A new diagnostic algorithm for the evaluation of microscopic hematuria
| Autor: | Raji Gill, Jamison S. Jaffe, Richard C. Harkaway, Phillip C. Ginsberg |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male Urologic Diseases medicine.medical_specialty Ureteral Calculi Urinalysis Urology Urine Kidney Diagnosis Differential medicine Humans Microhematuria Microscopic hematuria Aged Hematuria Ultrasonography Aged 80 and over medicine.diagnostic_test business.industry Urography Cystoscopy Middle Aged medicine.icd_9_cm_classification Kidney Neoplasms medicine.anatomical_structure Etiology Female Kidney Diseases Radiology business Algorithm Renal pelvis Algorithms Follow-Up Studies Pyelogram |
| Zdroj: | Urology. 57:889-894 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/s0090-4295(00)01124-9 |
| Popis: | Objectives. To evaluate a new diagnostic algorithm for microscopic hematuria in which intravenous urography (IVU) is performed as a secondary radiographic study when microhematuria has persisted for 3 months after the initial workup with renal ultrasound (US) and cystoscopy was negative. Methods. We evaluated 372 consecutive patients who presented with microhematuria and negative urine cultures and cytologic findings at our institution. All patients underwent renal US scanning and cystoscopy as their initial evaluation. All patients underwent re-evaluation 3 months after the initial workup. Patients with persistent microhematuria with no apparent etiology were then evaluated with IVU. Results. The initial evaluation was negative in 212 of 372 patients. Eighty-one of these patients had persistence of their microhematuria at the 3-month follow-up without a definitive diagnosis. Seventy-five of these patients underwent IVU. Abnormalities were found in 11 of the 75 patients. Six patients had renal stones, two had ureteral stones, two had ureteral tumors, and one had a tumor of the renal pelvis. Forty of the 131 patients with resolution of their microhematuria underwent IVU at their request. All those studies were normal. Conclusions. The combination of cystoscopy and renal US along with urinalysis, urine culture, and cytology is a good initial evaluation in patients with microhematuria. Those patients with persistent microhematuria after 3 months without definite etiology of the bleeding may still benefit from IVU. |
| Databáze: | OpenAIRE |
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