Painless Bloody Urination in a 60-Year-Old Woman

Gideon Lorber, MD; Ofer Nathan Gofrit, MD, PhD

Disclosures

August 18, 2016

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Background

A 60-year-old woman is referred to the emergency department because of a recent event of painless macroscopic hematuria. She reports having experienced several similar episodes during the past year, all of which spontaneously resolved. She regards these episodes as being of gynecologic origin because she is 5 years postmenopausal.

She describes a general feeling of malaise in the days preceding the current episode but denies having any fever, dysuria, or increased frequency or urgency of urination. The patient also describes an unintentional weight loss of 11 lb (5 kg) during the past 2 years.

The patient's medical history includes hypothyroidism that was treated medically with thyroxine. Her surgical history includes two treatments of dilatation and curettage and a tonsillectomy.

She has no known drug or food allergies, and she denies smoking, drug use, or alcohol consumption. She has no history of kidney stones or recurrent urinary tract infections.

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