Unilateral essential hematuria.

At the Mayo Clinic between 1961 and 1975, 54 patients presenting with gross hematuria had "essential hematuria" of unilateral origin diagnosed. Criteria for this diagnosis included normal findings on excretory urogram, unilateral bleeding demonstrated at cystoscopic examination, the absence of infection, and a negative history for bleeding diathesis, analgesic abuse, renal surgery, or trauma. Of these patients, 52 responded to follow-up inquiry; 2 died of unrelated causes. Ancillary studies such as renal arteriography, renal biopsy, and repeated excretory urography and cystoscopic examinations were not helpful in establishing a cause, and no explanation for the hematuria was ever found in any of these patients. Although contributing no information as to the cause of unilateral essential hematuria, the study suggests that the patient who fulfills the above criteria need not undergo an extensive workup beyong excretory urography and cystoscopy and that repeated examinations are unnecessary and unrewarding. Most patients continue to do well despite intermittent or persistent hematuria. Essential unilateral hematuria probably is a benign condition that seldom requires surgical intervention.