60 yr old male with total painless gross hematuria .Inv of choice to know the cause of hematuria would be
|D||Urine for malignant cells|
a. Hematuria, is the presence of red blood cells (erythrocytes) in the urine.
b. It may be idiopathic and/or benign, or it can be a sign that there is a kidney stone or a tumor in the urinary tract (kidneys, ureters, urinary bladder, prostate, and urethra, ranging from trivial to lethal.
c. If white blood cells are found in addition to red blood cells, then it is a signal of urinary tract infection.
d. USG investigation of the renal tract is often used to distinguish between various sources of bleeding.
e. X-rays can be used to identify kidney stones, although CT scanning is more precise.
Note: As in this case it is very clear that patient has gross hematuria i.e. it is visible red color urine due to RBCs in the urine, so in this case best next line of investigation should be USG
a. The presence of WBCs, leukocyte esterase, and nitrites points to an infectious process that should be confirmed by urine culture and treated with antibiotics.
b. The presence of significant proteinuria, red cell casts, and dysmorphic RBCs requires nephrology consultation for an intrinsic renal process.
c. Older patients with painless, gross hematuria should be considered at high risk for malignancy, and urine cytology should be performed
d. A serum creatinine is used to assess baseline renal function and suitability for radiographic studies that require IV contrast. A CBC is helpful for evaluating potential anemia and for the presence of infection.