Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with gross hematuria, suprapubic pain, and irritative voiding symptoms including frequency, urgency, and dysuria. History significant for [chemotherapy/radiation/viral infection/cyclophosphamide exposure]. Symptoms duration: [X] days. Absence of fever or flank pain noted.
Clinical Examination Findings
Abdominal exam reveals suprapubic tenderness upon deep palpation. No palpable bladder distension or costovertebral angle tenderness. External genitalia exam: no meatal stenosis or urethral discharge. Digital rectal exam (if applicable): prostate non-tender, normal size/consistency.
Treatment Protocol
Initiate aggressive intravenous hydration to maintain high urine output. Administer bladder irrigation with normal saline to prevent clot retention. Consider urinary analgesics (phenazopyridine) and antispasmodics. If refractory, evaluate for cystoscopy with clot evacuation, fulguration of bleeding sites, or intravesical instillation of alum/aminocaproic acid.