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In evaluating a patient with haematuria, the primary care physician must answer the following three questions: 1. Is it really haematuria? 2. Should this patient with haematuria, be further evaluated, and if so, how? 3. Should this patient with haematuria, be referred to a specialty, and if so, to which specialty? The aim of this critical review is to discuss whether family physicians should evaluate and manage haematuria. Discussion Haematuria must be confirmed by a microscopic examination. Complete urological work-up entails assessment of renal function, urine culture, upper urinary tract imaging usually with computer tomography urogram and a referral to urology for cystoscopy. If a renal disease is suspected, suitable laboratory studies followed by a referral to nephrology, is appropriate. Conclusion While most patients with haematuria will undergo urological work-up to some degree, it is important to efficiently recognise those patients, who are at a minimal risk of serious underlying urologic condition for whom detailed work-up is not necessary, those patients who are at a high risk for whom a complete work-up with cystoscopy is warranted, and those patients with likely renal causes for whom a nephrology referral is prudent. Introduction In evaluating a patient with haematuria, the primary care physician must answer the following three questions: 1. Is it really haematuria? 2. Should this patient with haematuria be further evaluated, and if so, how? 3. Should this patient with haematuria be referred to a specialty, and if so, to which specialty? This critical review addresses these questions. Because few studies have good evidence, the recommendations are mostly based on expert consensus. Discussion Is it really haematuria? Gross haematuria Gross haematuria is defined as urine that is visibly discoloured by blood. It may occur with as little as 1 ml of blood in 1 l of urine. Because patients can recognise the abnormal colour of the urine, they typically present to their physician soon after the episode. Gross haematuria must be differentiated from other causes of discoloured urine1. These are

How should family physicians evaluate and manage haematuria?