THE ROLE OF CYSTOSCOPY IN THE EVALUATION OF HEMATURIA IN THE PRESENCE OF NORMAL RADIOLOGICAL AND MICROBIOLOGICAL WORK-UP

Year 2003, Volume: 16 Issue: 4, 255 - 260, 03.12.2016

Cenk Yazıcı Levent Türkeri Yalçın Ülker Ferruh Şimşek

Abstract

Objective: The etiology of microscopic and
macroscopic hematuria may range from
conditions posing minimal risk to the patient to
potentially life-threatening conditions. There are
contraversial ideas about the evaluation of
hematuria. In this survey, we examined the
necessity of cystoscopy in patients with
microscopic and macroscopic hematuria who
were radiologically and microbiologically normal.
Methods: A total of 139 patients with
microscopic or macroscopic hematuria who were
microbiologically and radiologically normal and
had cystoscopy between 1991 and 2003 were
retrospectively analyzed. Routine history,
physical examination, routine blood tests, urine
analysis, urine culture, a plain radiography,
urinary system ultrasonography / intravenous
pyelography, computerized tomography and
tuberculosis tests, including ARB-Bactec were
unable to diagnose a pathology to identify the
reason for hematuria, and cystoscopy was
performed on all patients.
R e su lts : Seventy five (53.9%) patients were
male and 64 (46.1%) were female. There was
no pathology in 86 (61.8%) patients in
diagnostic cystoscopy whereas, 21(15.2%) had
a papillary tumor and 16 (11.5%) had a
suspicious lesion in the bladder that was
biopsied. In 16 (11.5%) patients prostatic
hypertrophy was the only cystoscopic finding.
According to the histopathological examination,
15 (93.5%) of the suspicious lesion biopsies
were benign, but 1 (6.5%) patient had
carcinoma in-situ. All of the papillary lesions
were reported as superficial transitional cell
carcinoma (TCCA). Overall, TCCA was detected
in 4(4.9%) and 18(31%) patients with
microscopic and macroscopic hematuria,
respectively. Irrespective of the type of the
hematuria, none of the patients under 40 years
of age were found to have bladder cancer.
C o n c lu s io n : Our findings indicate that all
patients older than 40 years of age with
microscopic and macroscopic hematuria should
undergo a cystoscopy. The current study further
suggests that patients younger than 40 years of
age with microscopic hematuria can only be
safely followed up with non-invasive methods,
without performing cystoscopy.
K e y W o rd s : Microscopic, Macroscopic,
Hematuria, Cystoscopy, Diagnosis

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