Intractable Hematuria Due to Advanced Cardiac Failure and Venous Stasis

Bora Özveren* and Selçuk Yücel

Intractable   gross   hematuria   without   an   obvious   or   common urologic   pathology   needs   more   effort   for   correct   diagnosis   and appropriate  management.  In  this  case,  we  report  on  a  patient  with intractable  hematuria  originating  from  varicose  vessels  of  urinary bladder due to advanced venous stasis after severe cardiac failure.

Case Report

A 66-year-old male was consulted for massive hematuria and clot retention  subsequent  to  urethral  catheterization  after  admission  into intensive  care  unit  because  of  cardiac  decompensation.  His  medical history revealed cardiomyopathy and aortic metallic valve replacement 20  years  ago  and  gout  disease  for  25  years.  He  had  been  on  oral anticoagulation  with  warfarin  for  20  years.  On  physical  examination severe  ascites  and  pulmonary  effusion,  and  extensive  venous  stasis in  lower  trunk  was  found.  Central  venous  pressure  was  30  cmH2O. His  blood  biochemistry  work-up  revealed  moderate  hyponatremia (132  meq/L)  and  a  serum  creatinin  of  2.6  mg/dl  (normal  0.5  to  1.4). Anticoagulation was terminated at first. Prothrombin time / INR level returned  within  normal  limits  following  cessation  of  warfarin  and  he had only mild anemia.

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Published on: May 18, 2016 Pages: 11-12

Full Text PDF Full Text HTML DOI: 10.17352/2455-5495.000009
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