pyelonephritis Kidney: pyelonephritis.
  • Cystitis Cystitis.
  • Urethritis.
• Acute renal failure Kidney: acute kidney injury (AKI).
• Idiopathic:
  • Benign renal hematoma.
• Traumatic:
  • Renal or bladder hemorrhage following abdominal trauma Kidney: trauma Bladder: trauma rupture.
  • Iatrogenic urethral damage.
  • Calculi Urolithiasis.
• Toxic:
  • Cyclophosphamide-induced cystitis.
  • Ethylene glycol poisoning Ethylene glycol poisoning.

 Genital tract hemorrhage

• Neoplasia:
  • Prostatic (male) Prostate: neoplasia.
  • Uterus/vagina (female).
• Inflammatory/infectious:

Abnormalities of hemostasis, ie coagulopathies

• Pyometra (female) Pyometra.
• Prostatitis (male) Acute prostatitis.
• Vaginitis (female) Vaginitis.
• Subinvolution of placental sites (following parturition) Uterus: subinvolution of placental site.
• Trauma.
• Congenital Hemostatic disorder: primary inherited.
• Acquired Von Willebrand's disease.

Timecourse

• Days to months before presentation (depending to some extent on severity).

Diagnosis

Treatment

Outcomes