{
  "schema_version": 1,
  "kind": "condition",
  "id": "visible-haematuria",
  "name": "Visible (macroscopic) haematuria",
  "category": "acute",
  "sources": "Gross and Microscopic Hematuria - disease-level clinical article (microscopic-haematuria-referral-full.txt) · Schistosomiasis - disease-level clinical article (schistosomiasis-full.txt) · AUA/SUFU Guideline on Microhematuria 2020",
  "review_status": "reviewed",
  "verified_against": "Gross and Microscopic Hematuria - disease-level clinical article (microscopic-haematuria-referral-full.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1948,
      "generic": "Urgent urological referral & safety-netting (no drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": null,
      "adult_duration": null,
      "dose_source": "Gross and Microscopic Hematuria - disease-level clinical article (microscopic-haematuria-referral-full.txt)",
      "rationale": "There is no primary-care drug for visible haematuria. The action is referral and the reason is the source's own: visible blood places the patient in a high-risk category regardless of symptoms, and the chance of finding a urinary-tract cancer rises from about 3% with microscopic blood to 10-20% when it is visible.",
      "cautions": [
        "Refer even when the blood has stopped. A single episode that cleared is still visible haematuria and still carries the risk.",
        "Refer even when the patient is on an anticoagulant. Anticoagulation does not explain haematuria and does not exclude underlying disease.",
        "A urinary tract infection is the commonest benign explanation, but it is only an explanation once treated and the urine has been rechecked and is clear.",
        "In Egypt, urinary schistosomiasis is a leading cause and its own source calls visible haematuria the most characteristic presenting symptom of S haematobium infection. Ask about canal or Nile water exposure - see the Schistosomiasis card.",
        "Chronic urinary schistosomiasis is a route to bladder cancer, so finding bilharzia does not close the question of malignancy in an older patient.",
        "Full evaluation is imaging, urine cytology and cystoscopy - a normal ultrasound alone does not clear the bladder."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children are the exception to the cancer logic - isolated haematuria in a child generally does well, and it is the company it keeps (proteinuria, hypertension, impaired renal function) that points to glomerular disease and a worse outlook. Refer to paediatric nephrology, not to urology, when those are present.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "visible-haematuria"
    }
  ]
}