Haematuria as the presenting symptom: experience from a tertiary referral centre in Sri Lanka.

ABSTRACT

OBJECTIVES: To examine the causes of macroscopic (gross) haematuria in patients where it is the main presenting symptom and to evaluate the role of cystoscopy in their investigation. DESIGN: Prospective audit. SETTING: One urology unit at the National Hospital of Sri Lanka, Colombo. PATIENTS 174 consecutive new patients with macroscopic haematuria, where haematuria was the presenting symptom. OUTCOME MEASURES: Causes of macroscopic haematuria in the under 40 years and over 40 age groups; role of cystoscopy. RESULTS: Of the 156 (130 male and 26 female) patients evaluated for macroscopic haematuria 67 were under the age of 40 years and 89 over 40. The causes of macroscopic haematuria in the under 40s in descending order of frequency are urinary stone disease, idiopathic and inflamed urothelium. In the over 40 group bladder cancer was the commonest cause, affecting 31.5% of patients, followed by stone disease. CONCLUSIONS: Macroscopic haematuria in a patient over the age of 40 years could be due to bladder cancer and merits cystourethroscopy. In younger patients, urolithiasis is the predominant cause.