The Clinical Significance of Hematuria
Hematuria, or the presence of blood in the urine, should not be considered as a clinical entity for which treatment is instituted, but rather as a symptom which requires immediate investigation to ascertain the underlying, responsible, etiologic factors.
As a general rule, the presence of blood in the urine alarms the patient sufficiently that he seeks medical advice and relief. However, it is unfortunate that, in many instances, the hematuria is intermittent in character and, when the bleeding subsides, a false sense of security is established. The patient presumes that he is well and, as his general health may not seem to be impaired, he appears justified in such deductions. But to the physician, the cessation of bleeding is no indication that its significance can be minimized or its importance lessened and a delay in complete urological investigation should not be countenanced.
Herman1 of Philadelphia, in a study of 150 cases of diseases of the kidney, noticed the presence of hematuria in 43.3 per cent of this group. It is estimated that in 54 per cent of renal tumors in adults, the initial symptom is hematuria.
In a recent survey of cases of tumor of the bladder collected by the Carcinoma Registry of the American Urological Association2, hematuria was the cardinal symptom in 826 of the 902 cases in the Registry, and it was the initial symptom in 573 or 69.37 per cent of the 826 patients who complained of bleeding.
In a series of 798 consecutive cases of hematuria. . .