title: Streamlining the assessment of haematuria: 3-year outcomes of a dedicated haematuria clinic.
abstract: BACKGROUND
  Urgent assessment of haematuria is critical to exclude malignancy. The objective of this study is to report the outcomes of the first 3 years of a dedicated haematuria clinic at the Royal Melbourne Hospital, a Victorian tertiary hospital.
  
  
  METHODS
  All patients assessed in the haematuria clinic from April 2010 to April 2013 were included in the analysis. Outcomes were recorded prospectively and analysed retrospectively.
  
  
  RESULTS
  A total of 643 patients were seen in the haematuria clinic with non-visible (170, 26%) and visible haematuria (463, 72%) during this time period, all within 28 days of referral being triaged. Sixty-five (10%) patients were diagnosed with urothelial carcinoma, 63 with lower tract disease and two with upper tract urothelial carcinoma and another five (1%) patients with other tumours. Thirty out of 63 (48%) of the bladder urothelial carcinomas were invasive or high-grade. Two hundred and sixty-seven (42%) patients were discharged from the clinic after a single point of contact. One hundred and fifty-three (24%) patients were referred for further definitive management of suspected pathology. Two hundred and twenty-three (34%) patients were referred to outpatients clinic for further investigations. Urothelial carcinoma was diagnosed more often in males, older patients and patients with visible haematuria.
  
  
  CONCLUSIONS
  The Royal Melbourne Hospital haematuria clinic has served as an effective tool for rapid, streamlined assessment of patients presenting with haematuria. Follow-up of investigations by nurses and moving towards a 'one-stop' approach are helping to further decrease the number of patients requiring a second clinic visit.
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Sapre
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hayes
authors.forename: Pat
authors.initials: P
authors.lastname: Bugeja
authors.forename: Niall M
authors.initials: NM
authors.lastname: Corcoran
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Costello
authors.forename: Paul D
authors.initials: PD
authors.lastname: Anderson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D012017:Referral and Consultation; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000458:organization & administration; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000175:diagnosis*; D014739:Victoria; D055815:Young Adult
keywords: bladder cancer; clinics; flexible cystoscopy; haematuria; outcomes