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학습 자료 둘러보기 →The priority is painless gross hematuria with clots. This is the hallmark of urothelial carcinoma and indicates a friable, vascular tumor. The presence of clots signals a significant bleed and introduces the risk of clot retention.
Immediately assess for signs of acute urinary retention (suprapubic distension, pain, inability to void). Monitor vital signs for hemodynamic instability and urine output strictly. Ensure a large-bore IV is established.
Clots can cause acute obstructive uropathy leading to post-renal acute kidney injury. A sudden inability to pass urine with severe pain is a urological emergency requiring immediate intervention, such as manual bladder irrigation via a three-way catheter.
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