Established practice is to investigate visible haematuria in adults, even if it is painless and has stopped. The work-up usually includes urine culture to exclude infection, imaging of the upper tracts and cystoscopy of the bladder, with the specifics set by local guidelines and the patient's age and risk.
Ask about smoking, occupational exposures, anticoagulant use and prior pelvic radiation, and do not attribute haematuria to anticoagulants without investigating.
- Send a urine culture and check for infection.
- Arrange imaging and cystoscopy according to local guidance.
- Ask about smoking and occupational chemical exposure.
- Do not stop at an anticoagulant as the explanation.
Why it matters
A single episode of visible haematuria is a stronger cancer signal than microscopic findings.
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