- A clinical sign NOT a diagnosis.
- The presence of blood in urine micro- or macroscopically.
- Cause : several: urinary tract infection, urolithiasis, neoplasia, drug toxicity, urethral defects, exercise, systemic diseases, trauma.
- Signs : discolored urine (macroscopic) - variable other signs depending on cause.
- Diagnosis : urinalysis, blood biochemistry/hematology, rectal palpation, endoscopy, ultrasonography.
- Treatment : depends upon specific etiology.
- Prognosis : depends upon specific etiology.
- Urine discoloration due to drugs/chemicals.
- The timing of hematuria may reflect origin of blood:
- Throughout urination consistent with hemorrhage from kidneys, ureters or bladder.
- At beginning and end of urination may be associated with lesions in the distal and proximal urethra, respectively.
- Upper tract infection may → pyrexia, weight loss and anorexia.
- Lower tract infections, especially cystitis, manifest as stranguria or polliakiuria .
- Signs of renal colic or painful urination (stranguria, pollakiuria) .
- Urine not discolored.
- Void urine normally but at the end of urination a series of urethral contractions result in passage of squirts of fresh blood.
- Rarely causes dysuria or pollakiuria.
- Hematuria/myoglobinuria immediately post-exercise.
- Clinical signs of specific diease, eg coagulopathies [Disseminated intravascular coagulation] , liver disease , hemolytic anemia , exercise-induced rhabdomyolysis .
Idiopathic renal hematuria
- Severe spontaneous hematuria in the absence of other signs of disease.
- Death can occur.
- Signs consistent with acute blood loss, eg tachypnea/tachycardia, pale mucous membranes.
- Depends upon underlying cause.
Expected response to treatment
- Resolution of blood in urine.
Reasons for treatment failure
- Incorrect diagnosis.
- Inappropriate treatment.
- Recurrence of lesion/problem.