Faculty Collaboration Database

Utility of serial urinary cytology in the initial evaluation of the patient with microscopic hematuria. BMC Urol 2009 Sep 10;9:12

Date

09/12/2009

Pubmed ID

19744317

Pubmed Central ID

PMC2751768

DOI

10.1186/1471-2490-9-12

Scopus ID

2-s2.0-70349514869 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

BACKGROUND: We determine the utility of serial urinary cytologies in patients presenting with microscopic hematuria who were evaluated with upper and lower urinary tract studies to rule out a malignancy.

METHODS: Two hundred and thirty-seven patients with the diagnosis of microscopic hematuria were evaluated at an inner-city tertiary care hospital. Of these 239 patients, 182 patients had 405 cytologies obtained as part of their evaluation for hematuria. In addition, all patients had their lower urinary tract and upper tract thoroughly evaluated.

RESULTS: Two hundred and seventy four cytology samples were read as normal, 104 (26%) as atypia, 7 (2%) as suspicious/malignant, and 20 (5%) as unsatisfactory. Seventeen patients (9.3%) had biopsy confirmed bladder cancer. Of these 17 patients, 2 had normal cytology, 11 had atypia, and 5 had suspicious/malignant. No patient had a positive cytology and a negative biopsy. Overall the number of hematuric patients harboring bladder cancer was small (7%). Cytology #1 detected 4 cases of cancer, cytology #2 detected an additional case and cytology #3 did not detect any additional cancers.

CONCLUSION: Because of this low prevalence of bladder cancer in patients presenting with microscopic hematuria and the low sensitivity of detecting bladder cancers, the utility of urinary cytology in the initial evaluation of patients with hematuria may be minimal. The exact role of urinary cytology in the evaluation of hematuria is unknown.

Author List

Nakamura K, Kasraeian A, Iczkowski KA, Chang M, Pendleton J, Anai S, Rosser CJ

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Female
Hematuria
Humans
Male
Middle Aged
Retrospective Studies
Urine
Young Adult