How should a patient with hematuria be evaluated?
The upper and lower urinary tract of a patient with hematuria should be evaluated for stones, neoplasms, and other abnormalities that may cause hematuria. The upper urinary tract is usually evaluated with CTU for this purpose, as it is much more sensitive than IVU in diagnosing renal parenchymal abnormalities and in detecting small renal masses. The collecting systems are also satisfactorily evaluated with CTU. The urinary bladder is best evaluated with cystoscopy; all imaging studies are much less sensitive in showing pathologic conditions of the bladder compared to direct inspection by cystoscopy.