Melhem Motaz¹, Wani Mudassir², Burki Javid³, Zubair Bhat³, Omar Algurabi¹, Shahbaz Mehmood¹, Laith Abawi⁴, Vyrus Eleftheria⁵, Michael Conroy⁵ and Gilani Syed¹

¹Urology Registrar, Medway Maritime Hospital, Kent, UK
²ST4 Urology Trainee, Royal Glamaorgan Hospital, Cardiff, UK
³Urology Consultant, University College London Hospital, UK
⁴SHO Surgery, Medway Maritime Hospital, Kent, UK
⁵SHO, Medway Maritime Hospital, Kent, UK

*Corresponding Author: Gilani Syed, Urology Registrar, Medway Maritime Hospital, Kent, UK.

Received: November 07, 2023; Published: December 22, 2023

Abstract

Objective: To assess upper tract pathologies and diagnostic accuracy of imaging in patients presenting with haematuria.

Material and Method: We retrospectively analysed data of 821 patients, presenting to the haematuria clinic between January 2019 and January 2020. We recorded type of haematuria, age, sex, family, and occupational history. Results of cystoscopy and diagnostic imaging were collected from records. Involvement of upper tracts and diagnostic accuracy of imaging were assessed.

Results: Out of 821, 438 (58.83%) were male and 338 (41.17%) were female. 536 ( 65%) had non-visible haematuria (NVH) and 286 (35%) had visible haematuria (VH). 117(14%) were active smokers and 238 (27%) were ex-smokers. 9 patients had exposure to chemicals and 34 (4.2%) had a positive family history of urinary tract cancers. 813(99%) had flexible cystoscopy and 795 (97%) had upper tract imaging. 85% had CT Urogram and 46.6% had both CT and ultrasound. 87 (10.7%) patients had bladder tumours. 38 (4.7%) of patients had upper tract pathologies. Urolithiasis was diagnosed in 18(2.2%), and upper tract malignancies in 10(1.2%) of cases. Renal cell carcinoma was diagnosed in 6 (0.73%), and upper tract urothelial cancer in 4 (0.48%) of cases. 93.75% of patients with upper tract malignancies presented with visible haematuria. CT urogram had 100% diagnostic accuracy. Ultrasound was diagnostic in 93% of cases (16/17).

Conclusion: The prevalence of upper renal tract malignancies is very low in patients presenting with NVH. This is the time to risk stratify patients with non-visible haematuria and tailor the diagnostic imaging. Ultrasound can replace CT urogram in patients with NVH, further comparative studies are required.

Keywords: Haematuria; CT Urogram; Upper Tract Urothelial Cancer; Ultrasound

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Citation

Citation: Gilani Syed., et al. “Are We Over Investigating Non-Visible Haematuria, Time to Change Imaging Strategies?". Acta Scientific Clinical Case Reports 5.1 (2024): 51-55.

Copyright

Copyright: © 2024 Gilani Syed., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.