Bladder Cancer: Given the age of the patient, bladder cancer is a common cause of frank hematuria in the elderly. The risk of bladder cancer increases with age, and hematuria is the most common presenting symptom.

Benign Prostatic Hyperplasia (BPH): In men, BPH can cause urinary retention, which may lead to hematuria due to bladder overdistension or associated urinary tract infections.
Urinary Tract Infections (UTIs): UTIs are more common in the elderly and can cause hematuria, especially if the infection involves the upper urinary tract or is caused by a more virulent organism.
Kidney Stones: While less common in the elderly, kidney stones can still occur and cause hematuria, especially if they are large or obstructing.
Trauma: Even minor trauma can cause hematuria in the elderly due to decreased renal mass and increased susceptibility to injury.

Renal Cell Carcinoma: Although less common than bladder cancer, renal cell carcinoma can present with hematuria and is critical to diagnose early due to its potential for metastasis.
Sepsis from a Urinary Source: In the elderly, UTIs can quickly progress to sepsis, which is life-threatening. Early recognition and treatment are crucial.
Aortic Aneurysm: A ruptured abdominal aortic aneurysm can present with hematuria among other symptoms like abdominal pain and hypotension. It is a medical emergency.

Goodpasture Syndrome: An autoimmune disease that can cause glomerulonephritis and hematuria, though it is rare and more commonly seen in younger patients.
Alport Syndrome: A genetic disorder affecting the type IV collagen in the kidneys, leading to hematuria, but it typically presents earlier in life.
Sickle Cell Disease: Can cause hematuria due to sickling in the kidneys, but it is rare in the elderly population as it usually presents in childhood.
Vasculitis: Certain types of vasculitis, like ANCA-associated vasculitis, can cause renal involvement and hematuria, but they are less common and often have other systemic symptoms.