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- Title
Urothelial Malignancy After Normal Hematuria Clinic Investigations: Does Non-visible Hematuria Need Reinvestigation?
- Authors
Thompson, Alice; James, Bev; David, Rotimi; Youseff, Mohamed; Gill, Nicholas; Jefferies, Matthew; Bose, Pradeep; Swamy, Gokul Kanda
- Abstract
Objective: Hematuria is the most common referral to Urology. Most initial evaluations are normal; however there are few medium- to long-term studies about these patients after they are discharged. Methods: This study was a retrospective observational case-control study. Patients with normal initial investigations in our hematuria clinic (HC) over a 2-year period in 2012-2013 were included. We reviewed the electronic records of patients choosing January 1, 2021, as our reference date providing a median follow-up of 99 months. The primary aim of this study was to assess the missed urothelial malignancy (UM) rate in this cohort and also the UM rate in those re-referred to the HC. Results: The study included 573 patients of whom 24.6% (141/573) were re-referred to urology during the study period. The overall missed UM cancer rate was 0.5% and 0.2% died as a result in this follow-up period. The UM cancer rate in those re-referred was 4.3% and of those re-referred with visible hematuria (VH) the UM cancer rate was 5.7%. No patients re-referred with non-visible VH (NVH) were diagnosed with UM. The only urological death during this time was due to UM. Conclusion: All urological malignancy and mortality remain very low even at mediumto long-term follow-up after an initial normal HC investigation. In this study, no patients with recurrent NVH developed UM; therefore, recurrent NVH is unlikely to need reinvestigation. The risk of UM in those re-referred with VH is low but more substantial and warrants reinvestigation, which should include computed tomography urogram imaging.
- Subjects
CANCER risk factors; CANCER-related mortality; RISK assessment; URINARY organs; SCIENTIFIC observation; QUESTIONNAIRES; HEMATURIA; RETROSPECTIVE studies; DESCRIPTIVE statistics; CAUSES of death; ROUTINE diagnostic tests; TRANSITIONAL cell carcinoma; CASE-control method; MEDICAL records; ACQUISITION of data; MEDICAL referrals; DISEASE complications
- Publication
Urology Research & Practice, 2024, Vol 50, Issue 2, p102
- ISSN
2980-1478
- Publication type
Article
- DOI
10.5152/tud.2024.23025