Recurrence of Frank Hematuria Requires Careful Assessment-- Eric Metcalf
Monday, September 28, 2009
MONDAY, Sept. 28 (HealthDay News) -- In patients who have an initial episode of frank hematuria without a diagnosis, followed by a later recurrence, thorough evaluation is necessary due to a substantial risk of urological cancer, according to research published in the October issue of the Journal of Urology.
Said Fadel Mishriki, M.D., of the Aberdeen Royal Infirmary in the United Kingdom, and colleagues analyzed data from 578 patients with a first episode of frank hematuria between 1999 and 2001 who were followed for an average of nearly seven years.
The researchers found that a diagnosis was made upon the initial presentation in 35.6 percent of patients, including urological malignancy in 18 percent. In a questionnaire sent in 2007 to those who hadn't received a diagnosis, 20.3 percent reported recurrence of frank hematuria, with multiple recurrences in most cases. Repeat evaluation led to a significant urological diagnosis in 10.4 percent of patients.
"Performance of investigation for frank hematuria should be more selective in older patients and those with associated comorbidities. For the remaining approximately 20 percent of patients who do have frank hematuria recurrence thorough repeat investigations are mandatory because there is still a significant yield of urological malignancy (9.8 percent). Finally, diagnosis will not be confirmed in half of the patients with recurrent frank hematuria," the authors conclude.
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