Hematuria and other urinary symptoms

B FUN HIDE PISS

B Burning sensation

F Frequency

U Urgency

N Nocturia

H Hematuria

I Imcomplete bladder sensation

D Dribbling

E Episodes in the past?

P Painful urination/Painful CVA/Pyuria/Prostate exam in the past?

S Stream (Is it weak stream?/Straining?

Physical Examination for Hematuria:

Abdominal exam: Auscultation, Palpation, Percussion, Check for CVA tenderness.

Cardiovascular exam: Auscultation

Pulmonary exam: Auscultation

Differential Diagnosis for Hematuria:

Nephrolithiasis: Suddenonset of flank pain radiating to the groin, scrotum or vulva, hematuria, dark urin, N/V.

Bladder Cancer: History of taking cydophosphamide, weight loss, older age.

BPH: older age, dysuria, frequency, urgency, Nocturia, dobbling, weak stream, maybe hematuria

Prostate Cancer: older age, Long history of chronic frequenxy, urgencym nocturia, dribbling, weak stream, weigh loss, hematuria

Polycystic kidnery disease: family history, history of HTN, Abdominal mass, Hematuria

Renal Cell Carcinoma: Hematuria, weight loss, older age

Glomerulon ephritis: Hematuria, HTN, Edema

IgA nephropathy: most common glomerulonephritis, gross hematuria after 1 to 2 days upper respiratory.

Pyelonephritis: Dysuria, fever, flank pain, hematuria, Positive CVA tenderness

UTI: Dysuria, frequency, urgency, pelvic pain, hematuria.

Coagulation disorder: history of bruising.

Diagnostic Work up for Hematuria

Genital exam
Rectal exam (check for BPH or Prostate Cancer)
Urinalysis
PSA
CBC, PT/PTT
Urine Culture
Urine cytology
Kidney ultrasound
BUN/Cr
Cystoscopy
CT of abdomen/pelvis