Differential Diagnosis for Gross Hematuria in Elderly Male
Single Most Likely Diagnosis
- Bladder Cancer: This is the most common cause of gross hematuria in elderly males, especially those with a history of smoking. The risk of bladder cancer increases with age, and hematuria is often the presenting symptom.
Other Likely Diagnoses
- Benign Prostatic Hyperplasia (BPH): Enlargement of the prostate gland can cause urinary retention, leading to hematuria. This condition is common in elderly males and can cause significant urinary symptoms.
- Kidney Stones: Nephrolithiasis can cause severe pain and gross hematuria, especially if the stone is large or obstructing the urinary tract.
- Urinary Tract Infections (UTIs): UTIs are common in elderly males, especially those with catheters or other urinary tract instrumentation. Hematuria can be a presenting symptom, especially if the infection is severe.
Do Not Miss Diagnoses
- Renal Cell Carcinoma: Although less common than bladder cancer, renal cell carcinoma can present with gross hematuria and is often asymptomatic until advanced stages.
- Trauma: Elderly males may be more susceptible to trauma, which can cause hematuria. It's essential to consider trauma as a potential cause, especially if there's a history of falls or other injuries.
- Vasculitis: Conditions like Wegener's granulomatosis or microscopic polyangiitis can cause hematuria and are often diagnosed late, leading to poor outcomes.
Rare Diagnoses
- Sickle Cell Disease: Although rare in elderly males, sickle cell disease can cause hematuria due to sickling in the kidneys.
- Arteriovenous Malformations (AVMs): AVMs are rare vascular anomalies that can cause hematuria, especially if they're located in the kidneys or bladder.
- Goodpasture's Syndrome: This rare autoimmune disease can cause hematuria and is often associated with glomerulonephritis and pulmonary hemorrhage.