Open Access

ARTICLE

What is significant hematuria for the primary care physician?

Roland I. Sing, Rajiv K. Singal

Division of Urology, Department of Surgery, University of Toronto-Toronto East General Hospital, Toronto, Ontario, Canada
Address correspondence to Dr. Rajiv K. Singal, Department of Urology, Toronto East General Hospital, 840 Coxwell Avenue, Suite 218, Toronto, Ontario M4C 5T2 Canada

Canadian Journal of Urology 2012, 19(Suppl.5), 36-41.

Abstract

Hematuria is a common finding in primary care practice. Causes of significant hematuria include urinary tract infection, urolithiasis, malignancies, benign prostatic hyperplasia, and nephropathies. Hematuria is identified by taking a patient history and by performing a routine urine dipstick test. If a patient has a history of gross hematuria and/or a positive urine dipstick test, he or she should then have a microscopic urinalysis. The primary care physician can order ancillary tests such as laboratory tests to assess renal function, and possible imaging tests such as ultrasound, computed tomography urography, or magnetic resonance urography. The patient may be referred to a nephrologist or urologist for further assessment if required. Cystoscopy may be considered. Even if the patient has a negative work up, guidelines recommend that primary care physicians follow the patient semi-annually for 3 years.

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