Causes of Macroscopic Haematuria and their Evaluation from the Aspectof the Urologist

Overview

The objective of the presented retrospective study was an analysis of the most frequent causesof macroscopic haematuria and their subsequent treatment. The authors analyzed also thecauses of macroscopic haematuria when anticoagulant treatment is used. From a clinicaldatabase 86 patients were selected (30 women and 56 men) hospitalized on account ofmacroscopic haematuria with an obscure aetiology. The mean age of the patients was 70 years.After a detailed clinical examination of the patients in 29 (33.7%) malignant disease of theurogenital tract was diagnosed, in 46 patients (53.5%) benign disease of the urogenital tractand in 11 patients (12.8%) no abnormality of the urogenital tract nor the source of haemorrhagewas found. In 50 patients (58%) conservative treatment was indicated, in 36 patients (42%)surgical treatment, depending on the diagnosed cause. In 11 patients (12.8%) an abnormalprothrombin time was recorded. All these patients used oral drugs - Warfarin or Pelentan. Themean INR value of Quick™s test in these patients was 4.25, i.e. significantly higher than thetherapeutic range indicated in these patients. In view of the not negligible number of detectedmalignant and benign diseases, every case of haematuria calls for proper urological examinationaccording to a correct examination algorithm. It is important to persuade the patients on thenecessity of completed examination even if all complaints recede.

Key words:
haematuria - anticoagulants.