A B S T R A C TIntroduction. This study evaluates the prevalence of chronic pain, intensity of pain, activity limitation, and pain-related diagnoses in German general practices.Methods. In 40 general practices, up to 50 consecutive patients presenting to general practitioners (GP) for routine medical consultation were questioned, and those reporting pain that lasted for more than 3 months received a questionnaire referring to intensity of pain and activity limitations. GPs received a questionnaire asking about the duration of treatment and diagnoses.Results. Three hundred forty-six out of 1,860 questioned patients suffered from pain that lasted for more than 3 months (a point prevalence of 18.4% [95% confidence interval 16.7-20.3]). The average degree of pain equaled 5 out of 10 points on a numerical grading scale (NRS); the average degree of activity limitation was 4.8 out of 10. In most cases, the pain was related to musculoskeletal degenerative diseases.
Conclusion.Chronic pain patients constitute a considerable share of workload in general practice.
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.
399 Background: The diagnostic workup of patients with hematuria especially microhematuria is discussed controversially. For this reason the diagnostic and therapeutic procedures of 1049 patients with hematuria referred to our urological outpatient service in the years 2011-2012 were analysed. Methods: A number of 1049 consecutive patients with hematuria referred to the outpatient service Praxisklinik Urologie Rhein-Ruhr in the years 2011-2012 were retrospectively included into the analysis. The following parameters were measured: demographic data, concomittant diseases, clinical symptoms regarding the urinary tract, history of cancer or radiation of the pelvis, diagnostic and therapeutic procedures. Results: The median age was 58 years and the study group comprised 479 men and 570 women. A number of 160 patients had a urinary tract infection within 4 weeks of presentation and 89 individuals presented with macrohematuria. Symptoms of urolithiasis occured in 148 patients. All patients had ultrasound of the genitourinary tract and 731 were examined by excretion urogram, 111 patients via CT-scan of the abdomen and 888 individuals via urethrocystoscopy. Further workup revealed 77 stones via radiological examination and a total of 11 renal cell cancers, 57 papillary urothelial tumors of the bladder, 1 tumor of the ureter and 6 muscle-invasive bladder tumors were detected. Conclusions: Our data presented here reassures invasive diagnostic workup of patients with hematuria due to the fact that cancer of the genitourinary tract is detected in more than 5 percent of patients.
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