Management of Haematuria

Author: Evan Coughlan, Andrew Parfitt / Editor: Helen Blackhurst / Reviewer: Lakshay Chanana, Ahmad Alabood / Codes: A3, O5 / Published: 27/03/2023

This session covers the management of patients who present to the emergency department with macro or microscopic haematuria.

Prerequisites:

Before commencing this session you should have encountered patients presenting to the emergency department with a wide range of conditions causing haematuria and have a basic knowledge of how they should be managed.

You should also have completed the following Learning Sessions:

  • Urinary Tract Infections
  • Acute Urinary Retention
  • Renal Colic in Emergency Medicine
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References

  1. Keeler B, Ghani RK, Nargund V. Haematuria 1: risk factors, clinical evaluation and laboratory investigations. British Journal of Hospital Medicine, 2007; 68(8): 419.
  2. Sultana SR, Goodman CM, Byrne DJ, Baxby K. Microscopic haematuria: urological investigation using a standard protocol. Br J Urol. 1996 Nov;78(5):691-6; discussion 697-8.
  3. Khadra MH, Pickard RS, Charlton M, Powell PH, Neal DE. A prospective analysis of 1,930 patients with hematuria to evaluate current diagnostic practice. J Urol. 2000 Feb;163(2):524-7.
  4. Thompson IM. The evaluation of microscopic hematuria: a population-based study. J Urol. 1987 Nov;138(5):1189-90.
  5. Harper M, Arya M, Hamid R, Patel HR. Haematuria: a streamlined approach to management. Hosp Med. 2001 Nov;62(11):696-8.
  6. Coxon JP, Harris HJ, Watkin NA. A prospective audit of the implementation of the 2-week rule for assessment of suspected urological cancers. Ann R Coll Surg Engl. 2003 Sep;85(5):347-50.
  7. Golin AL, Howard RS. Asymptomatic microscopic hematuria. J Urol. 1980 Sep;124(3):389-91.
  8. Ghani RK, Keeler B, Nargrund A. Haematuria 2: imaging investigations, management and follow up. British Journal of Hospital Medicine, 2007 68:9, 489-493.
  9. McDonald MM, Swagerty D, Wetzel L. Assessment of microscopic hematuria in adults. Am Fam Physician. 2006 May 15;73(10):1748-54.
  10. Hicks D, Li CY. Management of macroscopic haematuria in the emergency department. Emerg Med J. 2007 Jun;24(6):385-90.
  11. Murakami S, Igarashi T, Hara S, Shimazaki J. Strategies for asymptomatic microscopic hematuria: a prospective study of 1,034 patients. J Urol. 1990 Jul;144(1):99-101.
  12. Sugimura K, Ikemoto SI, Kawashima H, Nishisaka N, Kishimoto T. Microscopic hematuria as a screening marker for urinary tract malignancies. Int J Urol. 2001 Jan;8(1):1-5.
  13. McCartney MM, Gilbert FJ, Murchison LE, et al. Metformin and contrast media–a dangerous combination? Clin Radiol. 1999 Jan;54(1):29-33.
  14. Sutton JM. Evaluation of hematuria in adults. JAMA. 1990 May 9;263(18):2475-80.

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