Abstract
Asymptomatic hematuria is very common in pediatric and adolescent patients. In contrast to painless hematuria in adults, the differential diagnosis and investigative modalities in the pediatric population is vastly different. This article presents the major diseases that may cause hematuria in children and suggests an evaluation algorithm for the pediatric urologist.
Highlights
Painless hematuria in adults is usually related to a malignant process of the urinary tract, while hematuria in children, which is not uncommon (5−30% of asymptomatic children[1]), is related to a wide spectrum of conditions mostly not related to malignancy
Examination of the abdomen demonstrating tenderness of the flank could lead to the diagnosis of a urinary tract infection or stone disease; abdominal, retroperitoneal, and pelvic masses are relatively easier to palpate in young children than in adults as the abdominal wall layers are less developed
Prophylactic antibiotics should be given until vesicoureteral reflux (VUR) is ruled out
Summary
Received February 1, 2006; Revised February 24, 2006; Accepted February 24, 2006; Published March 8, 2006. Asymptomatic hematuria is very common in pediatric and adolescent patients. In contrast to painless hematuria in adults, the differential diagnosis and investigative modalities in the pediatric population is vastly different. This article presents the major diseases that may cause hematuria in children and suggests an evaluation algorithm for the pediatric urologist
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