skip to main content

Haematuria with urinary symptoms — DRCOG MCQ

Instant feedback + full explanation. One question, done properly.

HardUrogynaecologyHaematuria with urinary symptomsDRCOG

A 46-year-old woman has persistent visible haematuria after a culture-confirmed UTI was treated successfully. Repeat urine culture is negative and menstruation has ended. She has no renal-colic symptoms. What is the next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Refer through the suspected-cancer pathway for bladder or renal assessment

The best answer is “Refer through the suspected-cancer pathway for bladder or renal assessment”. NICE recommends suspected-cancer referral for unexplained visible haematuria in people aged 45 or over when it persists or recurs after successful UTI treatment. A negative repeat culture and separation from menstruation make infection and vaginal contamination less likely. Primary-care repeat cultures or isolated pelvic investigation should not delay urinary-tract assessment.

Reference: NICE NG12: Suspected cancer recognition and referral: https://www.nice.org.uk/guidance/ng12/chapter/Recommended-actions-organised-by-symptom-and-findings-of-primary-care-investigations