Day case hematuria diagnostic service: use of ultrasonography and flexible cystoscopy.
OBJECTIVE
To assess the efficacy of a day case diagnostic service employing ultrasonography and flexible cystoscopy in the evaluation of patients presenting with painless gross hematuria.


METHODS
From July 1994 to June 1997 a prospective study was conducted for 312 consecutive patients presenting with painless gross hematuria. They were evaluated in a day case diagnostic service setting, where ultrasonography and flexible cystoscopy were performed together with other laboratory investigations. Intravenous urography was subsequently performed for possible additional diagnostic information.


RESULTS
Eighty-one urinary malignancies were detected in 78 patients; 51 were carcinoma of the bladder, and the next most common was renal cell carcinoma (n = 15). Definitive diagnoses were made in 68 patients and an abnormality was noted in 9 other patients after the day case workup. The day case diagnostic workup has led to highly selective use of computed tomography scans with high diagnostic yield; intravenous urography only added important diagnostic information, not available from the earlier workup, in 9 patients.


CONCLUSIONS
Day case diagnostic service is a feasible arrangement. By combining ultrasonography and flexible cystoscopy, most carcinomas were diagnosed and abnormalities detected. Such a service enhances rapid completion of diagnostic workup, and operations for surgical conditions can be scheduled more promptly.
Yip
S K
SK
Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong.
Peh
W C
WC
Tam
P C
PC
Li
J H
JH
Lam
C H
CH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003558:Cystoscopy; D005260:Female; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014570:Urologic Diseases / Q000150:complications / Q000175:diagnosis*