Surgery pp 533-543 | Cite as

Blood in Urine


A 68-year-old Caucasian man presents to the emergency department complaining of blood in his urine as well as small blood clots for 3 days. He denies dysuria, nocturia, urinary frequency or hesitancy, or a decreased urinary stream. He denies any fevers, chills, or weight loss. He has had similar episodes of visible blood in his urine in the last several months and has been treated twice with antibiotics for a possible urinary tract infection without improvement. He has a history of hypertension for which he takes a beta-blocker; otherwise he has had no surgeries and takes no other medications. He denies any family history of malignancy or renal disease. He denies any history of trauma and does not vigorously exercise. He has a 40-pack-year history of smoking and worked as a painter. On physical exam, he is afebrile with normal vital signs. His abdomen is soft, without any palpable masses. His genitourinary exam reveals a normal circumcised phallus without lesions and normal bilateral descended testicles. On digital rectal exam, his prostate is small without any nodularity, induration, or tenderness. On laboratory exam, his hematocrit is 42 %, creatinine is 1.0 mg/dL, INR and PTT are normal, and PSA is 2 ng/dL. His urinalysis shows a large number of red cells, no white cells, no casts, and no bacteria.


Hematuria Nephrolithiasis BPH Bladder Cancer Painless PSA Nephrectomy Cystectomy Prostatectomy 

Suggested Reading

  1. Cohen RA, Brown RS. Clinical practice. Microscopic hematuria. N Engl J Med. 2003;348:2330.CrossRefPubMedGoogle Scholar
  2. Khadra MH, Pickard RS, Charlton M, et al. A prospective analysis of 1,930 patients with hematuria to evaluate current diagnostic practice. J Urol. 2000;163:524.CrossRefPubMedGoogle Scholar
  3. Nakamura K, Kasraeian A, Iczkowski KA, et al. Utility of serial urinary cytology in the initial evaluation of the patient with microscopic hematuria. BMC Urol. 2009;9:12.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Urology, Renal Transplantation, Department of SurgeryHarbor-UCLA Medical CenterTorranceUSA
  2. 2.Department of UrologyDavid Geffen School of Medicine at UCLALos AngelesUSA

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