title: Gross hematuria in patients with prostate cancer: etiology and management.
abstract: The objective of the study is to assess the etiology and prognosis of gross hematuria (GH) in patients with carcinoma of the prostate (CAP). From 1991 to 2011, 81 men (mean age 74.3 years, SD 6.5) with CAP were hospitalized with GH. Primary treatment of CAP was radical surgery in 13 patients (group 1) and nonsurgical therapy in 68 (group 2), mostly radiotherapy (35 cases) and hormonal treatment (25 cases). The common etiologies of GH in group 1 were bladder cancer (38.5%) and urinary infection (23%). In contrast, CAP itself caused GH in 60% of the patients in group 2. Thirty-nine patients (48%) required transurethral surgery to manage GH which was effective in all cases; nevertheless, the prognosis of group 2 patients was dismal with median overall survival of 13 months after sustaining hematuria, compared to 50 months in group 1 (P = 0.0015). We conclude that the etiology of GH in patients with CAP varies according to primary treatment. After radical prostatectomy, it is habitually caused by bladder cancer or infection. When the primary treatment is not surgical, GH is most commonly due to CAP itself. Although surgical intervention is effective in alleviating hematuria of these patients, their prognosis is dismal.
authors: Department of Urology, Hadassah Hebrew University Hospital, P.O. Box 12000, Jerusalem 91120, Israel.
authors: Ofer N
authors: ON
authors: Gofrit
authors: Ran
authors: R
authors: Katz
authors: Amos
authors: A
authors: Shapiro
authors: Vladimir
authors: V
authors: Yutkin
authors: Galina
authors: G
authors: Pizov
authors: Kevin C
authors: KC
authors: Zorn
authors: Mordechai
authors: M
authors: Duvdevani
authors: Ezekiel H
authors: EH
authors: Landau
authors: Dov
authors: D
authors: Pode
references: J Urol. 2000 Feb;163(2):496-8
references: 10647664
references: Radiother Oncol. 2009 Nov;93(2):192-6
references: 19464745
references: Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1341-6
references: 7713792
references: Urology. 2008 Nov;72(5):1130-4
references: 18400265
references: Urology. 2009 Sep;74(3):601-5
references: 19589580
references: J Urol. 2005 Mar;173(3):781-3
references: 15711269
references: Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):1100-9
references: 17967304
references: BJU Int. 2006 May;97(5):900-2
references: 16643466
references: Int J Radiat Oncol Biol Phys. 2010 Jul 15;77(4):1060-5
references: 20045267
references: Int J Radiat Oncol Biol Phys. 1993 May 20;26(2):197-201
references: 8491677