Case history
Case history
A 64-year-old man presents with painless hematuria. 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 exam 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
Although bladder cancer is three times more frequent in men, vigilance and proper investigation of hematuria in women is especially important because survival in women is reduced, perhaps due to delay in diagnosis.[11][12][13] Microhematuria, 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, malodorous urine, lower extremity edema from lymphatic metastasis, weight loss, and abdominal mass.
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