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Introduction
In
the
canadian
guidlines,
significant
microscopic hematuria is defined as 2 or more
red blood cells per high power field, confirmed
in two microscopic urinalysis tests performed
when there is no benign etiology such as
menstruation, recent exercise, recent sexual
activity, or recent intrumentation of the
urinary tract
The
american
recommendations
define
significant microscopic hematuria as 3 or
more RBCs per high power field in a properly
collected specimen and in the absence of a
benign etiology
Urolithiasis
Kidney stones are common and both men and
women may have them
Smaller stones that reside in the kidney are
usually
asymptomatic,
and
microscopic
hematuria may be the only manifestation
Larger stones, including staghorn calculim,
may present with gross hematuria
Hematuria associated with acute onset of
lateralizing
flank
pain
is
the
classic
presentation of a stone thet moves into the
ureter
Malignancies
Gross hematuria is not as common, but it may
be seen if the patient has a larger mass
located more centrally in the kidney
Urothelial carcinoma arises from the lining of
the collecting system.
Gross hematuria tneds to be the common
symptom with this type of tumor
BPH
While the classic patient presentation is
usually that of lower urinary tract obstructive
or irritative symptoms, hematuria is also
common
BPH may, in fact, be the most common cause
of microscopic hematuria in men
Less commonly, BPH may be the sole cause of
gross hematuria and clot retention
A diagnosis of BPH can be made only after full
urological evaluation and exclusion of other
causes of hematuria
Patient Management
Ancillary study
Laboratory investigation
Imaging
Laboratory investigations
Renal function
Imaging
Ultrasound
Terima Kasih