The urinary tract in haemophilia.

Scant attention has been paid to changes in the urinary tract in haemophilia, although haematuria, renal colic, the passage of clots and clot retention have long been known. Twenty-eight haemophiliac subjects were investigated with a total of 59 radiological examinations of the urinary tract including 41 intravenous urograms (IVU). In 10 patients (36%) abnormalities were demonstrated in the urinary tract, six patients showed changes of hydronephrosis, one a non-functioning kidney and in two patients blood clots were shown in the collecting system. These abnormalities were more common in clinically severe haematuria, while normal urographic appearances were common in clinically mild cases. The cause of hydroephrosis was extrinsic from compression, either renal or ureteric, or instrinsic from clot retention. In some cases the cause was not known. It is suggested that in these the hydronephrosis may result from organisation of the haematoma with peri-ureteric fibrosis.