Macroscopic Haematuria

Availability

North South North West Statewide

Pre-referral work-up

History

Who is more likely to require a Urologistbefore a Nephrologist?

  • Most patients with macroscopic haematuria will need urogenital lesions excluded in the first instance (especially true for patients >40 years of age and in smokers)
  • All older patients with microscopic haematuria are likely to require urothelial/urogenital causes excluded

All referrals should comply to referral standards and include in particular:

  • Pain
  • Dysuria
  • Associated symptoms (urological, gynaecological)
  • Vaginal examination (females) or Digital Rectal Examination(males) examination
  • History of excessive bruising or bleeding at other sites
  • Blood pressure

Tests

  • MSU micro and culture
  • Urine cytology x3
  • CT Urogram (Standard Protocol)
  • Triphasic CT scan with excretory urogram
  • Electrolytes, Urea, Creatinine, GFR
  • FBE
  • Consider INR and LFTS

Interim/GP management

To refer a patient with this condition, please see the Urology clinic page for the full referral process and templates.

Ensure adequate BP management.Advise on obstructive symptoms and what to do in such circumstances.

For more information please see the Tasmanian Health Pathways website.

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

For microscopic haematuria refer to Nephrology Clinic guidelines

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED
– Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED
– Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED
– Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED
– Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment