ArticleUrologia internationalis2022
Flexible Cystoscopy in the Setting of Macroscopic Hematuria: Do the Findings Justify Its Use?
Article in Urologia internationalis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Patient-Reported Pain and Satisfaction During Flexible Cystoscopy in Supine Versus Lithotomy Positions in Adult Men: A Retrospective Observational Study.Healthcare (Basel, Switzerland) · 2026Article
- Article
- A systematic review of outcomes associated with patients admitted to hospital with emergency haematuria.BJUI compass · 2025Review
- Can artificial intelligence aid the urologists in detecting bladder cancer?Indian journal of urology : IJU : journal of the Urological Society of IndiaReview
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients hospitalized due to gross hematuria frequently complete evaluation in the outpatient setting. The use of office flexible cystoscopy during hospitalization may lead to prompt diagnosis and treatment but can be limited due to low visualization and artifacts that can hamper diagnostic ability.
objectiveThe objective of this study was to assess flexible cystoscopy findings and yield performed in patients hospitalized due to gross hematuria.
methodsMedical records of patients who underwent flexible cystoscopy while hospitalized during September 2018-December 2019 were reviewed. Cystoscopic findings were categorized into (1) suspicious mass in the bladder or prostate, (2) nonsuspicious changes in the bladder, and (3) nondiagnostic exam. Descriptive statistics were used to report the clinical characteristics of the study cohort and the findings of cystoscopy. Univariate logistic regression analyses were used to identify predictors of malignant findings.
resultsThe study cohort consisted of 69 patients (median age of 76 years). Initial cystoscopy findings were suspicious for malignancy in 26/69 patients (38%), nonsuspicious for malignancy in 34/69 patients (49%), and nondiagnostic in 9/69 patients (13%). The median follow-up time was 9 months (range 4-14 months). Twenty patients (29%) were diagnosed with malignancy (sensitivity of 75% and specificity of 78%). The procedure led to either diagnosis or treatment of 39 patients (57%). However, in 30 patients (43%), the initial cystoscopy did not aid in the diagnosis, led to misdiagnoses, or required a follow-up cystoscopy. On univariate analyses, none of the precystoscopy variables were predictive of bladder malignancy.
conclusionFlexible cystoscopy in the setting of acute hematuria requiring hospitalization did not lead to diagnosis or treatment in over 40% of cases. In this setting, consideration should be given to performing an upfront cystoscopy under anesthesia.
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