MBBS, Urology Registrar, Western Health, Vic; Urology Research Fellow, Peter MacCallum Cancer Centre, Vic; Urology Research Fellow, Austin Health, Vic.
MBBS, Urology Research Fellow, Austin Health, Vic.
Aust J Gen Pract. 2021 Jul;50(7):467-471. doi: 10.31128/AJGP-03-21-5892.
The presence of haematuria may be a singular symptom signalling underlying urological pathology, either benign or malignant. However, a large proportion of patients with haematuria will have no identifiable cause found. Appropriate early investigation and management of haematuria in the primary care setting is important for timely referral of patients suspected of having serious underlying pathology while avoiding over-investigation in those patients prone to transient and benign causes.
The aim of this article is to provide a summary of the aetiology, investigation and management of haematuria in the primary care setting, with a focus on urological assessment and outcomes.
The approach to the diagnosis and investigation of haematuria differs depending on whether the haematuria is macro- or microscopic. In both cases, clinicians should begin by obtaining a careful patient history to include specific risk factors for urological malignancy, as often the decision for further work-up requires a risk-stratified approach.
血尿可能是一种单一的症状，提示存在泌尿系统的良性或恶性病变。然而，很大一部分血尿患者找不到明确的病因。在初级保健环境中，对血尿进行适当的早期检查和管理对于及时转诊疑似存在严重潜在疾病的患者很重要，同时避免对那些易出现短暂和良性原因的患者进行过度检查。
本文旨在概述初级保健环境中血尿的病因、检查和管理，重点介绍泌尿系统评估和结局。
血尿的诊断和检查方法因血尿是肉眼血尿还是镜下血尿而异。在这两种情况下，临床医生都应首先仔细询问病史，包括泌尿系统恶性肿瘤的特定危险因素，因为通常进一步检查的决策需要进行风险分层。
