Hematuria history and symptoms

Jump to navigation Jump to search

Hematuria Microchapters


Patient Information



Historical Perspective




Differentiating Hematuria from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings



Echocardiography and Ultrasound



Other Imaging Findings

Other Diagnostic Studies


Medical Therapy



Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hematuria history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Hematuria history and symptoms

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hematuria history and symptoms

CDC on Hematuria history and symptoms

Hematuria history and symptoms in the news

Blogs on Hematuria history and symptoms

Directions to Hospitals Treating Hematuria

Risk calculators and risk factors for Hematuria history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2] Steven C. Campbell, M.D., Ph.D. Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3]


History and symptoms of hematuria depend on the etiology. The history should also include an assessment of associated symptoms, such as gross hematuria, voiding symptoms, or flank pain. Patients' risk factors for known causes of hematuria also should be queried. It is important to know the patient's urologic history, particularly any surgeries or febrile UTIs. It is also critical to ask about the patient's general medical history, to identify potentially contributory diagnoses, such as hypertension, renal insufficiency, bleeding disorders, or sickle cell disease. Current medication use, including anticoagulants and antiplatelet therapies, should be elicited, along with recent coagulation values and any concomitant medications that would potentiate the effects of blood thinners. Family history of nephritis, polycystic kidneys, and rare familial tumor syndromes of the kidney (e.g., von Hippel-Lindau) or urothelium (e.g., Lynch syndrome) also may be informative.[1]

History and Symptoms

Medical history is crucial for the diagnostic evaluation of hematuria. Medical history can be detailed depending on the type of hematuria (microhematuria/gross).[2]

  • Microhematuria more commonly caused by glomerulopathys, urinary tract infection, benign prostate hypertrophy, and kidney stones, however, rulling out urinary tract cancer is crucial for evaluation.
    • Medical history should include the presence or absence of recent urinary tract infection, menstruation, sex, and urinary tract instrumentation to rule out these conditions while they might be the potential cause of hematuria.
  • Medical history for the evaluation of gross (visible) hematuria should include the following:
    • Trauma
    • Urinary tract infection
    • Kidney stone
    • Surgical procedures and complications
    • Anticoagulant usage
    • Strenuous exercise (i.e., marathon running)
    • Voiding pattern (e.g., frequency, dribbling after urination, urgency, urinary retention, etc.)
    • Suprapubic pain
    • Flank pain

History and symptoms of hematuria according to its cause can be seen in the table below:

Cause of hematuria[1]
History and symptoms
Ruptured abdominal aortic aneurysm
  • Recent onset of severe, constant back, abdominal, or leg pain
  • signs of vascular collapse and shock
  • Tenderness in the costovertebral angle and flank
Clots with obstruction
  • History of hemodynamically significant bleeding
  • Present with acute urinary retention present with inability to void.
Renal infarction
  • Present with accelerated hypertension, loin or flank or abdominal pain
Trauma—renal or urogenital laceration or rupture
  • History of motor vehicle accident.
  • Present with urgency to void and will generally be unable to do so.
Bleeding diathesis
  • Bladder
  • Prostate
  • Ureter
  • Kidney
Male gender, Age older than 35 years, Past or current smoking history, Occupational or other exposure to chemicals or dyes (benzenes or aromatic amines), Analgesic abuse, History of gross hematuria, History of urologic disorder or disease, History of Irritative voiding symptoms, History of pelvic irradiation, History of chronic urinary tract infection, Exposure to known carcinogenic agents or chemotherapy such as alkylating agents, History of chronic indwelling foreign body.

Obstructive symptoms, pain, bloody discharge.

  • History of urinary tract stones.
  • Present with severe abdominal, back, or flank pain
  • History of Upper respiratory tract infection, gastroenteritis, synchronous association of pharyngitis, children
  • Hypertension, azotemia, dysmorphic erythrocytes, cellular casts, proteinuria.
  • Symptoms of renal dysfunction such as malaise, fatigue, shortness of breath, and edema
  • Signs may include hypertension and signs of volume overload such as distended jugular veins, lung crackles, S3 gallop, and leg edema
Urinary tract infection
Benign prostatic enlargement
  • Male with elderly age.
  • Present with obstructive symptoms.
Polycystic kidney disease
  • Family history of renal cystic disease
Uretero-pelvic junction obstruction
  • History of UTI, stone, flank pain
Ureteral stricture
  • History of surgery or radiation, flank pain, hydronephrosis; stranguria, spraying urine
Urethral diverticulum
  • Discharge, dribbling, dyspareunia, history of UTI, female predominance
  • Pneumaturia, Fecaluria, abdominal pain, recurrent UTI, history of diverticulitis or colon cancer
Exercise-induced hematuria
  • Recent vigorous exercise
  • Cyclic hematuria in a menstruating woman
Papillary necrosis
  • African-American, sickle cell disease, diabetes, analgesic abuse
Interstitial cystitis
  • Voiding symptoms


  1. 1.0 1.1 Wein, Alan (2016). Campbell-Walsh urology. Philadelphia, PA: Elsevier. ISBN 978-1455775675.
  2. Ingelfinger, Julie R.; Longo, Dan L. (2021). "Hematuria in Adults". New England Journal of Medicine. 385 (2): 153–163. doi:10.1056/NEJMra1604481. ISSN 0028-4793.

Template:WH Template:WS