• Haematuria is either "microscopic" or "gross".
  • It can originate from either the upper urinary tract or the lower tract
  • A careful history should be recorded
  • Examination should include a careful exam of the external genitalia, abdomen and flanks
  • Males also require a rectal exam.
  • Urinalysis as well as "culture & sensitivity" should be obtained on all patients with haematuria
  • If there is significant proteinuria in addition to blood in the urine, "medical" renal parenchymal disease is likely, and a referral to a nephrologist may be more appropriate

If Microscopic haematuria:

  • These patients should undergo further investigation with either an IVP or US as an outpatient
  • They should have a urology consult.
  • Cystoscopy will likely be done to further delineate the source of bleeding.
  • The majority of patients with asymptomatic microscopic haematuria will have no identifiable abnormality, but the work-up is necessary in order to pick up the 5% with serious disease


If clinically well MUH patients should be referred to Fast Track clinic (each Tuesday). Others - refer with letter to their GP who can arrange follow up.

Contents by Dr Íomhar O' Sullivan 17/05/2005. Reviewed by Dr ÍOS 26/05/2006, 17/12/2007. Last review Dr ÍOS 13/12/21. MUH Haematuria Fast Track Clinic.