Time to abandon testing for microscopic haematuria in adults?

Malmström, Per‐Uno

doi:10.1136/bmj.326.7393.813

Cited by 55 publications

(34 citation statements)

References 24 publications

(21 reference statements)

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“…However, in this study, we could not detect CIS by cystoscopic appearance or symptoms alone. Although arguments against the routine use of cystoscopy as part of the evaluation for microscopic haematuria are being raised, 6 there are still no strict guidelines for indications to perform cystoscopy in a patient with LUTS.…”

Section: Abbreviations: Cis Carcinoma In Situ; Luts Lower Urinary Tmentioning

confidence: 99%

Importance of red patches diagnosed in cystoscopy for haematuria and lower urinary tract symptoms

Fernando

Thota²,

Burtt³

et al. 2007

Postgraduate Medical Journal

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Background: Biopsy of the red patches in the bladder, when found at cystoscopy, is routinely performed in urological practice. This is done to establish the sinister diagnosis of carcinoma-in-situ among other causes. Objective: To analyse the pathology of the red patches and to determine if routine biopsy of these patches is warranted. Patients and methods: This was a retrospective study conducted over a period of 36 months, in which 50 patients were identified, who underwent biopsies of their red patches. All patients with a history of bladder carcinoma and obvious bladder tumours were excluded from this study. Results: The mean age of the patients was 60.8 years. 25 patients had cystoscopy for lower urinary tract symptoms, 21 for haematuria and 4 for recurrent urinary tract infection. Carcinoma in situ was found in 4 (8%) patients, of whom only 2 had positive urine cytology. Conclusion: It is prudent to perform a biopsy of all incidentally diagnosed red patches because of a major yield rate of carcinoma in situ. This procedure also picks up other important pathologies, which help in further management.

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Section: Abbreviations: Cis Carcinoma In Situ; Luts Lower Urinary Tmentioning

confidence: 99%

Importance of red patches diagnosed in cystoscopy for haematuria and lower urinary tract symptoms

Fernando

Thota²,

Burtt³

et al. 2007

Postgraduate Medical Journal

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“…During the past, it has been discussed whether asymptomatic microscopic hematuria can be a sign of underlying pathology. In recent years, it has become clear that the evidence for this is weak 2,3 . The most recent study 4 found that the malignancy rate for patients referred with asymptomatic microscopic hematuria was 1,5 %, and the cancers were all detected in patients aged > 60 recommend examination of asymptomatic microscopic hematuria, some even recommend 36-month follow-up for patients with negative evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, it has become clear that the evidence for such an approach is weak [2][3][4] . Still many national guidelines 5,6 recommend urological examination for patients with asymptomatic hematuria, some even suggest a 36-month follow-up if an initial urological examination is negative 5 .…”

Section: Introductionmentioning

confidence: 99%

Is Asymptomatic Microscopic Hematuria Using a Dipstick Reliable?

Kristiansen

Fabrin

Skov

et al. 2017

ARC Journal of Urology

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“…The clinical significance of this feature remains controversial and some authorities suggest that it requires no investigation at all. 6 If investigation is needed, urgent referral seems unnecessary.…”

Section: Discussionmentioning

confidence: 99%

The Two-Week-Wait Cancer Initiative in Urology: Useful Modernization?

2004

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SUMMARYThe two-week-wait cancer initiative in the UK was designed to speed referral of patients suspected of having cancer and, by so doing, improve their outcome. We reviewed the case notes of all patients referred under this scheme to a single urology department over twelve months.In the department, nearly one-third of new outpatient appointments came under this scheme. 124 patients were referred and all but 7 were seen within the 14-day deadline. In 62 the reason for referral was haematuria, which was macroscopic in 42. Of those with macroscopic haematuria 6 proved to have cancer, newly diagnosed in 4 (2 bladder, 2 renal); no patient with microscopic haematuria had cancer. Of 35 referred with a raised prostate-specific antigen 11 had prostate cancer, in most cases beyond cure. Cancer was found in 1 of 19 patients referred with a testicular mass.In patients referred under the two-week-wait scheme with macroscopic haematuria, cancer is common.

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Time to abandon testing for microscopic haematuria in adults?

Abstract: Although there is no doubt that macroscopic haematuria is serious, the clinical significance of asymptomatic microscopic haematuria is controversial. Should it still be tested for?

Cited by 55 publications

References 24 publications

Importance of red patches diagnosed in cystoscopy for haematuria and lower urinary tract symptoms

Importance of red patches diagnosed in cystoscopy for haematuria and lower urinary tract symptoms

Is Asymptomatic Microscopic Hematuria Using a Dipstick Reliable?

The Two-Week-Wait Cancer Initiative in Urology: Useful Modernization?

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