Page 2 - Hematuria

Hematuria

A urine culture may be performed if a urinary infection Cystoscopy involves passing a thin “scope” through
is suspected. Cells which are normally shed in the urine the urinary tube (urethra) into the bladder to visually
can be examined microscopically (urine cytology). inspect the lower urinary system. Sometimes an x-ray
Occasionally, the appearance of these cells will of the kidneys is performed at the same time. The
suggest the possibility of a tumour growing in the procedure generally takes only a few minutes, usually
lining of the urinary system. If such cells are found, the with minimal discomfort. Cystoscopy will reliably
source must be identified. identify a bladder tumour. Cystoscopy may be
omitted in most children and young healthy adults in
Other blood and urine tests may be added to further whom the likelihood of bladder tumours is very low.
assess the cause of hematuria.
In many patients, especially those with microscopic
Imaging studies hematuria, a specific cause of blood in the urine is
not found. If all of the examinations including urine
Examination of the kidneys is often an important part tests, imaging studies of the kidneys and cystoscopy
of the investigation of hematuria. Imaging studies are normal, the risk of having a serious underlying
are used to “see” the details of kidney anatomy. condition is extremely low. Follow-up through your
Ultrasound can examine the kidneys painlessly family physician can ensure that any changes are
with sound waves. Intravenous pyelography (IVP) identified promptly.
in which a contrast “dye” is injected intravenously
and excreted by the kidneys will clarify the kidney If visible urinary bleeding recurs, these tests may need
drainage system anatomy. A CT scan or MRI will give to be repeated. Additional tests may be requested,
a more detailed view of the kidneys. Your doctor will including specialized imaging of the kidneys or their
determine which imaging study is most appropriate blood vessels and visual inspection of the kidney
for your circumstances. drainage systems.
Even if assessment is required, the common problem
Cystoscopy of microscopic hematuria in men and women is
often not related to any significant problem. In some
Although imaging studies are very accurate in people, a few blood cells leak through the filter of
detecting major problems in the kidneys, such as the kidney into the urine, but there is no abnormality
tumours or stones, they are not as useful at examining present. Gross hematuria suggests a much higher
the bladder and its outlet. For this reason, a minor likelihood that some disorder is present.
outpatient procedure called a cystoscopy is often
recommended to complete your investigation.

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