Haematuria (blood in urine)

Assessment

History: duration, urinary symptoms, trauma or instrumentation, UTIs or schistosomiasis exposure, anticoagulants or herbal medicines, cancer risk (over 40 years, smoking, occupation).
Examination: vital signs (anaemia, shock), flank tenderness, bladder distension or masses, genitalia.
Tests: urinalysis and microscopy (RBC morphology), urine culture, CBC, coagulation profile; ultrasound KUB first, X-ray KUB, CT/IV urography when indicated; cystoscopy for persistent unexplained gross haematuria, especially over 40 years.

Cause	Management
UTI	Antibiotics by local sensitivity (e.g. nitrofurantoin, ciprofloxacin, ceftriaxone), fluids, analgesia
Schistosomiasis	Praziquantel 40 mg/kg single dose
Stones	NSAID analgesia, hydration, referral for lithotripsy or surgery if obstructed or infected
Trauma	Bed rest, analgesia, catheter if retention, surgery if severe
Suspected cancer	Urgent referral for cystoscopy and biopsy
Glomerular disease	Nephrology referral
Coagulopathy	Correct it; transfuse if severe; haematology advice
Obstruction	Relieve by catheter or surgery; monitor kidney function

Supportive care: hydration, monitor vital signs and Hb, transfuse only if indicated, paracetamol or NSAIDs.
Refer: persistent unexplained haematuria, clot retention, suspected malignancy, severe anaemia or instability.

Imeandikwa:

20 Oktoba 2026, 08:09:44

Rejea za mada hii:

Ministry of Health, United Republic of Tanzania. Standard Treatment Guidelines and National Essential Medicines List for Tanzania Mainland (STG & NEMLIT). 7th ed. Dodoma: Ministry of Health; 2026. Chapter 21, Kidney and Urological Disorders: section 21.11.1 Hematuria (Tables 21.31–21.32), pp. 558–559.