Quick Case: Painless Haematuria


A male patient presented with painless haematuria. In this patient there was no evident clue to diagnosis, so investigations were asked.

Renal cell carcinoma is the most common type of kidney cancer in adults. Renal cell carcinoma may remain clinically occult for most of its course. Only 10% of patients present with the classic triad of flank pain, haematuria, and flank mass. The treatment options for renal cell cancer are surgery, radiation therapy, chemotherapy, hormonal therapy, immunotherapy, or combinations of these.

Case Report

Male Patient, 50 years old with a past history of hypertension


Presented Complaint: Haematuria (Blood in urine)


On one fine Sunday morning on a holiday, male patient aged 50 years presented to me with complain of blood in urine since the last night. There was no pain during urination. He was properly examined, and his vitals were normal. Pulse, blood pressure – all the things were normal. On abdominal examination nothing particular was found and there was no tenderness in any area. He was not taking any drugs which could be the cause of this bleeding. The first and foremost possibility in this kind of case is stone disease. The only against this was that there was no pain. He was immediately subjected to ultrasound of kidneys. The result was more than expected. He was having tumor in his right kidney. He was immediately referred to a urologist.

Management and Follow-Up

Patient was diagnosed to have renal cell carcinoma. He was operated upon and is now doing fine.

About The Author

Dr. Vachharajani is an experienced practicing family physician in Ahmedabad, Gujarat, with a special interest in obesity and lifestyle-related disorders. With a genuine passion and enthusiasm for healthcare information technology (HIT), he has championed the cause of using HIT in day-to-day clinical practice. In addition to his, MBBS, he holds a post-graduate certificate in environmental and occupational health (PGDMCH).

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    Posted Sep 2013 at 4:02 am | Permalink

    Painless hematuria is common in the place i am working in kerala, as the incidence of renal calculi is very high especially during summer,feb to june. what we have found is that painless hematuria can be difficult to manage, if UGS shows normal kidneys and bladder ! can BPH cause hematuria ?

  2. Gyanendra Sharma
    Posted Sep 2013 at 1:23 am | Permalink

    BPH can cause painless hematuria. However all other causes should be excluded before one makes the diagnosis that the cause of hematuria is BPH
    The 3 most common causes of painless hematuria are Trauma Tumor Tuberculosis
    Also some medical conditions like IgA nephropathy can also cause painless hematuria
    USG as the sole modality to diagnose the cause of hematuria may lead to a missed diagnosis as high as 30% of times

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