Usually self-limiting problem, with infection being the most common cause.
History
- Timing, frequency, duration, fresh or old blood
- Risk factors for STI
- Symptoms of UTI
- Recent urological investigations/interventions
- Anything to suggest bleeding probs
- Travel history – TB and schistosomiasis can cause UTIs
- Family history of prostate cancer (esp <60 ys) and of coagulopathies
Examination
- Testicles/epididymes for swelling
- DRE for prostate lumps
- BP for uncontrolled hypertension
- Abdo for hepatosplenomegaly (underlying probs)
Investigations
- Semen and urine for M, C & S
- FBC/clotting screen
- PSA in >40s
Referral if multiple episodes or >40
If single episode in <40-yr-old, and nil found on above, can simply reassure and leave – to present again if further episodes.
(Not clear what counts as ‘further episodes’. If persists for >10 episodes, evaluate further.)
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