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| Hematuria is the presence of blood cells in the urine. Gross hematuria is when blood is visible in the urine. Microscopic hematuria is defined as 3 or more red blood cells per high-powered field in a properly collected urine sample.
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| Hematuria is the presence of blood in the urine and is a common condition in urological practice. It accounts for around 20% of urological referrals and is important, as it can be a cardinal symptom of urological malignancy. Around 40% of patients investigated for hematuria are found to have significant underling pathology, half of whom will have a urological malignancy. Therefore, all patients presenting with a single episode of haematuria require urgent investigation. Haematuria in adults should be regarded as a symptom of urological malignancy until proven otherwise.
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| == Classification ==
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| ===== Classification by the extent of hematuria =====
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| # '''Dipstick hematuria:''' Detection of hemoglobin within red blood cells using reagent strips in macroscopically normal urine.This describes the use of reagent strips to detect blood chemically within urine.
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| # '''Microscopic hematuria:''' Defined as the presence of more than two to five red blood cells per high powered field within macroscopically normal urine on a properly collected urinary specimen in the absence of an obvious benign cause.<ref name="pmid23098784">Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=23098784 Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline.] ''J Urol'' 188 (6 Suppl):2473-81. [http://dx.doi.org/10.1016/j.juro.2012.09.078 DOI:10.1016/j.juro.2012.09.078] PMID: [https://pubmed.gov/23098784 23098784]</ref>
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| # '''Macroscopic hematuria:'''
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| ===== Classification by the visibility of hematuria =====
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| # '''Visible hematuria:''' Visible hematuria can be visualized with the naked eye and is also known as frank, gross or macroscopic hematuria. Visible hematuria is more likely to be associated with malignancy.
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| ## '''Initial hematuria:''' May indicate urethral pathology
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| ## '''Terminal hematuria:''' Hematuria at the end of the stream that comes from the proximal urethra (bladder neck/prostate).
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| ## '''Complete hematuria:''' Hematuria throughout the entire stream suggests bladder, ureteric or renal pathology.
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| # '''Non-visible hematuria:''' Non-visible hematuria encompasses dipstick and microscopic hematuria.<ref>{{cite web |url=http://www.surgeryjournal.co.uk/article/S0263-9319(10)00199-7/abstract |title=www.surgeryjournal.co.uk |format= |work= |accessdate=}}</ref>
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| ===== Classification by the duration of hematuria =====
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| # '''Transient hematuria:''' A single urinalysis with hematuria is common and can result from menstruation, viral illness, allergy, exercise, fever, or mild trauma.
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| # '''Persistent or Significant hematuria:''' >3 RBCs/HPF on three urinalyses, a single urinalysis with >100 RBCs, or gross hematuria.
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| === Age: ===
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| Young patients are more likely to have intrinsic renal pathology (i.e. glomerulonephritis whereas malignancy is more common in the elderly).
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| === Sex: ===
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| Malignancy of the bladder and kidney is at least twice as common in males than in females. Women are more commonly affected by urinary tract infections.
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| == References ==
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