Adult with gross painless hematuria, think of malignancy: bladder, renal, ureters
Do Contrast Abdo CT or IVU
If nothing is seen, do cystoscopy.
Note: Bladder mass more common than renal cell CA
Renal cell CA:
hematuria, flank pain , abdo mass in 10%. Presence of lft sided varicocoele which doesn't empty when recumbent, is highly suggestive of RCC.