Clinical Assessment – Haematuria

Haematuria can arise from a number of situations.

Exercise haematuria

This can occur after non contact strenuous exercise such as swimming and running. It is caused by blunt trauma of the posterior bladder wall against the trigone. It should settle over 48-72 h and, as long as it does, requires no further investigation.

Factitious haematuria

This is extremely rare and, although all emergency physicians will see the occasional addict seeking opiates, it should only be considered as a diagnosis following comprehensive exclusion of other causes.

Post ejaculatory haematuria

This may be associated with a urethral haemangioma or occur following prostate trauma, such as bicycling on hard saddles.

Learning bite

Free hemoglobin, myoglobin, or porphyrins in the urine result in a positive urine test strip reaction for blood.