Abstract
Objectives:
To assess the impact of the 2015 National Institute of Health and Care Excellence (NICE) guidance for referral of non-visible haematuria (NVH) and to compare diagnostic findings in patients referred using 2005 and 2015 guidance.
Patients and method:
Review of the referral details and diagnostic findings for urgent NVH referrals was assessed over a 27-month period. Referrals continued to be received under 2005 and 2015 NICE guidance during this period, and the diagnostic findings from each pathway were compared.
Results:
The number of urgent haematuria referrals reduced by 34% over the 27-month period. NVH referrals fell from 144 in the first quarter to 30 in the last quarter. The transitional cell carcinoma (TCC) diagnosis rate was low in patients referred using 2005 and 2015 criteria (1.7 and 1.9% respectively). No muscle-invasive bladder cancer (MIBC) was diagnosed. There was a high rate of benign urological findings. Non-adherence to referral criteria was high in the 2015 pathway (56%).
Conclusion:
The reduction in NVH referrals following introduction of 2015 NICE guidance could allow resource re-allocation. Low adherence to referral criteria should be investigated. The absence of MIBC and low rate of TCC diagnosis is reassuring and consideration should be given to investigating NVH patients semi-urgently.
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