<aside> 💡 Gross Hematuria is Bladder cancer until proven otherwise

</aside>

• Microscopic : > 2 RBC on high power
• Gross : can see with naked eyes

S/S

• Painless Hematuria
• Voiding (Obstructive) Sx
• • Abdominal Pain
• Constitutional symptom

DDx

• BPH
• Bladder Stone (Kidney Stone (Urolithiasis)

RF

• Older Adult > 65 (RF)
• Male

Investigation

1. US to ID the bleeder (if actively bleeding)
2. CT with IV contrast (CT urogram) after bleeding resolves
3. Cystoscopy

• Don’t do Biopsy → unnecessary

For < 40 AND No RF, Microscopic Hematuria (? UTI, stone)

• Urine Cytology → Part of UA
• Renal US

For [Gross] OR [> 40 AND/OR RF, Microscopic Hematuria] (? TCC)

• Cystoscopy [Dx]
• CT Urogram
• Urine Cytology→ Part of UA

Treatment

• TUR Trans-urethral resection of Bladder Cancer