Is routine urine cytology useful in the haematuria clinic?
BACKGROUND
The objective of this study was to determine the value of routine urine cytology in the initial evaluation of patients presenting to a one-stop haematuria clinic.


METHODS
A total of 1000 consecutive patients who attended the haematuria clinic between June 2003 and November 2004 were studied prospectively. A standard protocol was used to investigate these patients. This included urine cytology, upper tract imaging and flexible cystoscopy.


RESULTS
Overall, 986 samples of urine were sent for cytology. In 126 patients, the report was abnormal; of these, 71 patients were found to have bladder transitional cell carcinoma by flexible cystoscopy and a further 3 had upper tract transitional cell carcinoma diagnosed radiologically. The remaining 52 patients with abnormal cytology were not found to have cancer on further investigations. The total cost for urine cytology and additional investigations was pound50,535.


CONCLUSIONS
In this study of the initial evaluation of patients with haematuria, no case of urothelial malignancy was diagnosed on the basis of urine cytology alone. Therefore, urine cytology need not be used routinely in the initial diagnostic work-up for haematuria.
Viswanath
S
S
Department of Urology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK. vishpad@hotmail.com
Zelhof
B
B
Ho
E
E
Sethia
K
K
Mills
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis*; D003362:Cost-Benefit Analysis; D003558:Cystoscopy; D003955:Diagnostic Tests, Routine / Q000191:economics; D006417:Hematuria / Q000175:diagnosis* / Q000191:economics / Q000652:urine; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis; D014556:Urine / Q000166:cytology*; D014571:Urologic Neoplasms / Q000000981:diagnostic imaging*