A 66-year-old woman presents with painless hematuria for one week.
There is no history of blood clots in the urine, dysuria, frequency, urgency, bipedal edema, facial puffiness, abdominal distension, palpitations, or recent excessive physical activity.
Her medical history is positive for hypertension for ten years, which is well controlled on Enalapril alone. There is no family history of malignancy, coagulation disorders, or renal disease.
Urinalysis demonstrates a field full of red blood cells, with no cell casts or pus cells. Urine cytology reveals no malignant cells. A complete blood count and coagulation profile are within normal parameters.