Curriculum · Nephrology and Urology
Bladder transitional cell carcinoma
How it presents
Hematuria is the presenting sign, and it is described three ways: microscopic or macroscopic, initial, total or terminal, painful or painless. Painless hematuria is malignant until proven otherwise. Bladder cancer, like a kidney stone, gives hematuria with no casts, because casts are what mark a glomerular or renal tubular origin.
Causes and risk
Smoking is the named risk factor, and the associated symptoms are asked for alongside it. Hematuria in a patient on anticoagulation is not attributed to the drug: it should still be investigated for underlying urothelial pathology.