A clear history of lower urinary tract haematuria does not always require extensive radiological investigation of the upper urinary tract
BAUS ePoster online library. Stewart H.
Jun 26, 2018; 211353
Disclosure(s): Yes
Ms. Heather Stewart
Ms. Heather Stewart
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Rate & Comment (0)
Introduction: We investigated the incidence of upper urinary tract (UUT) abnormalities in males with initial and/or terminal visible haematuria (VH) suggesting a lower urinary tract (LUT) cause. Is extensive UUT imaging really necessary?

Materials/Method: Two-armed (retrospective (n=419) and prospective (n=1173)) study of all consecutive male patients with VH over 5 years. All patients underwent flexible cystoscopy (FC) and UUT imaging (USS+/-IVU/CT urogram). Those with initial and/or terminal VH were scrutinised further.

Results: 62/419 (14.8%) of patients in the retrospective group (R-G) and 183/1173 (15.6%) in the prospective group (P-G) presented with initial and/or terminal VH. In the R-G, FC revealed these LUT abnormalities: 4 bladder calculi; 3 bladder tumours; 1 urethral stricture. Only one UUT malignancy was identified (single case of renal cell carcinoma detected on USS and IVU). In the P-G, 129/183 patients underwent CT and 75 had an USS. 178/183 had a FC with these findings: 70 large/vascular prostates (38.3%); 25 bladder tumours (13.7%); 16 urethral strictures (8.7%); 1 bladder neck stenosis and 66 normal inspections (36.1%). UUT imaging demonstrated an abnormality in 13 (7.1%) patients (5 non-obstructing renal calculi; 4 angiomyolipoma; 2 hydronephrosis due to known bladder tumour; 1 polycystic kidney disease; 1 known/pre-existing tumour.) No new UUT malignancies were identified in 183 patients.

Conclusions: Patients with an exclusive history of initial and/or terminal VH do not require extensive UUT imaging due to the low incidence of serious UUT pathology. FC and USS (rather than CT) may suffice, also reducing inconvenience, radiation exposure and healthcare costs.
    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Save Settings