A Study On Differential Diagnosis Related To Haematuria In Urological Practice In A Tertiary Care Hospital

Abstract

Background:  Haematuria is the presence of red blood cells in urine, a common clinical finding with multiple differential diagnosis and it can often be a diagnostic dilemma. It serves as a key feature in numerous urological and nephrological disorders. In the differential diagnostics, haematuria is typically classified as painful or painless, and further distinguished as gross haematuria, visible to the naked eye or microhaematuria, detectable only under microscope. The underlying causes are broadly divided into pre-renal (haematological), renal (glomerular) and non-renal (non-glomerular) origins. To avoid missing early indicators of malignant or significant benign conditions, while at the same time avoiding unnecessary investigations, a structured differentiated approach is imperative. This article provides a clear and practical framework to identify patients with clinically significant haematuria and cases those requiring urgent urological intervention.

Methods: This descriptive type of cross sectional study was carried out at Combined Military Hospital, Dhaka with a duration of 12 months from 01 July 2022 to 30 June 2023. A total of 100 respondents were included who presented either with gross or microscopic haematuria in the said duration. Cases were chosen by purposive sampling from patients who reported to urology outpatient department (OPD) or admitted in inpatient ward.

Results:  Of the 100 patients, 74% were male and 26% female (ratio 3:1). The highest frequency was observed in the 51-60 years age group (28%). Malignancy accounted for the majority of cases (55%), followed by urolithiasis (21%) and benign prostatic hyperplasia (9%). Among malignancies, transitional cell carcinoma of the urinary bladder (TCC UB) was the predominant type (65.45%).

Conclusion: The occurance of haematuria should always be given utmost importance in urologic practice. A high index of suspicion regarding all potential aetiologies is needed to deal every single case.

Bangladesh Armed Forces Med J Vol 58 No (2) December 2025, pp 66-72