Abstract
BackgroundWe 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.MethodsTwo 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.ResultsTwo 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.ConclusionBecause 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.
Highlights
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
The question arises as to how effective is urinary cytology in diagnosing bladder cancer in a patient presenting with microscopic hematuria? we report the utility of urinary cytology of patients presenting to a urology clinic for evaluation of microscopic hematuria
Microscopic hematuria was characterized as microscopic hematuria [≥ 3 red blood cells (RBC) per high power field] [6]
Summary
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. Gross or microscopic hematuria [≥3 red blood cells (RBC) per high power field (hpf)] may be caused by numerous factors - urinary calculi, hematologic abnormalities, infection, trauma, tuberculosis, and tumor [1]. Some of these factors (e.g., tumor) may be life threatening. Interpretation of urinary cytology may be difficult, especially in the face of such conditions as urinary tract infection With these notable limitations, the question arises as to how effective is urinary cytology in diagnosing bladder cancer in a patient presenting with microscopic hematuria? The question arises as to how effective is urinary cytology in diagnosing bladder cancer in a patient presenting with microscopic hematuria? we report the utility of urinary cytology of patients presenting to a urology clinic for evaluation of microscopic hematuria
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