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Diagnostic value of repeated comprehensive investigation with CT urography and cystoscopy for recurrent macroscopic haematuria

Abuhasanein, Suleiman ; Chaves, Vanessa ; Mohsen, Ali Moustafa ; Al-Haddad, Jasmine ; Sunila, Merete ; Ströck, Viveka ; Jerlström, Tomas ; Liedberg, Fredrik LU ; Swärd, Jesper and Gårdmark, Truls , et al. (2024) In BJUI Compass 5(2). p.253-260
Abstract

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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bladder cancer, computed tomography, cystoscopy, haematuria, recurrent, urography, urological neoplasm
in
BJUI Compass
volume
5
issue
2
pages
8 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:38371208
  • scopus:85185123512
DOI
10.1002/bco2.300
language
English
LU publication?
yes
id
ce25040e-ac3b-4917-ada3-27c9880b6ee9
date added to LUP
2025-01-10 14:23:30
date last changed
2025-07-12 05:41:49
@article{ce25040e-ac3b-4917-ada3-27c9880b6ee9,
  abstract     = {{<p>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.</p>}},
  author       = {{Abuhasanein, Suleiman and Chaves, Vanessa and Mohsen, Ali Moustafa and Al-Haddad, Jasmine and Sunila, Merete and Ströck, Viveka and Jerlström, Tomas and Liedberg, Fredrik and Swärd, Jesper and Gårdmark, Truls and Jahnson, Staffan and Kjölhede, Henrik}},
  keywords     = {{bladder cancer; computed tomography; cystoscopy; haematuria; recurrent; urography; urological neoplasm}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{253--260}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{BJUI Compass}},
  title        = {{Diagnostic value of repeated comprehensive investigation with CT urography and cystoscopy for recurrent macroscopic haematuria}},
  url          = {{http://dx.doi.org/10.1002/bco2.300}},
  doi          = {{10.1002/bco2.300}},
  volume       = {{5}},
  year         = {{2024}},
}