Open AccessHaematuria work‐up in general care—A German observational study
Author(s) -
Eisenhardt Andreas,
Heinemann Daniel,
Rübben Herbert,
Heß Jochen
Publication year - 2017
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12982
Subject(s) - medicine , urinary system , bladder cancer , work up , cystoscopy , cancer , population , outpatient clinic , retrospective cohort study , incidence (geometry) , urine cytology , urology , environmental health , physics , optics
Summary Background Haematuria is a common finding in the population and the diagnostic workflow of this symptom represents a large proportion of “work‐load” in the urological outpatient clinic. Aims The intention of this study was to verify if the intensive diagnostic procedures of haematuria patients is justified by detection of a significant proportion of genito‐urinary tract cancers. Materials and methods In a retrospective design 1049 consecutive patients, who presented themselves with macro‐ or microhaematuria in the outpatient clinic PURR in the time from 2011 to 2012, were included in the study and the diagnostic procedures including ultrasound, intravenous urography, computed tomography of the abdomen and urethrocystoscopy as well as therapeutic consequences with its results were analysed. Results The study group comprised 570 women (54.3%) and 479 men (45.7%) with a median age of 58 years and macrohaematuria occurred in 89 patients. Diagnostics revealed seven patients with renal cell cancer, six patients with urothelial cell cancer of the renal pelvis, four patients with urothelial cell cancer of the ureter, 65 patients with urothelial cell cancer of the lower urinary tract and 17 patients with prostate cancer. Age, male gender and macrohaematuria were associated with a higher risk of cancer. Conclusions The high incidence of urinary tract cancer in the data presented here support the rationale for diagnostic work‐up of patients with micro‐ or macrohaematuria. Prospective randomised trials are necessary to identify index patients for second work‐up after a primarily negative investigation as well as the role of molecular markers, which possibly enable to omit invasive work‐up.