Incidence of Urologic Disease Among 95 Consecutive Filipino Patients Presenting With Asymptomatic Microscopic Hematuria
10.35460/2546-1621.2022-0036
- Author:
Ralph Albert Patrick UY
1
;
David BOLONG
1
Author Information
1. Section of Urology, Deparment of Surgery, University of Santo Tomas Hospital, Manila, Philippines
- Publication Type:Other Types
- Keywords:
Microscopic hematuria
- MeSH:
Urologic Diseases;
Hematuria
- From:
Journal of Medicine University of Santo Tomas
2022;6(2):971-978
- CountryPhilippines
- Language:English
-
Abstract:
Objective:One of the common clinical problems
warranting urologic evaluation is asymptomatic
microscopic hematuria (AMH). According to some
studies, it has prevalence as high as 38% with a
possibility of urologic disease or malignancy around
23%. The presence of AMH would be quite a
dilemma to a urologist in terms of how aggressive
urologic evaluation and follow up is recommended.
The present study was to determine the incidence of
significant urologic diseases among Filipino patients
with AMH on initial evaluation and on follow-up.
This study would also determine if there would be
a significant difference in terms of incidence of
urologic disease among patients less than 35 years
old and more than 35 years old with AMH.
Methods:A total number of 95 patients (38 male,
57 female) were included in this study. All patients
presented with AMH. They were grouped in terms of
age, gender, and duration of follow-up. All patients
underwent cystoscopy and a diagnostic imaging
(ultrasound, CT urogram, or CT stonogram) on initial
evaluation. Patients then were followed up. They
were divided into two groups, those less than 2
years of follow-up and those more than 2 years of
follow-up. Excluded from the study are those patients with gross hematuria, on indwelling catheter, with
urinary tract infection, with previous malignancy,
history of pelvic irradiation, and those who did not
undergo cystoscopy, or any urologic imaging.
Results:Out of 95 patients with AMH who
underwent urologic evaluation, the incidence of
urologic disease was noted to be 12% (11 out of
95). There was no malignancy related cause of
AMH discovered. Age and gender failed to show
any significant difference in terms of developing
urologic disease. Among patients with negative
findings on initial urologic evaluation, no urologic
disease was noted even on follow-up. Among those
with positive findings on initial evaluation, no new
urologic disease was discovered on follow-up.
Conclusion:AMH has a low incidence of urologic
disease or any GUT malignancy. Age and gender
alone are not sufficient risk factors warranting
an invasive endoscopic procedure. They are
recommended only to those patients with high risk
of urologic disease and can be avoided in majority
of the population. We would recommend a kidney,
urinary bladder, and prostate (KUBP) ultrasound as
the initial imaging of choice since the only findings
noted on evaluation through imaging were just two
cases of nephrolithiasis, one via CT stonogram and
the other through a CT urogram, which can also
be diagnosed with a regular KUBP ultrasound. This
would be more cost-effective as well as beneficial in
terms of the patient’s risk regarding radiation and
contrast-related effects. Clinicians may decrease
unnecessary repeated urologic evaluation and follow-ups on patients with AMH, as the results of
the study failed to show any significant difference
in developing urologic disease for patients with
persistent AMH on initial assessment and even on
follow-up.
- Full text:Incidence of Urologic Disease.pdf
