Urology research & practice最新文献

{"title":"Role of Chemoablation Using UGN-101 in Upper Tract Urothelial Carcinoma: A Systematic Review and MetaAnalysis of Available Evidence.","authors":"Abdalla Ali Deb, Pragnitha Chitteti, Naufal Naushad, Wael Asaad, Steve Leung, Hartley Alice, Serag Hosam","doi":"10.5152/tud.2024.23215","DOIUrl":"10.5152/tud.2024.23215","url":null,"abstract":"<p><p>To examine the safety and efficacy of chemoablation using UGN-101 in patients with upper tract urothelial cancer (UTUC). We conducted a systematic search through 7 databases/registries to identify key observational and experimental studies reporting either the efficacy or safety of UGN-101 in UTUC patients regardless of the risk or grade of the disease. The outcomes included efficacy (complete/partial/no response, survival, death, recurrence, or progression) and safety endpoints. All meta-analyses were conducted through STATA. The prevalence rate and its 95% CI were pooled across studies. A subgroup meta-analysis was conducted on follow-up. The quality was assessed using the Newcastle Ottawa Scale. Twenty studies (1051 patients) were analyzed. Complete response was reported in 49% (39%-60%) of cases, and 5% (0%- 15%) had disease progression. Treatment cessation was reported in 13% (3%-27%) of patients. Four percent of cases needed radical nephroureterectomy. Recurrence and death occurred in 14% (7%-23%) and 6% (2%-10%) of patients. Complications occurred in 63% (39%-85%), the majority of which were of grades I, II, and III. Ureteral stenosis was the most common complication accounting for 35% of cases. Chemoablationrelated complications occurred more than procedure-related ones. Based on available evidence, the intracavitary instillation of UGN-101 gel provides an alternative therapeutic option for upper tract urothelial cancer. Chemoablation provides good clinical outcomes in terms of complete response, disease progression and recurrence, and the need to undergo nephroureterectomy. Complications were encountered in more than half the population; however, most of them were of low grades.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 2","pages":"72-84"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can We Predict Renal Function Recovery After Pyeloplasty in Pediatrics with Ureteropelvic Junction Obstruction? A Systematic Review.","authors":"Safendra Siregar, Akhmad Mustafa, Steven Steven","doi":"10.5152/tud.2024.23220","DOIUrl":"10.5152/tud.2024.23220","url":null,"abstract":"<p><p>Chronic unilateral renal obstruction, primarily caused by ureteropelvic junction obstruction (UPJO), poses challenges in determining the optimal timing for corrective surgery. The goal is to preserve renal function and alleviate symptoms, but there is no definitive diagnostic test to reliably predict the outcomes of surgery. This systematic review aimed to identify predictors for renal function recovery after pyeloplasty in order to guide effective treatment options. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A literature search was performed on PubMed, Embase, and Scopus using keywords related to renal function, pyeloplasty, and predictors. The search was conducted on March 10, 2022. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Out of 344 potentially relevant articles, 11 met the eligibility criteria for this study. These included 6 retrospective and 5 prospective studies, with a total of 925 participants. Most studies evaluated renal function using differential renal function (DRF). The overall quality of the included studies was considered average. The findings indicated that age at the time of surgery and gender did not significantly influence functional recovery after pyeloplasty. However, preoperative DRF consistently emerged as a critical predictor. Preoperative DRF can serve as the most common predictors used for renal function recovery following pyeloplasty. These findings contribute to understanding effective treatment options for chronic unilateral renal obstruction. However, further research for each predictor is needed to validate these predictors and their clinical utility. Cite this article as: Siregar S, Mustafa A, Steven S. Can we predict renal function recovery after pyeloplasty in pediatrics with ureteropelvic junction obstruction? A systematic review. Urol Res Pract. Published online March 31, 2024. DOI:10.5152/tud.2024.23220.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in Hypospadias Management: Trends, Techniques, Training, and Patient-Centric Outcomes.","authors":"Vinaya Bhatia, Nicolas Fernandez, Christopher Long, Renea Sturm, Walid Farhat, Fardod O'Kelly","doi":"10.5152/tud.2024.23219","DOIUrl":"10.5152/tud.2024.23219","url":null,"abstract":"<p><p>Hypospadias has drawn increasing attention due to its prevalence, complex etiology, and significant impacts on psychological and sexual quality of life. This comprehensive review delves into the facets of hypospadias management, exploring pivotal themes that shape present understanding and practice. We demonstrate potential explanatory factors for its incidence through an analysis of geographic, genetic, and environmental influences. We then contextualize care by exploring historical and evolving surgical techniques, and highlight that advances in surgical approaches employ a spectrum of repair strategies. Innovation in surgical training, with a focus on simulation-based methodologies, offers a bridge between didactic learning and real-world application, which is particularly relevant due to the demonstrated effect of personal experience with hypospadias repair outcomes. Considering the importance of mentorship, case exposure, and hands-on practice, a holistic understanding of expertise cultivation at each training stage is essential. Lastly, patient-centric outcomes research must take center stage, particularly as the impact of our interventions on children with hypospadias will be judged by them as adults. Shifting from solely surgeon-reported outcomes to patient-reported outcomes is emphasized in the review, allowing for a more comprehensive assessment of the influence of surgical interventions across the lifespan. Integrating patients' perspectives refines surgical decision-making to align with expectations, ultimately enhancing overall satisfaction. Our multi-pronged exploration of advancements in hypospadias underscores the symbiotic relationship between evolving surgical techniques, training methodologies, personal experience, and patientreported outcomes. As the field progresses, these insights will collectively contribute to optimizing hypospadias care, advancing both medical practice and patient well-being.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 2","pages":"94-101"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines of Guidelines: Conservative, Pharmacological, and Surgical Management for Neurogenic Lower Urinary Tract Dysfunction.","authors":"Diana Carolina Ochoa, Alessia Christina Mahoney, Christina Fontaine, Hashim Hashim","doi":"10.5152/tud.2024.23232","DOIUrl":"10.5152/tud.2024.23232","url":null,"abstract":"<p><p>Neurogenic lower urinary tract dysfunction (NLUTD) encompasses a broad spectrum of neurological conditions affecting the lower urinary tract. Managing NLUTD requires a tailored approach focused on preserving kidney function and enhancing patients' quality of life. Clinical guidelines provide valuable guidance for healthcare professionals, but discrepancies in recommendations arise among other factors due to limited high-quality clinical evidence. Prominent guidelines from organisations like the International Consultation of Incontinence, the European Association of Urology, the American Urological Association, and the National Institute for Health and Care Excellence offer varying recommendations for NLUTD management. This study reviews and summarizes the recommendations for conservative, pharmacological, and surgical management options across these guidelines. Cite this article as: Ochoa DC, Mahoney AC. Fontaine C, Hashim H. Guidelines of guidelines: conservative, pharmacological, and surgical management for neurogenic lower urinary tract dysfunction (NLUTD). Urol Res Pract. Published online March 31, 2024. doi: 10.5152/tud.2024.23232.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy in Using Urodynamic Parameters of Intravesical Electrical Stimulation for Detrusor Underactivity.","authors":"Rahmat Aidil Fajar Siregar, Hendy Mirza, Widyawan Hami Seno, Nugroho Purnomo, Moammar Andar Roemare Siregar, Andika Afriansyah","doi":"10.5152/tud.2024.23235","DOIUrl":"10.5152/tud.2024.23235","url":null,"abstract":"<p><strong>Objective: </strong>Intravesical electrical stimulation (IVES) remains a controversial therapy for detrusor underactivity (DUA). The purpose of this study is to determine the efficacy of IVES in patients with DUA using pre- and post-IVES urodynamic parameters.</p><p><strong>Methods: </strong>Intravesical electrical stimulation procedure is performed using a specific catheter equipped with an internal electrical electrode (cathode). The anode is subsequently affixed to the lower abdomen (suprapubic). Afterward, this specialized catheter is connected to a stimulator. Patients undergo a series of 12 IVES procedures in 1 month with the following predetermined parameters: 20 mA amplitude, 20 Hz frequency, 200 µs pulse width, and 60 minutes stimulation time. Patients underwent a follow-up urodynamic examination 1 month after the IVES series is completed.</p><p><strong>Results: </strong>After IVES, several notable changes were observed, including an increase in Qmax from 7.28 ± 5.24 to 7.29 ± 4.09 (P=.030), a decrease in post-void residual (PVR) from 73.03 ± 43.91 to 62.07 ± 39.10 (P=.005), and an increase in PDet@tQmax from 17.10 ± 12.35 to 18.87 ± 12.47 (P=.009). The aetiologies of DUA were categorized into 3 groups: chronic obstruction (CO), idiopathic (Idio), and neurological disorder (ND). The CO group exhibited significant changes in urodynamic parameters, specifically Qmax (P=.001), PVR (P=.001), and PDet@Qmax (P=.035). Similarly, the idiopathic group also demonstrated improvements in Qmax (P=.008), PVR (P=.037), and PDet@ Qmax (P=.033).</p><p><strong>Conclusion: </strong>Intravesical electrical stimulation has been shown to have a positive effect on patients diagnosed with DUA, particularly those whose DUA is idiopathic or due to chronic obstruction.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Functional, Sexual, and Cosmetic Outcomes in Adult Patients Who Underwent Hypospadias Repair During Childhood at a Highly Specialized Italian Pediatric Hospital.","authors":"Alessia Celeste Bocchino, Andrea Cocci, Marta Pezzoli, Antonio Elia, Luca Landi, Alberto Mantovani, Chiara Cini, Lorenzo Masieri","doi":"10.5152/tud.2024.24005","DOIUrl":"10.5152/tud.2024.24005","url":null,"abstract":"<p><strong>Objective: </strong> This study aims to evaluate long-term functional, sexual, and cosmetic outcomes in adult patients who underwent hypospadias repair during childhood at a national highly specialized pediatric hospital.</p><p><strong>Methods: </strong> Medical records of pediatric patients who had undergone surgical repair of hypospadias between 1993 and 2004 at Meyer Children Hospital of Florence were reviewed. Adult patients were contacted by telephone between July and August 2021 and invited to participate. Long-term surgical outcomes were assessed focusing on complications and reinterventions, and 3 validated questionnaires on urinary function, erectile function, and penile cosmetic appearance were administered.</p><p><strong>Results: </strong> From January 1993 to December 2004, a total of 799 patients with hypospadias underwent repair surgery. Two hundred thirty-nine patients gave consent to be included in the study. Follow-ups occurred between 17 and 28 years after the first surgery. Most patients had anterior localization of hypospadias (210/239) and associated penile curvature (132/239). The most frequent surgery for hypospadias repair was meatal advancement and glanduloplasty incorporated (MAGPI) (88/239), and the most used surgical treatment for penile curvature was the Nesbit technique (49/132). The complication rate was 27% (65/239) in an average time of 4.7 years, and 48 surgical procedures have been performed to treat them. At follow-up, the mean IPSS was 0.96 ± 1.97, the mean IIEF-5 score was 24.10 ± 1.02, and the mean HOSE score was 15.47 ± 0.45. Patients who underwent reintervention reported a lower IPSS than those who underwent only 1 surgery (0.29 vs. 1.16).</p><p><strong>Conclusion: </strong> Hypospadias repair during childhood leads to rather normal urinary and sexual function and penile cosmetic appearance in adolescence and adulthood.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 2","pages":"127-133"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Prunus cerasus (Sour Cherry) on Nephrolithiasis in Children: The First Noninferiority Two-Arm Randomized Clinical Trial.","authors":"Fatemeh Ghane-Sharbaf, Zahra Reza-Jafar, Elham Bakhtiari, Sara Saadat","doi":"10.5152/tud.2024.23206","DOIUrl":"10.5152/tud.2024.23206","url":null,"abstract":"<p><strong>Objective: </strong> The present study evaluated the effect of Prunus cerasus (sour cherry) on children with nephrolithiasis.</p><p><strong>Method: </strong> We conducted a randomized noninferiority controlled trial to evaluate the therapeutic efficacy of P. cerasus among children with nephrolithiasis. Subjects in the intervention group received 1.25 mL/kg of cherry concentrate once daily for 2 months, while the control group received 1 mL/kg Polycitra-K, which consists of 220 g citrate potassium and 68 g citric acid in 1000 mL sterile water. The major outcome was sonographically determined number and sizes of kidney stones, which were assessed before and after the trial.</p><p><strong>Results: </strong> Sixty-eight children completed the study. At trial onset, both groups were similar in baseline characteristics (P >.05). In within-group analysis, the number of stones significantly decreased in both groups (P <05). After 2 months, the number of nephrolithiasis was 1.55 ± 0.49 and 1.47 ± 0.67 in the control and intervention groups, respectively (P value=.56). The percentage of change in calculi number was 44.11 ± 11.12 and 38.14 ± 14.08 in the control and intervention groups, respectively (P value=.08). At the end of the study, the urine pH was 6.46 ± 0.99 and 6.14 ± 0.83 in the control and intervention groups, respectively (P value=.19). Urine calcium and uric acid concentrations were 32.00 ± 12.32 and 28.95 ± 10.96 mg/mm (P value=.68) and 24.11 ± 10.58 and 30.03 ± 11.39 mg/mm (P value=.012) in control and intervention groups, respectively.</p><p><strong>Conclusion: </strong> Our clinical data supported the efficacy of sour cherry in the treatment of nephrolithiasis compared to Polycitra-K. Future randomized controlled trials are needed to confirm the present observation.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 2","pages":"134-138"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Impact of Family History, Demographics and Ecological Factors on Urolithiasis Prevalence: Insights from a Nationwide Study.","authors":"Abbas Basiri, Amir Hossein Kashi, Mazyar Zahir, Hossein Salehi Omran, Nasrin Borumandnia, Maryam Taheri, Shabnam Golshan, Behzad Naroie, Sakineh Hajebrahimi","doi":"10.5152/tud.2024.23221","DOIUrl":"10.5152/tud.2024.23221","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to evaluate the potential risk factors of lifetime urolithiasis occurrence on a nationwide scale in Iran.</p><p><strong>Methods: </strong> All data regarding urinary stone events were extracted from the cross-sectional Iran National Stone Survey (INSS) study, and the possible determinants of urolithiasis incidence were evaluated.</p><p><strong>Results: </strong> Our multivariable logistic regression suggested that while older age at presentation, male sex, and a positive family history of urolithiasis in either of the patient's parents or siblings were all significantly associated with an increased odds of lifetime urolithiasis occurrence (all P < .001), a positive family history in one's sister (odds ratio; OR=5.56) or brother (OR=4.70) were the most significant predictors. Moreover, belonging to Baluch ethnicity (i.e., an ethnical group indigenous to the south eastern regions of Iran) and residing in regions with higher water hardness (i.e., total concentration of dissolved minerals) were also associated with an increased odds of urolithiasis occurrence (P < .001 and P=.023, respectively). Conversely, living in regions with higher mean humidity decreased the chances of developing a urinary stone event during one's lifetime (OR=0.62, P <.001).</p><p><strong>Conclusion: </strong> Our results indicated that a constellation of demographic, ecological, and familial risk factors are associated with an elevated risk of developing urinary stones during one's lifetime. These findings can assist in implementing novel regional healthcare policies, considering the specific demographic and ecological characteristics. They also support tailoring personalized preventive strategies, particularly for individuals with multiple nonmodifiable risk factors.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 2","pages":"115-120"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Comparative Analysis of Supine Versus Prone Percutaneous Nephrolithotomy in Patients with Complex Renal Stone Disease and Difficult Anatomy.","authors":"Sunirmal Choudhury, Prakhar Patel, Gourab Kundu, Shahbaaz Ahmed, Malay Kumar Bera","doi":"10.5152/tud.2024.24010","DOIUrl":"10.5152/tud.2024.24010","url":null,"abstract":"<p><strong>Objective: </strong> In complex renal stone disease, few studies have shown that supine percutaneous nephrolithotomy (PCNL) is not inferior to prone PCNL. In our study, we evaluated the safety and efficacy of supine versus prone PCNL in patients with complex renal stone disease and patients with difficult anatomy.</p><p><strong>Methods: </strong> We prospectively analyzed 106 patients over 15 months from October 2022 to December 2023 and divided them as group S (Calcutta position supine arm) and group P (classical prone arm) by simple randomization. The measured data included body mass index (BMI), stone size, location of stone, number of punctures/ access, tract length, bleeding, operative time, stone-free rate (SFR), length of hospital stay, and postoperative complications.</p><p><strong>Results: </strong> The operative time was 104.722 ± (34.48) versus 124.30 ± (22.67) minutes (group S vs. group P), which was significant (P=.01). The nephroscopy time was 89.722 ± 34.55 in group S vs. 92.212 ± 20.18 minutes, which was also significant (P = .01). The mean postoperative hospital stay was 3.889 ± 1.09 and 4.558 ± 1.33 days in supine and prone group (P = .021), respectively. Four patients in group S required re-look PCNL in comparison to 8 in group P. Overall SFR at 1 month was 76.92% and 68.51% (P .331), respectively in case of group S and P.</p><p><strong>Conclusion: </strong> The study revealed that supine position in Calcutta position is a viable alternative to classical prone position even in patients with complex renal stone and patients with difficult anatomy as major complications are less, SFR is higher, and need of auxiliary procedures are rare.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 2","pages":"107-114"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urothelial Malignancy After Normal Hematuria Clinic Investigations: Does Non-visible Hematuria Need Reinvestigation?","authors":"Alice Thompson, Bev James, Rotimi David, Mohamed Youseff, Nicholas Gill, Matthew Jefferies, Pradeep Bose, Gokul Kanda Swamy","doi":"10.5152/tud.2024.23025","DOIUrl":"10.5152/tud.2024.23025","url":null,"abstract":"<p><strong>Objective: </strong> Hematuria is the most common referral to Urology. Most initial evaluations are normal; however there are few medium- to long-term studies about these patients after they are discharged.</p><p><strong>Methods: </strong> This study was a retrospective observational case-control study. Patients with normal initial investigations in our hematuria clinic (HC) over a 2-year period in 2012-2013 were included. We reviewed the electronic records of patients choosing January 1, 2021, as our reference date providing a median follow-up of 99 months. The primary aim of this study was to assess the missed urothelial malignancy (UM) rate in this cohort and also the UM rate in those re-referred to the HC.</p><p><strong>Results: </strong> The study included 573 patients of whom 24.6% (141/573) were re-referred to urology during the study period. The overall missed UM cancer rate was 0.5% and 0.2% died as a result in this follow-up period. The UM cancer rate in those re-referred was 4.3% and of those re-referred with visible hematuria (VH) the UM cancer rate was 5.7%. No patients re-referred with non-visible VH (NVH) were diagnosed with UM. The only urological death during this time was due to UM.</p><p><strong>Conclusion: </strong> All urological malignancy and mortality remain very low even at mediumto long-term follow-up after an initial normal HC investigation. In this study, no patients with recurrent NVH developed UM; therefore, recurrent NVH is unlikely to need reinvestigation. The risk of UM in those re-referred with VH is low but more substantial and warrants reinvestigation, which should include computed tomography urogram imaging.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"50 2","pages":"102-106"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}