Hematuria; its Clinical Significance

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Hematuria, although one of the more common symptoms of urinary disease, is frequently underestimated in its importance by the patient and often, unfortunately, by his physician. It should be emphasized that the presence of blood in the urine is not a clinical entity or disease per se, but rather a sign of an existing pathologic lesion requiring immediate and exhaustive investigation to determine the underlying etiologic factors.

Usually, the presence of gross blood in the urine is sufficiently alarming to cause the patient to seek medical advice. However, when the hematuria is intermittent, the cessation of the bleeding lulls the patient into a false sense of security; he may presume he is well. To the physician, however, this subsidence of hematuria is no indication that its significance is to be minimized. A complete urologic investigation should not be delayed.

Frequently, hematuria is the outstanding symptom. Often it is the only complaint, and at other times the blood may be only found upon microscopic examination. Fortunately, the bleeding in many instances is associated with concomitant symptoms. The presence of other symptoms often causes the individual to seek investigation and medical advice earlier than does the recognition of blood in the urine, although from the urologic point of view, the latter may be more serious. First among the symptoms is pain. Other complaints accompanying the hematuria may be burning and frequency of urination, chills and fever, sweats, the presence of a mass, loss of weight, history of trauma, etc.

MacKenzie1 reported an. . .



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