Talk:Hematuria

Wiki Education Foundation-supported course assignment
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Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 14 June 2021 and 11 July 2021. Further details are available on the course page. Student editor(s): Mohammad Aldalou. Peer reviewers: Neuro1111.

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Wiki Education Foundation-supported course assignment
This article is currently the subject of a Wiki Education Foundation-supported course assignment, between 10 January 2022 and 4 February 2022. Further details are available on the course page. Student editor(s): Michaelorlando.

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Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Copene, Cheikhnjie. Peer reviewers: Pas94110, Jmirzabe.

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Sports-related Hematuria
Hematuria can also be caused by bleeding due to impacts to the bladder, especially during running and cycling. Someone (preferably an experienced MD) should cite that to improve the article. Fbergo (talk) 23:54, 24 November 2007 (UTC)

ACP guideline
10.7326/M15-1496 is a clinical guideline from the ACP. All macroscopic haematuria, even if self-limiting, requires urological assessment. Microscopic haematuria on urinalysis requires microscopy for confirmation, and if there's no other explanation it should be assessed by a urologist even if the patient is on antiplatelets/anticoagulation. JFW &#124; T@lk  08:44, 27 January 2016 (UTC)

I had to have a meatotomy (NSFW: graphic WP article) for having had this during prepubescence (blood in urine; male)
but there isn't any indication of a corrective meatotomy, or any mention on the meatotomy page that isn't cosmetic on its page. 63.135.197.206 (talk) 16:51, 29 October 2016 (UTC)

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UCSF Medical Students Editing Hematuria
Hi there,

We are a group of fourth year UCSF medical students who are taking the Wikipedia elective at our school. We hope to improve the way health information is disseminated to the public by editing existing articles. Over the next few weeks, we will work on this page, modifying content and structure and adding new references. We hope the changes made will be helpful to anyone who visits the page!

Copene (talk) 04:38, 27 November 2017 (UTC)

The structure of our page will be as follows: -Update the intro to provide an overview of hematuria and the various causes -Create an epidemiology section, detailing the ages, gender breakdown, and syndromes that increase risk of hematuria -Add more detail to differential diagnosis and types of hematuria section -Create diagnostic workup section -Medical management -Outcomes and follow up

We look forward to working on this page!

Copene (talk) 05:12, 27 November 2017 (UTC)
 * Sounds good. Doc James  (talk · contribs · email) 01:41, 28 November 2017 (UTC)
 * Adjusted the section ordering to follow WP:MEDMOS Doc James  (talk · contribs · email) 19:59, 2 December 2017 (UTC)

Peer Review of "Causes" subsection

- I would clarify what you mean by "gross hematuria", or make the terminology consistent with the visible/non-visible organization you are using

- I would change the organization under visible hematuria to painful and not painful (as opposed to painful and no pain), just to keep the terminology symmetric

- I like the use of bullet points. The information is concise and easy to follow

- Under the "kidney stones" bullet point: might want to include the term nephrolithiasis as well, though I think the link to the kidney stones page may be sufficient.

- the phrase that begins "cause sharp, colicky...": consider rephrasing to "other symptoms include..."

- Second bullet point: to help with clarity and structure, I think the bulleted list would be improved by having the cause, followed by a dash and a brief description. For example:

- Kidney stones/ nephrolithiasis - other symptoms include x, y, z

- Lower urinary tract infection - typically presents with pain above the pubis (insert link) and pyuria, which is white blood cells in the urine, in addition to hematuria

- Under the Non-visible blood subsection: I appreciate the explanation of how microscopic hematuria is detected. The language is clear and avoids jargon.

- The sentence that begins "any part of the kidneys...", I would consider rephrasing to "Microscopic hematuria can originate from any part of the kidneys, ureter or bladder."

- Consider a brief description of each cause of non-visible hematuria.

- Add citations for all bullet points

Pas94110 (talk) 01:12, 12 December 2017 (UTC)

Dear Pas94110,

Thank you for the helpful edits!! I really like the idea of moving epidemiology and hematuria mimics to earlier on in the article. As you can see, they have both been moved to the lead section. I have also gone back and added descriptions to many of the etiologies listed.

Thank you!

Copene (talk) 04:08, 15 December 2017 (UTC)

Peer Review for UCSF Wikipedia Class
GREAT JOB WITH ARTICLE! I LIKE YOUR BREAKDOWN OF THE TYPES AND THE IMAGE OF GROSS HEMATURIA. MY EDITS IN CAPS BELOW! Jmirzabe (talk) 05:09, 13 December 2017 (UTC) JMIRZABE, WEDS DEC 12

BROAD STROKES: CONSIDER REORGANIZING TO PUT EPI AND MIMICS EARLIER ON, RECONCILE MIMICS AND AN IMAGE OF THE ANATOMY WOULD BE HELPFUL FOR THE DIFFERENTIAL.

Hematuria is the presence of red blood cells (erythrocytes) in the urine. Gross hematuria is easily identified, as it causes red or brown discoloration of the urine. Microscopic hematuria is invisible to the naked eye and is often found incidentally on urinalysis or urine dipstick. Any part of the kidneys or urinary tract (ureters, urinary bladder, prostate, and urethra) can leak blood into the urine. The causes of hematuria are broad, ranging from urinary tract infection to kidney stones to a bladder cancer.[1] Contents [hide] 1	Causes 1.1	Visible blood 1.1.1	Painful 1.1.2	No pain 1.2	Non visible blood 1.2.1	Glomerular causes 1.2.2	Non-glomerular causes 2	Diagnosis 2.1	Mimics 2.1.1	False positive dipstick 2.1.2	Red-brown urine 3	Epidemiology 4	References 5	External links Causes[edit]

Gross hematuria causing red discoloration of the urine Visible blood[edit] Gross hematuria causes obvious brown or red discoloration of the urine. It can be painful or painless. Painful[edit] Kidney stones–cause sharp, colicky (SEVERE AND FLUCTUTING) flank pain that radiates to the groin[2] Infection of the lower urinary tract or bladder can cause gross hematuria, white blood cells in the urine, and pain above the pubiC BONE Pyelonephritis, infection of the kidneys, can cause gross hematuria with fever and flank pain Polycystic kidney disease (FINISH SENTENCE) Trauma to the urinary system Vigorous exercise [3] (ADD DETAILS) No pain[edit] The most worrisome cause of painless, gross hematuria is kidney or bladder cancer, especially in a person wIth risk factors such as male sex, age over 35, history of smoking, and exposures to dyes, SUCH AS THOSE USED IN MEDICAL IMAGING[4] [5] Non visible blood[edit] Microscopic hematuria does not discolor the urine and is thus found incidentally on urinalysis or light microscopy. It is defined as greater than three red blood cells per high powered field. Any part of the kidneys or urinary system can cause microscopic hematuria. In many of these cases, no source or cause is found[6]. Any part of the kidneys or urinary system can cause microscopic hematuria. Causes can be separated into glomerular, arising from the filtering system of the kidney, and non-glomerular, arising from the remainder of the kidney, the ureters, urinary bladder, prostate, or urethra. [1] Glomerular causes[edit] (CONSIDER DEFINING THESE OR LINKING) IgA nephropathy[7] Hereditary nephritis (Alport's disease)[7] Benign familiar hematuria[7] Non-glomerular causes[edit] The three most common causes of microscopic hematuria are benign prostatic hyperplasia, urinary tract infection, and urinary tract stones. [6] CONSIDER MOVING TO INTRO FOR MICRO HEMATURIA Vigorous exercise Cancer or tumor of the bladder or prostate Polycystic kidney disease Renal papillary necrosis Sickle cell disease or trait Diagnosis[edit] Sometimes the cause of hematuria can be determined based on the medical history and urine testing. This is especially true for people less than 35, in whom the risk of cancer is low. It is imperative to ascertain key risk factors such as smoking, occupational exposures to benzene, history of recent weight loss and/or history of urologic disorders such as Benign enlargement of the prostate or recurrent kidney stones to help with risk stratification. The most common causes of hematuria are related to kidney stones causing obstruction and infection of the prostate or bladder. Additionally, athletes with vigorous exercise regimens may sometimes have either gross or microscopic hematuria.[citation needed] ADD CITATION The first step in evaluation of Hematuria is to perform a Urine dipstick (A FASTER, POINT OF CARE TEST) to assess for blood in the urine, followed by a urinalysis(A MORE COMPLETE TEST) with microscopic evaluation for confirmation. If hematuria is present, and is associated with acute onset of unilateral flank pain, it is generally indicative of a presence of a kidney stone and evaluation should be done with a non-contrast CT scan of the abdomen/pelvis. If hematuria is associated fever, pain with urination, urinary frequency or presence of white blood cells in the urine; it is highly suggestive of a urinary tract infection and additional work-up with urine cultures should be done to further evaluate. If neither of these features are present, the next step is to separate the evaluation into gross vs microscopic hematuria.[citation needed] CITE For patients with gross hematuria and evidence of blood clots, further imaging with an Abdominal CT scan should be done and an urgent referral to a Urologist made. Otherwise, the next step involves determining if source of bleeding is glomerular in nature as evidenced by presence of inappropriately shaped/dysmorphic red blood cells, presence of protein in the urine, new or worsening hypertension or swelling. If source is glomerular patients should be referred to a Nephrologist for further evaluation. Non-glomerular source of bleeding will usually require further work-up by a Urologist.[citation needed] CREATE SUBSECTION HEADING In patients with microscopic hematuria, it is important to rule out any possible confounders such as menstruation in women, possible presence of semen in sample or recent rigorous exercise. In menstruating women, tests should be repeated during non-bleeding parts of their cycles. In individuals with history of recent rigorous exercise, urinalysis should be repeated 4-6 weeks following cessation of exercise. All women of child-bearing age should undergo a pregnancy test, and if positive should receive an ultrasound of their kidneys and bladder with further invasive diagnostic work-up deferred until completion of pregnancy.[citation needed] If diagnostic work-up has been unyielding so far or the aforementioned risk factors are present, it is important to begin a thorough work-up for possible malignancy especially of the bladder and kidney by referring to a Urologist to look at the urethra and bladder with a cystoscopy(DEFINE OF LINK) and also performing additional imaging using the more sensitive CT urography, which provides a more thorough view of the complete urinary system.[citation needed] For individuals with persistent hematuria with no immediate identifiable cause, urinalysis should be repeated once a year, and if it is negative for 2 years then you can stop repeating the tests. However, if it is positive for 3 years, repeat anatomic evaluation should be done.[citation needed] Mimics[edit]COULD BE RECONCILED WITH SECTION ABOVE TALKING ABOUT MIMICS OF MICRO HEMATURIA. CONSIDER ADDING TO ARTICLE START The presence of certain substances can mimic hematuria either by discoloring the urine or by causing a false positive on urine dipstick. False positive dipstick[edit] Causes of a false positive urine dipstick include:[7] Hemoglobin (only the red pigment, not the red blood cells) Semen Other pigments Myoglobin in myoglobinuria Porphyrins in porphyria Betanin, after eating beets Drugs such as rifampicin, phenazopyridine, and sulphonamides Alkaptonuria Red-brown urine[edit] Medications: sulfonamides, quinine, rifampin, phenytoin[8] Consumption of beets ("beeturia") Menstruation

Epidemiology[edit] WOULD BE BETTER SUITED TO BEGINNING OF ARTICLE Microscopic hematuria is found regularly on routine urinalysis with a prevalence between 0.18% and 37%.[9] In many patients, no specific cause is found. Urologic malignancy, cancer of the kidney, prostate, bladder, or testes, is found in 5% of patients with microscopic hematuria and up to 40% of those with gross hematuria.[6]

Wording
Have gone through and change a bunch of "patients" to "people"

Also "gross" has a common meaning that you do not mean. So better to use the word visible blood.

Doc James (talk · contribs · email) 04:12, 14 December 2017 (UTC)

Dear Doc James,

Thank you for the helpful feedback, and for making the people to patients edits. I gone back and edited many of the gross hematuria mentions to gross, or visible, hematuria... I do think it's helpful to include the scientific language.

Copene (talk) 04:07, 15 December 2017 (UTC)
 * Sure we say it once in the second sentence "Visible hematuria, also known as gross hematuria,"
 * Than we can use common English after that and do not need to mention the technical term each time.
 * We can says "children" we do not need to say "Pediatric Etiologies"
 * You do know that "Etiology" is simply the Latin for "Cause" and this subsection is under the cause section already? This is a general encyclopedia. Our goal is to be as widely understood as possible.
 * Also way all the caps?
 * Same with "Gross/Visible Hematuria"
 * It would be very useful to read the WP:MEDMOS. Doc James  (talk · contribs · email) 05:08, 16 December 2017 (UTC)

Lead imagine
The image of actual hematuria is much better than an image of RBCs

Why do people think an image of RBCs and NOT hematuria is appropriate for the article on hematuria? IMO a strait image of RBCs is misleading. Doc James (talk · contribs · email) 05:12, 16 December 2017 (UTC)

Distomum haematobium, Bilharzia haematobium "Schistosoma" haematobium causative agent of hematuria
To the moderator, This is my first post ever and I am not computer saavy nor experienced in contributing, please read entire link and add realted content to wikipedia article as it is important and relevant. Extensive reading that I have done on the subject of schistosome parasites and the diseases associated over the past four years, it is my honest opinion this parasite can be linked to many diseases of unknown origin in the U.S.. Distomum haematobium, Bilharzia haematobium "Schistosoma" haematobium (all one in the same) causative agent of hematuria, this was actually proven in 1851 by Theodor Maximillian Bilharz, a German physician, as per this article states. The name Bilharz is also another name or earlier name for schistosoma haematobium. This information is very specific and verifiable and should be part of your article about hematuria. Thank you for all you do.

The article reads;

Schistosomiasis is one of the most prevalent human parasitic infections. It is a major source of morbidity affecting more than 207 million people in 76 countries. It was estimated that 97% of the infected cases are on the African continent.(1) The disease is caused by trematodes of the genus Schistosoma, which exhibit dioecy and have complex life cycles comprising several morphologically distinct phenotypes in definitive human and intermediate snail hosts.(2)

The history of schistosomiasis in Egypt is longstanding for over 5000 years, with reports of Schistosoma haematobium eggs in ancient mummies.(3-7) Schistosoma mansoni does seem to be a relatively modern arrival as it has not been found in mummies. Jury is still out on when S. mansoni first appeared in Egypt.(8) There have been numerous attempts to find descriptions of the disease in the medical papyri.(9,10) The most debatable word is "aaa", which occurs in over 50 early papyri including the Ebers papyrus. In some papyri "aaa" occurs together with the initial hieroglyph suggesting a penis discharging what has been interpreted as blood.(11) The juxtaposition is the papyri of "aaa", antimony-based remedies, and possibly worms in the body suggests urinary schistomiasis, and this interpretation is widely quoted in textbooks. Unfortunately, things are not as simple as this because no passages from the papyri link "aaa" with the bladder or urine and the discharge from the penis might represent semen and not blood. It is to be mentioned here that there have been a number of other suggestions about what "aaa" might be, including hookworm disease.(12) This topic is discussed in detail by Nunn and Tapp (2000), who rejected "aaa"  as a possible ancient Egyptian word for schistosomiasis.(13) However, since schistosomiasis was almost certainly common and widespread in ancient Egypt, it is strange that the Egyptians did not have a word for it unless it was so common that it was ignored.(12) Probably the first authoritative description of hematuria in the earliest medical literature is by Avicenna (Ibn-Sina, 979-1037A.D.) in his famous book “Al Kanon fi al Tib”.(14) Centuries later, an epidemic among soldiers in Napoleon’s army in Egypt in 1798 was described by a French army surgeon, A. J. Renoult.(15) However, the cause of the disease was unknown. In early 1851, Theodor Maximillian Bilharz, a German physician working at Kasr El Ainy Hospital in Cairo, discovered the causative agent of hematuria while performing an autopsy on a young Egyptian man. He named the parasite Distomum haematobium and reported his discovery in a series of letters to his old teacher, Carl Theodor Ernst von Siebold. In 1853, extracts from these letters with von Siebold comments were published in the German Zoological Journal.(16) At the time when Bilharz wrote his letters, he did not know that he was dealing with two species of schistosomes. He regarded these lateral-spined eggs as abnormalities.(16,17) Bilharz made the connection between schistosomiasis and hematuria later.(18) The peculiar morphology of the worm (the presence of the gynaecophoric canal or the schist) made it clear that it could not be included in the genus Distomum. The parasite was described in 1856 as Bilharzia haematobium, after its discoverer, by Meckel von Hemsbach in a thesis entitled “The Geology of the Human Body”. This work was published but had a limited circulation.(19) In 1858, Weinland, apparently not knowing of this thesis, described the worm as Schistosoma haematobium.(20) In 1948 the International Commission on Zoological Nomenclature established the name Schistosoma and it is thus the current name of the parasite.(21) However, both bilharzia and schistosomiasis are used to denote the various diseases caused by the numerous species of the genus in man and animals.

Please read the entire article here: Human Schistosomiasis in Egypt:... (PDF Download Available). Available from: https://www.researchgate.net/publication/236153274_Human_Schistosomiasis_in_Egypt_Historical_Review_Assessment_of_the_Current_Picture_and_Prediction_of_the_Future_Trends [accessed Jun 24 2018].

(Dna91911 (talk) 20:59, 24 June 2018 (UTC))

UCSF Medical Student Editing Hematuria
Hello to Wikipedia community and the Wikiproject in Medicine,

My name is Manuel Armas-Phan. I am fourth-year medical student at UCSF and will be graduating this upcoming spring with an MD degree. I am currently applying to urology residency programs and hope to some day be an academic urologist. I became aware of the wikipedia initiative thanks to the fourth-year elective supervised by Amin Azzam MD, MA.

'''Why this topic? '''

This is a topic commonly and frequently encountered by urologists and other providers. As a medical student, I've seen multiple patients with the chief complaint of hematuria -- both in the outpatient and inpatient setting. Blood in the urine is a concerning finding for both patients and even many non-urology providers. It results in a heightened level of anxiety that probably stems from low-quality, non-easily-accessible educational materials. My effort is broadly an effort to improve a wikipedia page that likely is frequently visited soon after new patient encounters. This wikipedia pages is still labeled as start-level and has mid-importance in the Wikiproject Medicine.

'''Planned changes: '''


 * Reorganization of material into sections that follow the Wikiproject Medicine guidelines
 * A refocus of the wording thats more appropriate to both lay and medical audiences
 * More images where possible

 WIP #1 (12/2/2019)  Outline
 * A) What did I do this week?
 * B) What will I do by next week?
 * C) What questions do I have for Amin, Whit and/or the group?

A --
 * Re-structured the entire hematuria wikipedia page. This restructure follows the Wikipedia Medicine Project guidelines for a clinical sign.
 * I developed the following sections: differential diagnosis, epidemiology, & evaluation.
 * Under evaluation, I included a subsection on evaluation of trauma-induced genitourinary (GU)  injuries. It is titled (trauma-induced genitourinary tract injuries).
 * I changed the lede’s image to a patient sample of hematuria.

B --
 * Develop subsections in the differential diagnosis.
 * Include the proportion of patients with hematuria who have diagnosis x, diagnosis y, negative evaluation, etc.
 * Include for each of the most common diagnoses what historical elements, clinical signs, and medical testing makes this diagnosis very likely.

C -- 
 * Should I change the title of subsection “trauma-induced GU injuries” to traumatic hematuria or something else?
 * What sections are missing?
 * What sections need development?

Peer Review of the WP Hematuria Page. 12/15/19
Greetings all, below is some some general feedback about the page for your consideration.

Overall Impression: Overall, great work! I like the structure of the page and feel like the subheadings follow the recommended structure of a clinical WP page. I also like that the content is focused and concise, highlighting the most pertinent information necessary for a hematuria illness script. The image of visible hematuria is relevant and the anatomical image is also helpful to the reader.

Areas I thought were particularly strong: I found the introduction focused and thought it gave a good overview of the page. I liked the differential diagnosis was bulleted and linked to specific etiologies. Additionally, I liked the updates made to the categorization of the illness script (anatomical, temporality, frank vs microscopic) that you updated the illness script overall for the page.

Areas I thought would benefit from continued editing:
 * Introduction-Paragraph#2: I would move the sentence “In general, nephrologists are the experts of glomerular..” to the end of this paragraph or make this sentence its own paragraph as the subsequent content is about differential diagnosis and logically follows the first two sentences.
 * Typo/confusing sentence: “The site that is bleeding is suggested by when hematuria begins and if it occurs throughout urination.” I would suggest writing: When hematuria becomes visible during urination and how long blood remains visible in the urine stream is suggestive of bleeding origin.
 * Section on “Temporality and Associated Symptoms”: I found the explanation of when hematuria begins during urination as an indicator of where bleeding is occurring within the urinary tract to be confusing and incomplete. I think the explanation could be expanded upon.
 * Microscopic hematuria section: Is it possible to hyperlink the following terms (in case your audience is not familiar with them)? High-powered field, hemoglobin, false positives, myoglobin.
 * Hemoglobinuria section: Is it possible to add a sentence describing when hemolysis would occur? Otherwise, this section feels random and without context.

Epidemiology section:
 * I would clarify whether the prevalence statistics being referred to are global or United States-based percentages.
 * In the sentence “When asymptomatic populations are screened with dipstick and/or microscopy medical testing about 2-3% of those with hematuria have a urologic malignancy” I think you mean microscopy-based medical testing.
 * Is it possible to hyperlink “benzenes” and “aromatic amines.” I don’t think a general audience will know what these compounds are. I would also hyperlink “malignancy” and “radiation therapy” if WP pages on these topics already exist.
 * When discussing risk factors, I would recommend using the phrase “associated risk factors” or “causative risk factors” as appropriate.
 * For the sentences “Microscopic hematuria results in a cancer diagnosis in 5% of cases. Macroscopic hematuria results in a cancer diagnosis in 40% of cases” I would rephrase “results” to is indicative of. Hematuria doesn’t cause cancer.


 * Evaluation section: I would change “Initial Negative Evaluation” to Follow Up Screening

Management section:
 * The following sentence is incomplete: “One of three urologic emergencies that can occur with hematuria.”
 * I would write out “CBC” and “BUN” as your audience might not know what those acronyms stand for.
 * Overall, this section is pretty technical. Is there anyway you can make it more accessible to a wider audience?
 * I find it odd that this section only focuses on acute clot retention when two other emergencies are mentioned at the beginning of this section. I think adding some additional content on anemia and shock would address this concern.

Again overall, really strong work. I hope my suggestions are helpful! CADonald (talk) 05:37, 16 December 2019 (UTC)

Response to feedback
Thanks for the feedback!

I incorporated many of your suggestions. I think these suggestions added a lot to my work and helped improve the article further.

For the management section:

I chose to only focus on the management of acute clot retention since it is specific to hematuria while the other two occur with hematuria but also occur with other medical conditions. Also, each has a wikipedia page devoted to the topic.

Marmasphan (talk) 10:03, 20 December 2019 (UTC) Armas-Phan

Prevalence
User:N2e, the source cited is a practice guideline. You can read a (slightly updated) copy at https://www.auanet.org/guidelines/asymptomatic-microhematuria-(amh)-guideline It is describing the results of about 16 studies. WhatamIdoing (talk) 05:44, 4 March 2020 (UTC)


 * Just to make this a little clearer: A practice guideline is the document that, if you are a healthcare provider and you don't follow it, your patient's attorney will be waving in your face during the malpractice lawsuit.  Providing WP:INTEXT attribution to a practice guideline, when there's no evidence that other practice guidelines both exist and disagree on that point, is a bit like providing in-text attribution to statements about a general scientific consensus.  The answer is "according to the entire profession".  WhatamIdoing (talk) 16:05, 5 March 2020 (UTC)

Work Plan : Osmosis Wiki Editing Course
'''Greetings everyone, this is Mohammad Aldalou, a medical student at Alazhar University and currently participating in the aforementioned course, and have assigned myself to improve this article.

My planned changes are as the following:'''


 * Definition/ Improve with more scientific details


 * Differential diagnoses/ Review


 * Pathophysiology or Mechanism/ Add


 * Diagnostic approach/ Edit it to method based categories and expand it


 * Treatment or Management/ Improve and expand & covering follow-up


 * Epidemiology/ Update to the latest statistics


 * General Improvements/ Addition of citations where needed.

''Mohammad Aldalou (talk) 01:22, 29 June 2021 (UTC)

Medical Student Work Plan
Hello Wikipedians, I am a fourth year medical student from the United States who is going to attempt to improve this article. I have found several areas that could use improvement. A large portion of the article uses citations from unreliable/inappropriate resources, and not every sentence has a citation. There are citations from merriam webster dictionary, "Uptodate.com", and "Amboss.com". Further, not all links work. Some are generic "Uptodate.com" or "Amboss.com" links, and these are not accessible to those not in the medical community. I am going to improve both the reliability and quantity of references. Additionally, in terms of the structure and content of the article, I think the organization of the article can be adjusted to be more friendly to the average Wikipedia reader. Rather than begin the article with "Differential Diagnosis", I will adjust the article to begin with a "Causes" section and expand that upon it while also improving terminology and using images to give the average reader a better understanding of the topic. While I am going to attempt to revamp the entire article, I will primarily focus on the "Causes" and "Diagnosis" sections. To accomplish this, I intend to use primarily textbooks eg Harrison's Principles of Internal Medicine and Essentials of Family Medicine, but I will also use secondary academic journal articles if available. Cheers. --Michaelorlando (talk) 14:33, 13 January 2022 (UTC)
 * As an update to my previous post, I ended up veering away from my work plan. In this article, I rewrote the lead section, left the differential diagnosis section as the first section, added to it and corrected its citations, and I added the Evaluation section with visible hematuria and microscopic hematuria subsections. Cheers.Michaelorlando (talk) 21:55, 31 January 2022 (UTC)

Peer Review
Overall, I think you did a great job in your edits to the article. I can see that you made a significant contribution, focusing mainly on the lead, differential diagnosis, and evaluation sections. I think you made this article much better for patients – congrats! Here are some minor suggestions for improvements:

1.	I know you had to veer from your original workplan, but I liked that your original plan was going to remove citations from sources like Amboss (as they are unlikely to be sources easily accessible to the average patient). Source 15 comes from Amboss, so I would consider finding another source like a textbook or PubMed article.

2.	I think there are a few places in the article where you could link back to another wiki article. An example would be for menstruation, as this is a term that not all patients (even female ones!) are familiar with and could add to the clarification.

3.	I would take a quick read through the article and correct some small grammatical/punctuation/spelling errors. An example is under “glomerular hematuria” in the differential diagnosis section, the first sentence needs an “and” – “A glomerular etiology is suggested by brown colored urine, red blood cells casts, dysmorphic red blood cells, [and] protein”.

4.	Under the “cystoscopy” subsection, I think you could clarify malignancy (e.g. cancer) and briefly explain some of the risk factors.

Do not hesitate to ask for further clarification; as I said previously, I think you did a great job!Arwinter23 (talk) 19:45, 1 February 2022 (UTC)

Wiki Education assignment: UCSF SOM Inquiry In Action-- Wikipedia Editing 2022
— Assignment last updated by ClinicalSciences (talk) 17:44, 12 September 2022 (UTC)