Endourologic Diagnosis and Treatment of Essential Hematuria

Macroscopic lateralizing hematuria was noted at cystoscopy in eight patients. All patients underwent ureterorenoscopy, percutaneous nephroscopy, or both, and in all cases, an active or suspected bleeding site was identified and fulgurated. No patient required an open operation or blood transfusion. Follow-up at 2 weeks to 36 months revealed resolution of hematuria in six of the eight patients. The other two patients have been managed medically. An endourologic algorithm for approaching lateralizing macroscopic hematuria is presented.