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Risk factors can help in determining which patients are at higher risk of urinary tract and bladder cancer. Risk factors include: 2,6. There are a number of recommended investigations in the assessment of haematuria, including urine sampling, blood tests and imaging Figure 1.
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An approach to the investigation and initial management of macroscopic haematuria 3,7,13, A urine dipstick can give instant results and tests for haemoglobin. It relies on Hb to catalyse the oxidation of a chromagen by organic hydrogen peroxide. Unfortunately, myoglobin, bacterial peroxidases, povidone and hypochlorite can also cause this reaction, which can result in false positives.
Urinary tract infections are one of the most common causes of haematuria, and this should be ruled out before an episode of haematuria is investigated further.
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