ABSTRACT
Haematuria may be caused by bleeding from any part of the renal tract, precipitated by infection, inflammation, neoplasia or other miscellaneous factors. Haematuria may be visible to the naked eye or detected only by microscopy or urine dip testing. Urine may also be discoloured by haemoglobin, myoglobin, porphyrins and a variety of other substances. Emergency Management: Severe haematuria may occasionally cause life-threatening hypovolaemia or anaemia. Provide fluid resuscitation and blood transfusion if required. Correct any bleeding disorder or coagulopathy, including reversal of anticoagulation unless this is essential. Frank haematuria may cause bladder outflow obstruction or urethral catheter occlusion due to blood clots. This should be prevented by providing bladder irrigation via a three-way catheter. Timing of haematuria within the urinary stream: initial haematuria suggests urethral pathology; and terminal haematuria suggests bladder pathology.
