The evaluation of CT urography in the haematuria clinic

Abstract

Objective:

We set out to evaluate the diagnostic yield of a haematuria clinic that utilised CT Urography (CTU) as the primary imaging modality in order to provide some guidance on imaging in this setting.

Patients and methods:

Records of 1000 consecutive patients attending a haematuria clinic over a 2-year period were analysed. Patients aged over 40 years with either visible (VH) or non-visible haematuria (NVH) underwent CTU & cystoscopy unless contraindicated.

Results:

560 males and 440 females (median age 62 years; range 17–98) were assessed. 130 malignancies related to the urinary tract were identified from the clinic; 17% for men and 8% for women. There were no upper tract urothelial tumours in patients under the age of 50 years, yet 4 were identified in patients over 50 years who presented with NVH. 28 patients who were found to have a positive MSU were diagnosed with an underlying malignancy, all over the age of 50 and 22 of these with VH.

Conclusion:

Our results aid in the development of an evidence-based protocol for the use of CTU in haematuria assessment. We also suggest full investigation of patients presenting with VH over the age of 50 and a positive MSU.