Haematuria (hematuria ) : causes and initial workup

Hematuria, defined as the abnormal presence of blood in urine, presents in two primary classifications: gross and microscopic. Gross hematuria refers to visible blood in urine, while microscopic hematuria indicates red blood cell (RBC) detection through urinalysis or urine microscopy without apparent visual blood. Hematuria is one of the most commonly diagnosed urological disorders, accounting for over 20% of all urological evaluations .

While there are many classifications of hematuria (e.g., intermittent or constant, glomerular or nonglomerular, symptomatic or asymptomatic), the most clinically useful is gross or microscopic. Hematuria evaluation encompasses a broad spectrum of etiologies, with malignancy being a critical consideration, especially in patients with predisposing factors. This table outlines the broad causes of both gross and microscopic hematuria, helping to guide clinicians in their diagnostic approach.