An unusual case of haematuria

Abstract

A 40-YEAR-OLD MAN presented with a 3-month history of painless haematuria. He had been tetraplegic from the age of 21 following a road traffic accident, and had a neurogenic bladder with frequent episodes of urinary infection. He was otherwise well with no history of weight loss and no symptoms referable to the respiratory or cardiovascular systems. He was a life-long nonsmoker, lived with his wife and an adopted daughter. Despite his disability he was in full-time employment as a bank clerk. He had no prior exposure to chemicals or asbestos, and at presentation was taking only muscle relaxants for lower limb spasms. Examination on referral revealed that he was tetraplegic in keeping with his history of cervical trauma. He was otherwise well with no evidence of weight loss and no palpable lymphadenopathy. Examination of the chest and abdomen revealed no abnormality. At presentation he had an indwelling urinary catheter.