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Microscopic haematuria: urological investigation using a standard protocol
S R Sultana1, C M Goodman, D J Byrne
1Department of Urology, Dundee Royal Infirmary, UK.
British Journal of Urology
|November 1, 1996
Summary
Investigating older patients with microscopic haematuria is crucial, as malignancy is often found. Full urological investigation for younger patients with microscopic haematuria is less clearly beneficial.
Area of Science:
- Urology
- Oncology
- Diagnostic Medicine
Background:
- Microscopic haematuria (MH) is a common finding requiring investigation to rule out significant urological pathology.
- Determining the optimal investigation strategy for MH, particularly asymptomatic microscopic haematuria (AMH), is essential for efficient healthcare resource allocation.
Purpose of the Study:
- To identify patient subgroups with AMH who warrant further investigation for significant urological pathology.
- To evaluate the diagnostic yield of standard urological investigations in patients presenting with haematuria.
Main Methods:
- Prospective audit of a standard protocol for investigating patients with haematuria over one year.
- Investigations included urine analysis (culture, cytology), flexible cystoscopy, and upper tract imaging (excretory urography, renal ultrasonography).
Main Results:
- Malignancy was not detected in patients under 50 years with AMH (n=131).
- In patients over 50 years with AMH, malignancy incidence was 5% (6/126), compared to 10.5% in symptomatic patients (p>0.05).
- Overall malignancy incidence in patients >50 years with MH was 7.5% (19/250); frank haematuria patients >50 years had 34.5% incidence.
Conclusions:
- Investigation of older patients (>50 years) with microscopic haematuria, and all patients with frank haematuria, is justified due to significant malignancy rates.
- The value of extensive urological investigation for younger patients (<50 years) with microscopic haematuria remains uncertain.