Xinying Shen1. 1. Adult Acute Care Nurse Practitioner Program, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. xinyings@yahoo.com
Abstract
PURPOSE: To present a logical and cost-effective diagnostic approach for primary care physicians to a common symptom, hematuria. DATA SOURCE: Selected research, review articles, as well as medical textbooks and current government guidelines. CONCLUSION: Dipstick test and microscopic urinalysis are two common screening tests for hematuria. Once hematuria is discovered, its etiology should be investigated through a comprehensive history, a focused physical examination, laboratory studies, and radiographic imaging. Microscopic urinalysis is simple yet important in distinguishing glomerular from nonglomerular sources of bleeding. Intravenous urography, renal ultrasonography, or computed tomography may be needed to determine the location and characteristics of lesions. Cytoscopy is important in evaluating lower urinary tract lesions. IMPLICATIONS FOR PRACTICE: Hematuria is a frequently encountered symptom that has a broad differential diagnosis ranging from insignificant etiology to potentially life-threatening neoplastic lesions. A systematic method can be useful in efficiently and cost-effectively managing hematuria. Early and appropriate diagnosis of this common symptom results in improved clinical outcomes.
PURPOSE: To present a logical and cost-effective diagnostic approach for primary care physicians to a common symptom, hematuria. DATA SOURCE: Selected research, review articles, as well as medical textbooks and current government guidelines. CONCLUSION: Dipstick test and microscopic urinalysis are two common screening tests for hematuria. Once hematuria is discovered, its etiology should be investigated through a comprehensive history, a focused physical examination, laboratory studies, and radiographic imaging. Microscopic urinalysis is simple yet important in distinguishing glomerular from nonglomerular sources of bleeding. Intravenous urography, renal ultrasonography, or computed tomography may be needed to determine the location and characteristics of lesions. Cytoscopy is important in evaluating lower urinary tract lesions. IMPLICATIONS FOR PRACTICE: Hematuria is a frequently encountered symptom that has a broad differential diagnosis ranging from insignificant etiology to potentially life-threatening neoplastic lesions. A systematic method can be useful in efficiently and cost-effectively managing hematuria. Early and appropriate diagnosis of this common symptom results in improved clinical outcomes.