EAU 2018: A Challenging Evaluation for Etiology of Recurrent Hematuria: Urinary System Pathology or a Complication of Antiplatelet/Anticoagulant Treatment
Dr. Dikmen (MD) from Polati Duatepe Government Hospital Department of Urology in Ankara Turkey presented a retrospective analysis of 2500 patients with recurrent hematuria between March 2010 and July 2017. Of side note, Dr. Dikmen credits her colleagues and leadership in her institution for the opportunity to present this year at the EAU congress 2018 and wishes to acknowledge these parties for the opportunity to present.
Of the 2500 patients included in this study, 1312 patients had recurrent microscopic hematuria and 1188 patients had recurrent macroscopic hematuria. Of these, 1680 (67.2%) of patients were utilizing antiplatelet/anticoagulant treatment. Further evaluation of these patients found 116 (8.9%) of patients presenting with microscopic hematuria and 92 (7.7%) with macroscopic hematuria had tumoral lesions (3.9% pT2 and all others >pT2).
In discussion, it is noted that microscopic hematuria does not typically require urgent treatment upon initial presentation and the majority of cases do not confer a diagnosis of tumoral lesions. Regardless, Dr. Dikmen states that the standard clinical care pathway in her institution is to adopt an active surveillance approach and monitor the patients over the following 6 month period. Re-assessment for tumoral lesions are performed until hematuria is resolved.
Overall, Dr. Dikmen states that a complete and comprehensive urinary analysis evaluation should still be conducted in patients who have recurrent hematuria. In particular, even if there are no pathologies identified and the patient is not on antiplatelet or anticoagulant therapy, the patient still undergoes active surveillance and periodic observation.
Presenter: Ayse V. Dikmen
Written by: Linda M. Huynh, B.S, University of California-Irvine, at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark