Treatment included vigorous hydration with hypotonic fluids, diuretics, urine alkalinization and bed rest. Chronic relapsing hematuria can be treated with exchange transfusion, EACA, iron, and the avoidance of intense physical activities. Severe cases may need urological intervention, and, occasionally, selective embolization, but nephrectomy is not indicated since it would recur in the contralateral kidney. Admit for evaluation and treatment. Retrograde pyelogram is most sensitive, but an IVP or ultrasound may provide the diagnosis.
Treatment is with intravenous hydration and straining of urine to document the passage of tissue.
A urine culture should always be obtained to rule out associated infection. Urology consultation is recommended for persistent pain, infection or obstruction. Nephrology consultation is necessary for further evaluation and treatment. The mainstem of prevention is to maintain an adequate hydration and urine output, specially those instances that seems to be induced by physical activity. Bed rest and adequate hydration at the onset of symptoms may prevent severe hematuria.