“Essential Hematuria” — An Obsolete Term

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THE term “essential hematuria” was coined to denote a condition in which the etiologic factor eludes detection. The definition of essential hematuria as cited in Dorland’s Illustrated Medical Dictionary1 conveys the impression of a clinical entity, for it states: “essential hematuria, hematuria for which a cause cannot be determined.” To imply to our medical colleagues the existence of such an entity is fraught with danger, when incontrovertible proof of such a disease remains a nebulous uncertainty.

As years have elapsed since the introduction of the expression in urologic nomenclature, it has been employed to describe the condition of patients with hematuria of undetermined origin, although case reports themselves may reveal lack of a complete, comprehensive, general diagnostic survey. An accurate appraisal of this so-called entity in more recent years permits seasoned conclusions to be quoted without the fear of one’s being designated a disputative philosopher.

Progress in clinical medicine and research, enhanced by the ever-restless inquisitiveness of the investigator and by curiosity concerning the sciences, has gradually and subtly been rewarded by clarification of the etiologic factors responsible for hematuria. Yes, the term “essential hematuria” is sinking into the opalescent sea of the unknown.

The diagnostician’s inability to ascertain the contributing factor or factors responsible for the production of renal bleeding is, unfortunately, oftentimes due to sins of omission. Even as our medical colleagues, all too frequently, fail to evidence the fervid enthusiasm of urologists for complete urologic survey (preferably at the time that the patient observes blood in the. . .



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