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Diagnostic value of repeated comprehensive investigation with CT urography and cystoscopy for recurrent macroscopic haematuria
Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Surgery, Urology Section, NU Hospital Group, Uddevalla, Sweden.
Department of Surgery, Urology Section, NU Hospital Group, Uddevalla, Sweden.
Department of Surgery, Urology Section, NU Hospital Group, Uddevalla, Sweden.
Department of Surgery, Urology Section, NU Hospital Group, Uddevalla, Sweden.
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2024 (Engelska)Ingår i: BJUI Compass, E-ISSN 2688-4526, Vol. 5, nr 2, s. 253-260Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives: To perform a descriptive analysis of a series of patients with recurrent macroscopic haematuria after a primary standard evaluation including computed tomography urography (CTU) and cystoscopy negative for urinary bladder cancer (UBC) and upper tract urothelial cancer (UTUC) and to identify potential factors associated with occurrence of recurrent macroscopic haematuria.

Methods: All patients older than 50 years who underwent urological investigation for macroscopic haematuria with both cystoscopy and CTU 2015-2017 were retrospectively reviewed. A descriptive analysis of the primary and later investigations for recurrent macroscopic haematuria was performed. To investigate the association between explanatory variables and the occurrence of recurrent macroscopic haematuria, a Poisson regression analysis was performed.

Results: A total of 1395 eligible individuals with primary standard investigation negative for UBC and UTUC were included. During a median follow-up of 6.2 (IQR 5.3-7) years, 248 (18%) patients had recurrent macroscopic haematuria, of whom six patients were diagnosed with UBC, two with prostate cancer, one with renal cell carcinoma and one had a suspected UTUC at the repeated investigation. Within 3 years, 148 patients (11%) experienced recurrent macroscopic haematuria, of whom two patients were diagnosed with low-grade UBC (TaG1-2), one with T2G3 UBC and one with low-risk prostate cancer. The presence of an indwelling catheter, use of antithrombotic medication, pathological findings at CTU or cystoscopy or history of pelvic radiotherapy were all statistically significant independent predictors for increased risk for recurrent macroscopic haematuria.

Conclusion: In the case of recurrent macroscopic haematuria within 3 years of primary standard evaluation for urinary tract cancer, there was a low risk of later urological malignancies in patients initially negative for UBC and UTUC. Therefore, waiting 3 years before conducting another complete investigation in cases of recurrent macroscopic haematuria might be appropriate.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2024. Vol. 5, nr 2, s. 253-260
Nyckelord [en]
bladder cancer, computed tomography, cystoscopy, haematuria, recurrent, urography, urological neoplasm
Nationell ämneskategori
Urologi och njurmedicin
Identifikatorer
URN: urn:nbn:se:oru:diva-110759DOI: 10.1002/bco2.300ISI: 001127510600001PubMedID: 38371208OAI: oai:DiVA.org:oru-110759DiVA, id: diva2:1829220
Anmärkning

The study was supported by grants from the Department of Research and Development, NU-Hospital Group.

Tillgänglig från: 2024-01-18 Skapad: 2024-01-18 Senast uppdaterad: 2024-03-06Bibliografiskt granskad

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Jerlström, Tomas
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Institutionen för medicinska vetenskaperRegion Örebro län
Urologi och njurmedicin

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