Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Assessment and Clinical Significance of Haematuria in Malaysian Patients - Relevance to Early Cancer Diagnosis

  • Ng, Keng Lim (Department of Surgery, Faculty of Medicine, University of Malaya) ;
  • Htun, Thi Ha (Department of Surgery, Faculty of Medicine, University of Malaya) ;
  • Dublin, Norman (Department of Surgery, Faculty of Medicine, University of Malaya) ;
  • Ong, Teng Aik (Department of Surgery, Faculty of Medicine, University of Malaya) ;
  • Razack, Azad Hassan (Department of Surgery, Faculty of Medicine, University of Malaya)
  • Published : 2012.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Aim: To study the causes and significance of both microscopic and macroscopic haematuria in adult patients and assess possible relevance to early detection of urological cancers. Methods: 417 patients presenting with haematuria were assessed in our Urology Unit. Following confirmation of haematuria, these patients were subjected to imaging techniques and flexible cystoscopy. Parameters analysed included clinical characteristics, imaging results, flexible cystoscopy findings, time delay to diagnoses and eventual treatment and final diagnoses of all cases. Results: 390 haematuria cases were analysed from 417 consecutive patients with haematuria. After 27 cases were excluded as they had previous history, 245 microscopic and 145 macroscopic. Age range was 17 to 95 years old with predominance of 152 females to 239 males. The racial distribution included 180 Chinese, 100 Indians,95 Malays and 15 other races. The final diagnoses were benign prostatic hyperplasia (22.6%), no cause found (22.3%), other causes (18.7%), urolithiasis (11.5%), urinary tract infection UTI (10.8%), non specific cystitis (10.3%), bladder tumours (2.8%) and other genitourinary tumours (1%). 11 new cases (2.8%) of bladder cancers were diagnosed, with a mean age of 59 years. Only 3 of 245 (1.2%) patients with microscopic haematuria had newly diagnosed bladder tumour compared with 8 of 145 (5.5%) patients with frank haematuria (p=0.016). Mean time taken from onset of symptoms to diagnosis of bladder cancer was 53.3 days with definitive treatment (TURBT) in 20.1 days from diagnosis. Conclusion:- This study has highlighted the common causes of haematuria in our local setting. We recommend that full and appropriate investigations be carried out on patients with frank haematuria especially those above 50 years old in order to provide earlier detection and prompt management of bladder diseases especially tumours.

Keywords

References

  1. Alishah S, Byrne D, Goodman CM, et al (2002). Haematuria investigation based on a standard protocol; emphasis on the diagnosis of urological malignancy. J R Coll Surg Edinb, 47, 422-7.
  2. Carroll PR (2000). Urothelial carcinoma, cancers of bladder, ureter and renal pelvis; In Tanagho EA, McAninch JW eds; Smith's General Urology, 15th edition, Chap 21. McGraw-Hill, 355-77.
  3. Edwards, TJ, Dickinson AJ, Natale S, et al (2006). A prospective analysis of the diagnostic yield resulting from the attendance of 4020 patients at a protocol drivan haematuria clinic. Br J Urol, 97, 301-5. https://doi.org/10.1111/j.1464-410X.2006.05976.x
  4. Greene LF, O'Shaughnessy EJ, Hendricks ED (1956). Study of 500 patients with asymptomatic microscopic haematuria. JAMA, 161, 610-3 https://doi.org/10.1001/jama.1956.02970070042011
  5. Khadra MH, Neal DE (2001). A prospective analysis of 1930 patients with haematuria to evaluate current diagnostic practice. J Urol, 165, 524-7. https://doi.org/10.1097/00005392-200102000-00047
  6. Kumar V, Cossar E, Patel H, et al (2004). Flexible cystoscopy - are we using it judiciously? BJU, 93 (Suppl 4), 48.
  7. Mohr DN, Offord KP, Owen RA, et al (1986). Asymptomatic microhaematuria and urologic disease; a population based study. JAMA, 256, 224-9. https://doi.org/10.1001/jama.1986.03380020086028
  8. Paul AB, Collie DA, Wild SR et al (1993). An integrated haematuria clinic. Br J Clin Pract, 47, 128-30.
  9. Rodgers MA, Herpel S, Aho T, et al (2006), Diagnostic tests used in the investigation of adult haematuria: a systemic review. BJU Int, 98, 1154-60. https://doi.org/10.1111/j.1464-410X.2006.06406.x
  10. Sultana SR, Baxby K (1996). Microscopic haematuria:-Urological investigations using a standard protocol. Br J Urol, 78, 691-6. https://doi.org/10.1046/j.1464-410X.1996.01975.x
  11. Tan PK, Sitoh YY (1998). Haematuria clinic. Singapore Med J, 39, 501-3.

Cited by

  1. Prevalence and risk factors for proteinuria: The National Kidney Foundation of Malaysia Lifecheck Health Screening programme vol.18, pp.8, 2013, https://doi.org/10.1111/nep.12112
  2. Identification of Patients with Microscopic Hematuria who are at Greater Risk for the Presence of Bladder Tumors Using a Dedicated Questionnaire and Point of Care Urine Test - A Study by the Members of Association of Urooncology, Turkey vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6283
  3. Patient Satisfaction in a One-Stop Haematuria clinic and Urology Outpatients: A Comparison of Clinics vol.10, pp.3, 2016, https://doi.org/10.1111/ijun.12086