Asimtomatik micros hematuria

History, PF, Urinalisis, Cultur :
1. Medical renal bleeding (glumerular)
                   ß
      Clearen Cr.
             Protein 24 jam
             USG ren
                   ß
             Serial evaluation
             a. Renal faillure ¯   à renal biopsi
             b. No renal deterioration  à serial evaluation
 
2. Sign of infection (cultur +)
                   ß
             Th/  UTI
                   ß
             repeat urinalisis
 
3. Cytologi urin, IVU, USG renal
      a. Abnormal à additional evaluation, th/sesuai causa
      b. Normal :
§   Low risk (age 40, rokok+, citologi+) à cystoskopi
 
 
 
 Causes of asymptomatic micros hematuria :
1. Highly significant :
§    Bladder Ca
§    Renal cell Ca
§    Ca Prostate
§    Ureteral, renal  calculus
§    Hydronefrosis
§    Renal artery stenosis
§    Renal lymphoma
§    Renal / ureteral TCC
§    Renal parenchim disease
2.  Moderately significant :
§    Renal calculus
§    Bacterial cystitis
§    Reflux vesikoureteral
§    Interstitial cystitis
§    Bladder divertikel
§    Bladder calculus
§    UPJ obstruksi
§    Radiatiion cystitis
§    Renal contusio
§    Renal parenchim disease
§    BPH, prostatitis
§    Polikistik kidney
§    Striktur uretra.
 
 
Causes of bacterial persistence in women :
§   Infection stone
§   Ureteral duplication
§   Urothelial polip
§   Infected atropi kidney
§   Divertikel uretra
§   Infected parauretral gland
§   Urachus anomali
§   Medullary sponge kidney
§   Fistel
§   Papillary necrosis
 
The Most Common Causes of Hematuria by Age and Sex
——————————————————————————
0-20 Years
Acute glomerulonephritis
Acute urinary tract infection
Congenital urinary tract anomalies with obstruction
20-40 Years
Acute urinary tract infection
Stones
Bladder tumor
40-60 Years (males)
Bladder tumor
Stones
Acute urinary tract infection
40-60 Years (females)
Acute urinary tract infection
Stones
Bladder tumor
60 Years (males)
Benign prostatic hyperplasia
Bladder tumor
Acute urinary tract infection
60 Years (females)
Bladder tumor
Acute urinary tract infection