RADIOLOGICAL EXPLORATION OF HEMATURIA

Hematuria is defined as the presence of blood in urine. Its site of or igin can be in any point of the urinary tract. Its discovery leads to clinical, biological and radiological investigations. The causes of he maturia are dominated, in terms of frequency, by urinary infection and lithiasis. The risk of associated lesions, especially of a tumor, mus t lead to regarding them as excluding diagnoses. Besides the so-called ''medical'' hematurias of glomerular origin (hematuria with proteinur ia and cylinder casts) and hematurias occurring during a first episode of cystitis in women, the radiological exploration of ''surgical'' he maturia is systematic and always begins with an IVP. When the IVP is n ormal, a cystoscopy is most often made. The other radiological examina tions (CT, Doppler ultrasound) are performed only according to the fin dings of IVP and cystoscopy. Arteriography combined with renal phlebog raphy is indicated if the assessment is negative in case of recurrent hematuria or of massive hematuria. It is mainly aimed at detecting a v ascular malformation. When this exploration is completed, an etiology is found is about 90 % of all cases.