Definition of Haematuria
Haematuria is the passage of blood in the urine.
abrot. Aconite alco. aloe alumn. am-c. ambr. amyg-p. ant-c. Ant-t. antip. APIS ARG-N. ARN. ARS. ars-h. ars-s-f. asc-t. aspar. Aurum aur-ar. aur-s. Belladonna bell-p. benz-ac. Berberis borx. BOTH. bufo CACT. cadm-met. cadm-s. CALC. Camph. CANN-S. CANTH. Caps. Carb-ac. Carb-v. carbn-s. carc. Causticum chel. Chim. chin. Chinin-ar. chinin-s. chir-fl. cimic. cina COC-C. coch. Colchicum coli. coloc. Conium Copaiva crot-c. CROT-H. cub. cupr. cupr-s. cyn-d. dig. diosm. diph-t-tpt. dulc. epig. equis-h. Erig. eucal. euph. fab. ferr. Ferr-ar. ferr-m. ferr-p. fic-r. fuma-ac. gaert. gal-ac. ger. graph. guat. HAM. Helleborus hep. hydrang. Hypericum IP. jatr-c. Kali-ar. kali-bi. Kali-chl. kali-i. kali-m. kali-n. kalm. Kreosotum Lachesis lat-m. led. loxo-lae. loxo-recl. Lycopodium Mangi. Mercurius MERC-C. Mez. MILL. moni. murx. Natrum mur. nat-n. nitricum acidum Nux-v. oci. ol-sant. Opium opun-v. ox-ac. oxyurn-sc. pall. pareir. petr. Ph-ac. PHOS. pic-ac. Plb. psor. PULS. rhod. Rhus-a. Rhus-t. sabad. Sabin. sal-ac. santin. Sarsaparilla scarl. SEC. Senec. Sepia ser-ang. Solid. SQUIL. stigm. Sul-ac. Sulph. tab. tann-ac. tarent. TER. terebe. thal-xyz. Thlas. thuj. tril-p. tub. uva vac. vanad. vesp. vip. Zincum met. zinc-p.
Types of Haematuria
Frank haematuria
It is the presence of blood on macroscopic examination.
Alumn. apis ars. bell. Cact. canth. Chim. coc-c. colch. Ip. kreos. Lycopodium mela. Millefolium Ph-ac. Platina puls.
Microscopic haematuria
It indicates that RBCs are only seen on microscopy.
Aconite ant-t. apis ARN. ars. Ars-h. Berberis CACT. cadm-s. calc. cann-s. CANTH. caps. Carb-ac. Carb-v. cham. CHIM. chin. chinin-ar. chinin-s. colch. coloc. con. crot-h. Dulcamara ferr-p. Hamamelis hell. hep. ip. kali-bi. Kali-chl. lyc. merc. mez. nat-n. nitricum acidum pareir. PH-AC. phos. pic-ac. PULS. santin. sec. SEP. sul-ac. sulph. Ter. uva Zincum met.
Haemoglobinuria
It is defined as the presence of free Hb in the urine.
acon. act-sp. agar. all-c. alum. Am-c. am-caust. ant-c. ant-t. apis arg-n. ARN. ARS. ARUND. Aspar. aur-m. bapt. bell. Benz-ac. Berberis bry. Cact. Camph. Carb-v. Causticum chel. Chim. chin. chinin-ar. Chinin-s. Cimic. cob. coc-c. colch. Coloc. con. Copaiva DIG. Elaps get. Gloninum grat. hedeo. Hyoscyamus Ip. Kali-c. kali-n. Lachesis Ledum LOB. LYC. Meph. MERC-C. Mez. Natrum mur. Nat-s. nit-ac. nux-m. Nux-v. Oci. Opium ox-ac. pall. PAREIR. Petroleum PHOS. pic-ac. PLAN. Psorinum puls. pyrog. rumx. SEL. SENEC. SEP. Silicea sumb. TARENT. ter. thuj. valer. zinc. zinc-p.
Initial haematuria
When blood comes on commencing urination. It suggests a urethral cause.
con.
Terminal haematuria
When blood comes after passing urine. It suggests a bladder base or prostatic cause.
HEP. mez. puls. sars. sulph. Thuja
Key Points for Haematuria
- Haematuria always requires investigation to exclude an underlying cause.
- Initial haematuria suggests a urethral cause.
- Terminal haematuria suggests a bladder base or prostatic cause.
- Ribbon clots suggest a pelvi-ureteric cause.
- Renal bleeding can mimic colic due to clots passing down the ureter.
Causes of Haematuria
Important Diagnostic Features of Haematuria
Kidney
Trauma: mild to moderate trauma commonly causes renal bleeding; severe injuries may not bleed (avulsed kidney- complete disruption).
acon. Arnica bell. verat-v.
Tumours: may be profuse or intermittent.
Anil.
Renal cell carcinoma: associated mass, loin pain, clot colic or fever, occasional polycythaemia, hypercalcaemia and hypertension.
calc. chim. form. sars. solid.
Transitional cell carcinoma (TCC): characteristically painless, intermittent haematuria.
agath-a. Aloe Am-c. Ant-c. Ant-t. CALC. Cann-s. cic. Conium Helleborus heroin. hyos. Kreosotum laur. Lycopodium mosch. olnd. Opium Ph-ac. positr. psil. sacch. Secale stram. Sulph. syph. tung-m.
Calculus: severe loin/groin pain, gross or microscopic, associated infection.
act-sp. alum. am-c. am-m. ambr. Ant-c. apoc. Arg-n. arn. baros. bell. bell-p. BENZ-AC. Berberis cact. cal-ren. CALC. Cann-xyz. Cantharis cham. chin. chinin-s. Chlf. cimic. coc-c. coli. coloc. Dioscorea epig. equis-h. erig. ery-a. eup-pur. fab. frag. gali. guat. hed. hedeo. hep. hydrang. ipom-p. kali-bi. kali-c. kali-i. lach. lipp. LITH-C. Lith-f. Lith-met. Lith-p. LYC. mag-p. med. mill. morg-g. nat-m. nitricum acidum nux-m. nux-v. oci. onis. op. oxyd. PAREIR. Petroleum Phosphorus pipe. polyg-h. rub-t. Ruta saroth. SARS. Sepia Silicea solid. Stigm. sulfa. sulph. Tabacum ter. thlas. thuj. urt-u. uva vesi. Zincum met.
Glomerulonephritis: usually microscopic, associated systemic disease (e.g. systemic lupus erythematosus (SLE)).
APIS eberth. streptoc.
Pyelonephritis: rare.
apis bals-p. benz-ac. berb. bry. coc-c. coli. ferr-m. kali-sula. lyc. morg-g. naphtin. nux-v. podo. puls. sars. syc. ter.
Renal tuberculosis (rare): sterile pyuria, weight loss, anorexia, Pyrexia of unknown origin (PUO), increased frequency of micturition day and night.
ARS. BELL. calc. Carcinocin chin-ars. Coli. HEP. kreos. Lachesis led. LYC. Natrum mur. NIT-AC. ox-ac. PHOS. psor. PULS. SENEC. SEP. SULPH. Tuberculinum Vac. vanad. Zincum met.
Polycystic disease (rare): palpable kidneys, hypertension, chronic renal failure.
kres.
Renal arteriovenous malformation or simple cyst (very rare): painless, no other symptoms.
Renal infarction (very rare): may be caused by an arterial embolus, painful tender kidney.
bacls-7. LAT-M. mand. prot.
Ureter
Calculus: severe loin/groin pain, gross or microscopic, associated infection.
apis Belladonna Berberis canth. carb-an. hydrang. Lycopodium oci. par. polyg-h. SARS. sep. ter. verat.
TCC: characteristically painless, intermittent haematuria, history of work in rubber or dye industries.
agath-a. Aloe Am-c. Ant-c. Ant-t. CALC. Cann-s. cic. Conium Helleborus heroin. hyos. Kreosotum laur. Lycopodium mosch. olnd. Opium Ph-ac. positr. psil. sacch. Secale stram. Sulph. syph. tung-m.
Bladder
Calculus: sudden cessation of micturition, pain in perineum and tip of penis.
all-s. Ambr. ant-c. ant-t. apoc. arg-n. ars. aspar. bell. BENZ-AC. BERB. bry. cact. cal-ren. CALC. Cann-s. CANTH. carb-v. card-m. China Coc-c. Coch. coff-t. colch. coloc. cupr. dig. epig. equis-h. Eup-per. graph. hydrang. kali-c. Kalm. kreos. Lachesis lipp. Lith-c. Lith-m. Lith-p. Lith-s. LYC. Meny. merc. Merc-c. mez. Millefolium naja nat-m. nat-s. nitricum acidum Nux-m. Nux-v. oxyd. pall. Pareir. Petroleum Phosphorus Pulsatilla Raph. rhod. Ruta SARS. SEP. Silicea sul-ac. sulph. tarent. thuj. zinc.
TCC: characteristically painless, intermittent haematuria, history of work in rubber or dye industries.
Anil. arg-n. ars. blatta-o. chim. clem. con. congo-r. crot-h. equis-h. gamb. hydr. mal-ac. sabal sars. staph. tarax. TER. thuj. tor.
Acute cystitis: suprapubic pain, dysuria, frequency and bacteriuria.
acon. ant-t. apis ars. aspar. Belladonna benz-ac. berb. Camph. camph-ac. Cann-s. Cantharis caps. chim. con. Copaiva Cub. dig. Dulcamara elat. Equis-h. erig. Eucal. Eup-pur. fab. ferr-act. Ferr-p. Gelsemium hell. hydrang. hyos. lach. Merc-c. methyl. mez. nit-ac. nux-v. Ol-sant. Pareir. petros. pip-m. Pop. prun. Pulsatilla sabal Sabin. sars. Saur. sep. Stigm. sulph. Ter. tritic. uva vesi.
Interstitial cystitis (rare): may be autoimmune, drug or radiation induced, frequency and dysuria common.
Medorrhinum
Schistosomiasis (very rare): history of foreign travel, especially North Africa.
ant-t. ars. chin. ip.
Prostate
BPH: painless haematuria, associated obstructive symptoms, recurrent UTI.
PROSTATE GLAND – SWELLING – old people; in
aloe BAR-C. Benz-ac. Conium DIG. ferr-pic. Iodium nux-v. prost. Sabal SEL. Staphysagria sulph.
Carcinoma: rare.
bar-ox-suc. carc. chim. CON. Copaiva crot-h. Iodium kali-cy. Lycopodium naphthoq. plb. Psorinum SABAL Scir. Selenium senec. Silicea staph. sulfonam. Sulph. THUJ. thymol.
Urethra
Trauma: blood at meatus, history of direct blow to perineum, acute retention.
ARN. bell-p. cham. CON. dulc. euphr. ham. hyper. lach. Nat-c. nat-m. phos. Pulsatilla Rhus-t. samb. Sul-ac. sulph. Symphytum
Calculus: rare.
coc-c.
Urethritis: rare.
Aconite agar. agn. anemps. apis ARG-N. Arsenicum Aurum aur-ar. bell. bov. Cact. calc-f. camph. cann-i. CANN-S. CANTH. caps. carb-ac. caust. Chim. Clem. Copaiva Cub. cycl. dig. dor. dulc. ferr-p. Gelsemium gonotox. gran. Hepar hydr. kali-bi. kali-f. Kali-i. kola lith-c. lyc. lyss. mag-f. med. Mercurius Merc-c. napht. nat-c. nit-ac. Nux-v. oci-sa. pareir. Petroleum Petros. phys. pip-m. psor. puls. rham-f. Sabin. sars. staph. Sulph. sumb. syc. tab. TER. teucr. Thuja yohim.
KEY INVESTIGATIONS for Haematuria
Full Blood Count (FBC): infection, chronic blood loss. ‘Rouleaux’ suggest glomerulonephritis.
Clotting: exclude underlying bleeding cause.
Creatinine, Urea and electrolytes (U+E): renal function.
Microscopic study of urine, microbe culture and sensitivity (MSU MC + S): infection, parasites.
Renal cause: Intravenous pyelography (IVU), CT scan or Renal ultrasound (U/S) Renal Angiography for Arterio-Venous Malformation (AVM)
Bladder cause: Cystoscopy, Renal U/S
Glomerulonephritis: Autoimmune screen, Renal Biopsy (Bx)
References
Although hematuria is absent in 5% to 10% of patients with genitourinary trauma,98…
Principles of Critical Care > Chapter 95. Torso Trauma > Specific Abdominal Injuries—Diagnosis and Management Principles > Genitourinary Injuries
Atraumatic Hematuria
CURRENT Diagnosis & Treatment: Emergency Medicine > Chapter 37. Genitourinary Emergencies > Immediate Management of Serious & Life-Threatening Conditions
Blood (Hematuria)
Clinician’s Pocket Reference > Chapter 6. Laboratory Diagnosis: Urine Studies > Differential Diagnosis for Routine Urinalysis
Bloody Urine
Smith’s General Urology > Chapter 3. Symptoms of Disorders of the Genitourinary Tract > Symptoms Related to the Act of Urination
Carcinoma of the Renal Pelvis and Ureter
Harrison’s Online > Chapter 90. Bladder and Renal Cell Carcinomas
Colorless urine of low concentration from excessive fluid…
DeGowin’s Diagnostic Examination > Chapter 10. The Urinary System > Urinary System Signs > Key Sign Discolored Urine > DISCOLORED URINE—CLINICAL OCCURRENCE
Diseases of glomeruli (glomerulonephritis or vasculitis) and the renal microvasculature (hemolytic…
Harrison’s Online > Chapter 45. Azotemia and Urinary Abnormalities > Azotemia > Approach to the Patient: Azotemia > Intrinsic Renal Disease
Dysuria Associated with Hematuria in Either Sex
CURRENT Diagnosis & Treatment: Emergency Medicine > Chapter 37. Genitourinary Emergencies > Immediate Management of Serious & Life-Threatening Conditions > Dysuria > Clinical Findings
Erythrocytes
Smith’s General Urology > Chapter 5. Urologic Laboratory Examination > Examination of Urine > Interpretation
Exercise 9-4. Hematuria
Basic Radiology, 2e > Chapter 9. Radiology of the Urinary Tract
Figure 45-2. Approach to the patient with hematuria. RBC, red blood cell; WBC, white blood…
Harrison’s Online > Chapter 45. Azotemia and Urinary Abnormalities > Azotemia > Approach to the Patient: Azotemia > Intrinsic Renal Disease
Gastrointestinal Bleeding, Hemoptysis, and Hematuria
Hazzard’s Geriatric Medicine and Gerontology, 6e > Chapter 106. Hemorrhagic Disorders > Clinical Approach to Bleeding in the Elderly Patient > Bleeding Symptoms
Hematuria & Glomerular Disease
CURRENT Diagnosis & Treatment: Pediatrics > Chapter 22. Kidney & Urinary Tract
Hematuria & Renal Papillary Necrosis
CURRENT Diagnosis & Treatment: Nephrology & Hypertension > Chapter 49. Sickle Cell Nephropathy
Hematuria can also occur with papillary necrosis, a complication seen in both homozygous and…
Tintinalli’s Emergency Medicine > Chapter 135. Sickle Cell Disease > GU Complaints
Hematuria is considered the hallmark finding in GU trauma, although it is a nonspecific sign. …
Tintinalli’s Emergency Medicine > Chapter 251. Trauma in Children > Specific Pediatric Injuries > Pelvic and GU Trauma
Hematuria
Clinician’s Pocket Reference > Chapter 3. Differential Diagnosis: Symptoms, Signs, and Conditions
Hematuria
CURRENT Diagnosis & Treatment: Nephrology & Hypertension > Chapter 1. Approach to the Patient with Renal Disease > Complications
Hematuria
CURRENT Diagnosis & Treatment: Surgery, 13e > Chapter 38. Urology > Acquired Lesions of the Genitourinary Tract
Hematuria
CURRENT Medical Dx & Tx > Chapter 22. Kidney Disease > Approach to Kidney Disease > Urinalysis
Hematuria
CURRENT Medical Dx & Tx > Chapter 22. Kidney Disease > Cystic Diseases of the Kidney > Autosomal Dominant Polycystic Kidney Disease > Complications & Treatment
Hematuria
CURRENT Medical Dx & Tx > Chapter 23. Urologic Disorders > Urologic Evaluation > History
Hematuria
CURRENT Medical Dx & Tx > Chapter 23. Urologic Disorders
Hematuria
Diagnosaurus
Hematuria
Hazzard’s Geriatric Medicine and Gerontology, 6e > Chapter 127. Urinary Tract Infections > Clinical Presentation
Hematuria
Smith’s General Urology > Chapter 16. Urinary Stone Disease > Renal & Ureteral Stones > Symptoms & Signs at Presentation
Hematuria
Tintinalli’s Emergency Medicine > Chapter 128. Renal Emergencies in Infants and Children
Hematuria
Tintinalli’s Emergency Medicine > Chapter 230. Hemophilias and von Willebrand Disease > Hemophilia > Special Considerations
Hematuria
Tintinalli’s Emergency Medicine > Chapter 94. Urinary Tract Infections and Hematuria
Hematuria
Williams Hematology, 8e > Chapter 124. Hemophilia A and Hemophilia B > Hemophilia A (Classic Hemophilia, Factor VIII Deficiency) > Clinical Features
Hematuria
Williams Hematology, 8e > Chapter 48. Disorders of Hemoglobin Structure: Sickle Cell Anemia and Related Abnormalities > Clinical Features and Management > Genitourinary
Hematuria, Cyst Hemorrhage, and Retroperitoneal Hemorrhage
CURRENT Diagnosis & Treatment: Nephrology & Hypertension > Chapter 46. Cystic Diseases of the Kidney > Autosomal Dominant Polycystic Kidney Disease > Clinical Findings > Symptoms and Signs > Renal Manifestations
Hematuria, Proteinuria, and Pyuria
Harrison’s Online > Chapter 277. Glomerular Diseases > Approach to the Patient: Glomerular Disease
Hematuria, Pyuria, and Casts
Harrison’s Online > Chapter 45. Azotemia and Urinary Abnormalities > Abnormalities of the Urine
HEMATURIA—CLINICAL OCCURRENCE
DeGowin’s Diagnostic Examination > Chapter 10. The Urinary System > Urinary System Signs > Key Sign Discolored Urine
Normally, erythrocytes, leukocytes, hyaline casts, and crystals (urate, phosphate, oxalate) are…
DeGowin’s Diagnostic
Renal
CURRENT Diagnosis & Treatment: Nephrology & Hypertension > Chapter 47. Familial Hematurias: Alport Syndrome & Thin Basement Membrane Nephropathy > Alport Syndrome > Clinical Findings > Symptoms and Signs
The classic symptom complex for nephrolithiasis is the acute onset of a crampy intermittent pain…
Tintinalli’s Emergency Medicine > Chapter 97. Urologic Stone Disease > Clinical Features
The signs and symptoms of acute appendicitis lie along a spectrum that correlates with…
Tintinalli’s Emergency Medicine > Chapter 84. Acute Appendicitis > Clinical Features
Urinalysis
Williams Obstetrics, 23e > Chapter 5. Maternal Physiology > Urinary System > Kidney
Encyclopedia Homoeopathica
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