Letters To The Editor

In reply: Hematuria evaluation

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In Reply: Although a Foley catheter can contribute to macroscopic (gross) hematuria, to assume that it is the cause of the hematuria carries some undefined, but presumably small, risk of missing a more serious diagnosis. A more serious potential for misdiagnosis is in the setting of anticoagulation. As we discuss in our review, hematuria is analagous to hematochezia in the setting of anticoagulants. The possibility that anticoagulation has simply exposed an underlying bleeding source such as a tumor in either setting must not be underestimated, and we recommend that all patients with macroscopic hematuria undergo urologic evaluation unless there is a documented benign physical cause of bleeding such as traumatic catheterization.

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