The Significance of Hematuria in Young Men

Unexplained Hematuria

“…An extensive evaluation may uncover additional information in approximately half of the patients, but these le¬ sions will not be of a serious nature or require fur¬ ther therapy in most instances. The clinician must decide on the basis of the ( 1 ) severity of bleeding, (2) likelihood of obtaining significant information, and (3) probability of complication whether to pro¬ ceed with the evaluation. Whatever the decision, occult disease may become evident, and these pa¬ tients should be seen regularly by their physicians.…”

“…This communica¬ tion evaluates the benefit of an exhaustive evalua¬ tion of these patients by answering the following questions: (1) With all diagnostic measures avail¬ able, how often will an explanation for hematuria be found? (2) How productive are these tests and procedures, and is the cost in the terms of the pa¬ tient's time, money, and discomfort worthwhile? (3) What is the most likely cause of the bleeding, and what are its implications for the patient?…”

“…(3) What is the most likely cause of the bleeding, and what are its implications for the patient? Method A request was sent to all Army hospitals in the Fourth Army area (Arkansas, Oklahoma, Texas, Louisiana, and New Mexico) to send to Brooke General Hospital all patients meeting these cri¬ teria: (1) documented persistent hematuria, (2) no proteinuria or casts, and (3) normal excretory urograms and cystoscopic examination results. A cause for the bleeding in many of the patients re¬ ferred to us was uncovered in their admission evalu¬ ation and they were not included in the study.…”

“…Most of those meeting our criteria emanated from the dispensaries and clinics of our own induction center. These patients underwent an evaluation which included (1) the individual's own history of hematuria as well as detailed questioning about conditions known to be associated with blood in the urine (Table 1); (2) physical examination;…”

Role of i.v. urography in patients with haematuria

“…In adults, it must be presumed to be a feature of cancer of the urinary tract until proven otherwise. It is one of the commonest conditions confronting the clinical urologist and gross haematuria, which has a community prevalence of 2.5% (1), is responsible for 4-20% of all urological visits (2) and 3.9-13.6% of all urological admissions (3)(4)(5). With the growing popularity of "fast track" haematuria clinics, the onus is on the urologist to provide a swift diagnosis for those at maximum risk of a life-threatening disease.…”