Hematuria (blood in the urine), either microscopic or gross (blood only we can see or blood you can see), is a red flag that should not be ignored. It is the most common early finding of urinary cancer and renal disease. At Regional Urology we see many patients referred by their primary care doctors for evaluation of hematuria.

Hematuria can be caused by non cancerous problems such as infection, stones, prostate enlargement in men, kidney disease, trauma, excessive exercise, anticoagulants, or be idiopathic without a known cause.

At Regional Urology we evaluate hematuria in a manner to locate the source and exclude cancer. First we obtain a detailed history that includes asking about the details surrounding the hematuria and what urinary symptoms accompany it such as painful urination. We are interested in whether you are having back or flank pain. The history also includes excluding risk factors for GU (genitourinary) cancers such as age > 50, tobacco use, chronic chemical or petro chemical exposure and family history. Other important details include your medicines, the use of aspirin or anticoagulants, prior radiation therapy, chemotherapy, and clot passage.

In-house laboratory studies include close microscopic inspection of the urine for infection and/or a urine culture as infection, especially in women, can be a frequent cause.

When unsure as to the cause, especially where there is a concern about risk factors for cancer, we will proceed with a CT scan, cytology (urine exam for cancer cells), and cystoscopy which can be done here at Regional Urology as an outpatient in several hours to avoid the costlier and inconvenient hospital setting.

No matter what the source, we are prepared to offer timely evaluation, outpatient workup, and an immediate course of treatment, whether it be an antibiotic for infection, shock wave lithotripsy for stone, or state of the art endoscopic or robotic laparoscopic surgery for GU cancers. If hospitalization is necessary, we are on all the local staffs and go to your hospital.

Hopefully, the underlying condition is not serious and no treatment or simply regular follow-up is needed.

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