Urinary Hematuria: Which Specialist to Consult?

Regarding urinary occult blood?

Hello, if the health check report from your company shows the presence of occult blood in the urine, which department should you visit for a follow-up examination at the hospital? Should it be Family Medicine or Urology?

vicky, 30~39 year old female. Ask Date: 2011/09/01

Dr. Li Yilun reply Urology

Hello, your question is indeed very profound.
Currently, the classification of specialties by the Ministry of Health and Welfare in the Republic of China is not based on patient symptoms but rather on diagnoses.
Therefore, if considering possible external causes such as tumors, stones, or other etiologies, it is advisable to seek assistance from a urologist for diagnosis and treatment.
If there is a family history of kidney disease, it may be more appropriate to consult a nephrologist first.
If you are unsure, family medicine physicians are trained to provide consultations for general medical issues, so it is not necessarily limited to a specific specialty.
I hope this response addresses your concerns.

Reply Date: 2011/09/01

More Info

When it comes to urinary hematuria, the appropriate specialist to consult is a urologist. Hematuria, which is the presence of blood in the urine, can be indicative of various underlying conditions, some of which may require specialized evaluation and treatment.
A urologist is a medical doctor who specializes in the urinary tract and male reproductive system. They are trained to diagnose and treat conditions related to the kidneys, ureters, bladder, and urethra. Given that hematuria can stem from a range of issues, including urinary tract infections, kidney stones, tumors, or other renal pathologies, a urologist is best equipped to conduct the necessary evaluations, which may include urine tests, imaging studies (like ultrasound or CT scans), and possibly cystoscopy (a procedure to look inside the bladder).

If you initially visit a family medicine doctor or a general practitioner, they may perform an initial assessment and order some basic tests. However, if hematuria is confirmed, they will likely refer you to a urologist for further investigation.
In addition to consulting a urologist, it is important to consider the following points regarding hematuria:
1. Initial Evaluation: When you see a urologist, they will take a detailed medical history and perform a physical examination. They may ask about any associated symptoms, such as pain, frequency of urination, or any history of urinary tract infections.

2. Diagnostic Tests: The urologist may order additional tests, including:
- Urinalysis: To check for signs of infection, blood, or other abnormalities.

- Urine Culture: To identify any bacterial infections.

- Imaging Studies: Such as ultrasound, CT scan, or MRI to visualize the urinary tract and identify any structural issues.

- Cystoscopy: A procedure where a thin tube with a camera is inserted into the bladder to directly visualize the bladder and urethra.

3. Potential Causes: Hematuria can be caused by various factors, including:
- Infections: Such as urinary tract infections or bladder infections.

- Kidney Stones: Hard deposits that can cause bleeding as they move through the urinary tract.

- Trauma: Injury to the kidneys or bladder can lead to blood in the urine.

- Tumors: Both benign and malignant tumors can cause hematuria.

- Other Conditions: Such as glomerulonephritis or other kidney diseases.

4. Follow-Up: Depending on the findings, the urologist may recommend treatment options, which could range from medication for infections to surgical interventions for stones or tumors.

5. Importance of Early Diagnosis: Early evaluation and diagnosis are crucial, especially if there are concerning signs such as significant blood loss, pain, or other systemic symptoms.
In summary, if your health check-up reveals urinary hematuria, it is advisable to consult a urologist for a comprehensive evaluation. They will guide you through the necessary diagnostic steps and treatment options based on the underlying cause of the hematuria.

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