Case history
Case history
A 64-year-old man presents with painless haematuria. He had a similar episode 1 year ago and was given antibiotics for a presumed urinary infection and his bleeding resolved. He has a decreased urinary stream and nocturia twice a night. He has smoked a pack of cigarettes daily for 45 years. Physical examination shows only moderate enlargement of the prostate. Urinalysis is positive for 10 to 15 red blood cells and 5 to 10 white blood cells per high-power field with no bacteria detected.
Other presentations
Vigilance and proper investigation of haematuria in women is especially important. Women are often diagnosed with more advanced disease, and experience higher disease-specific mortality, partly due to delays in haematuria investigation.[11][12][13] Non-visible haematuria, defined as ≥3 red blood cells per high-power field, may be the only presenting symptom. Carcinoma in situ commonly presents with dysuria and frequency and can easily be confused with prostatitis. Rare presentations include the new onset of frequency, pelvic discomfort, malodourous urine, lower extremity oedema from lymphatic metastasis, weight loss, and abdominal mass.
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