Background:

Hematuria is common urological condition and may originate in any site in the urinary tract. Gross hematuria is alarming and has a high predictive value for malignancy while definition of microscopic hematuria is controversial. UB and renal masses are the commonest cause of painless hematuria. MDCT provides comprehensive non invasive evaluation of the urinary tract and is the modality of choice for evaluation of painless hematuria.

Aim/Objectives:

To evaluate the role of MDCT urography in patients with painless hematuria and to describe the MDCT findings of common etiologies causing it.

Material and Methods:

One Hundred and Twenty eight patients presenting with painless hematuria were included. Detailed history and findings of clinical examination were recorded. Non contrast, contrast enhanced and urographic phase images were obtained. Positive findings were recorded in detail and tabulated. Histopathological and cystoscopic correlation was performed wherever indicated.

Results:

Maximum cases were seen in 6^th decade with male preponderance (3:1). Positive MDCT findings were seen in 92% cases. The commonest findings were UB mass (75.8%), renal masses (11.7%) and BPH (2.3%). Two cases each of retrocaval/circumcaval ureter and partial PUJ obstruction were also seen. No cause was identified in 8% cases. MDCT was 100% sensitive in diagnosing UB mass while it was 92.9 % sensitive in diagnosis and characterisation of renal neoplastic masses.

Conclusions:

MDCT urography should be considered as first line imaging modality in patients with painless hematuria and can also diagnose congenital urinary tract anomalies with fair accuracy.