This document defines and discusses different types of hematuria including visible and non-visible hematuria. It outlines the renal, ureteral, bladder, and urethral causes of hematuria such as kidney stones, renal cell carcinoma, cystitis, prostate cancer, and trauma. The document provides diagnostic features of different causes of hematuria including loin pain and clots with kidney stones, flank mass and fever with renal cell carcinoma, and intermittent painless hematuria in workers exposed to chemicals indicating possible bladder cancer. Key points emphasize that hematuria always requires investigation and that location and characteristics of hematuria can provide clues to underlying causes.

1. By;
Mr. Adeel ABBAS

2. Define Haematuria?

3. Haematuria is defined as Blood in the Urine.

4. Define Haemoglobinuria?

5. Haemoglobinuria is the Passage of Free Haemoglobin
in the Urine.

6. What are the Types of Haematuria?

7. 1. Visible Haematuria (VH).
2. Non-Visible Haematuria (NVH).
1. Symptomatic Non-Visible Haematuria (s-NVH).
2. Asymptomatic Non-Visible Haematuria (a-NVH).

8. What Are The Causes Of Haematuria?

9. 1. Renal Causes.
2. Ureteric Causes.
3. Bladder Causes.
4. Urethral Causes.

10. Renal Causes;
Calculus.
RCC.
Trauma.
Pyelonephritis/Glomerulonephritis.
T.B.
Renal Adenoma.
Renal Cyst.
Renal Infarction.
A/V Malformation.

11. Ureteral Causes;
Stone.
A. Appendicitis.
TCC.

12. Bladder Causes;
Calculus.
TCC.
Cystitis.
Trauma.

13. Urethral Causes;
BPH.
Prostate Carcinoma.
Stone.
Trauma

14. Diagnostic Features

15. Diagnostic Features of Renal Causes
Calculus;
Sever Loin Pain.
Gross / Microscopic Haematuria.
Associated Infection.

16. Diagnostic Features of Renal Causes
Renal Cell Carcinoma;
Mass in Flank.
Loin Pain.
Haematuria / Clot.
Fever.
Para-Neoplastic Syndrome.

17. Diagnostic Features of Renal Causes
Trauma;
Mild to Moderate Injury Renal Bleeding.
Sever Injury May NOT Bleed (Avulsed Kidney –
Complete Disruption).

18. Diagnostic Features of Renal Causes
Glomerulonephritis;
Microscopic Haematuria.
Associated Systemic Disease (SLE).

19. Diagnostic Features of Ureteral Causes
Calculus;
Sever Loin / Groin Pain.
Gross / Microscopic Haematuria.
Infection.

20. Diagnostic Features of Bladder Causes
Calculus;
Sudden Cessation of Micturation.
Gross / Microscopic Haematuria.
Pain in Perineum.
Pain in Tip of Penis.

21. Diagnostic Features of Bladder Causes
Cystitis;
Supra-Pubic Pain.
Dysuria.
Frequency.
Bacteriuria.

22. Diagnostic Features of Bladder Causes
Transitional Cell Carcinoma;
Painless, Intermittent Haematuria.
Worker at Rubber or Dye Industry.

23. Diagnostic Features of Prostate Causes
BPH;
Painless Haematuria.
Obstructive Uropathy.
Recurrent UTI.

24. Diagnostic Features of Urethral Causes
Trauma;
Blood at Meatus.
Blow to Perineum.

25. Key Points
Haematuria ALWAYS Requires Investigation to
Exclude an Underlying Cause.
Haematuria on Commencing Urination Suggest a
Urethral Cause.
Haematuria After Passing Urine Suggest a Bladder or
Prostatic Cause.

26. Key Points
Passage of Ribbon Clots Suggest a Pelvi-Ureteric
Cause.
Renal Bleeding Can Mimic Colic Due to Clots Passing
Down the Ureter.