J Korean Med Assoc.  2023 Jun;66(6):363-373. 10.5124/jkma.2023.66.6.363.

Urologic malignancies that cause hematuria

• Kim SJ
• Park M
• Yoo S

• KMID: 2543850
• DOI: http://doi.org/10.5124/jkma.2023.66.6.363

Abstract

Background
Hematuria, characterized by red blood cells in the urine, is a clinical symptom that demands an immediate investigation for potential urologic cancers, particularly in cases of gross hematuria. This study seeks to comprehensively review various urologic malignancies causing hematuria, such as urothelial carcinoma, renal cell carcinoma, and prostate ductal carcinoma. The review is anchored on the current urologic clinical guidelines and published literature.
Current Concepts
Gross hematuria commonly signifies urologic cancer, with approximately 20% of gross hematuria cases and 5% of microscopic hematuria cases associated with a urologic cancer diagnosis. Cystoscopy and imaging studies of the upper urinary tract are recommended in patients presenting with gross hematuria, with urine cytology as a potential supplementary test. Conversely, in the presence of microscopic hematuria only, it is advisable to conduct appropriate tests while considering variables such as patient age. When hematuria occurs alongside antithrombotic drug administration, it is crucial not to forego appropriate testing due to the antithrombotic medication. Hematuria is a prevalent symptom of bladder cancer, renal cancer, and urothelial carcinoma; it can also be present in patients with prostate ductal carcinoma.
Discussion and Conclusion
In instances of no urinary tract infection or other discernible cause of hematuria, a consultation with a urologist is recommended, irrespective of the patient’s age. When dealing with patients with urologic cancer, an early diagnosis is a critical factor influencing patient prognosis. Therefore, enhanced attention and a deeper understanding of urologic cancers that can precipitate hematuria are necessary.

Keyword

Hematuria; Urologic cancers; Epidemiology; Diagnosis; 혈뇨; 비뇨기암; 역학; 진단