Literature DB >> 19097811

Are patients with hematuria appropriately referred to Urology? A multi-institutional questionnaire based survey.

Alan M Nieder1, Yair Lotan, Geoffrey R Nuss, Joshua P Langston, Sachin Vyas, Murugesan Manoharan, Mark S Soloway.   

Abstract

INTRODUCTION: Hematuria is a common finding that may be a sign of serious underlying urologic disease. Thus, the AUA guidelines (written in conjunction with the American Academy of Family Practice) recommend urologic evaluation for patients with both microscopic and gross hematuria. We sought to evaluate practice patterns of the evaluation of hematuria by primary care physicians (PCPs) in two locations in the United States.
METHODS: Anonymous questionnaires regarding use of urinalysis (UA) and evaluation of hematuria were mailed to 586 PCPs in Miami, Florida and 1,915 in Dallas, Texas. Surveys were mailed to physicians who identified themselves as practitioners of internal medicine, family practice, primary care, or obstetrics and gynecology.
RESULTS: Surveys were completed by 788 PCPs including 270 (46%) and 518 (26%) PCPs in Miami and Dallas, respectively. Screening UAs were obtained on all patients by 77% and 64%, of physicians in Miami and Dallas, respectively. In both Miami and Dallas, only 36% of PCPs reported referring patients with microscopic hematuria to an urologist. In patients with gross hematuria, referral rates were 77% and 69% in Miami and Dallas, respectively.
CONCLUSIONS: While many PCPs use UA in many of their patients routinely, few PCPs automatically refer their patients with microscopic hematuria to urology and not all patients with gross hematuria are referred. Further investigations regarding why and when patients are referred to urology is warranted. Increasing awareness of the complete and timely evaluation of hematuria may be beneficial in preventing a delay in bladder cancer. Copyright (c) 2010 Elsevier Inc. All rights reserved.

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Year:  2008        PMID: 19097811     DOI: 10.1016/j.urolonc.2008.10.018

Source DB:  PubMed          Journal:  Urol Oncol        ISSN: 1078-1439            Impact factor:   3.498


  27 in total

1.  Reluctance of general practitioners to refer gross hematuria patients to urology.

Authors:  Alan M Nieder
Journal:  Can Urol Assoc J       Date:  2011-04       Impact factor: 1.862

2.  The impact of female gender on bladder cancer-specific death risk after radical cystectomy: a meta-analysis of 27,912 patients.

Authors:  Shenghua Liu; Tian Yang; Rong Na; Mengbo Hu; Limin Zhang; You Fu; Haowen Jiang; Qiang Ding
Journal:  Int Urol Nephrol       Date:  2015-04-19       Impact factor: 2.370

3.  Urologist referral delay and its impact on survival after radical cystectomy for bladder cancer.

Authors:  F Santos; A Dragomir; W Kassouf; E Franco; A Aprikian
Journal:  Curr Oncol       Date:  2015-02       Impact factor: 3.677

Review 4.  Evaluation of asymptomatic, atraumatic hematuria in children and adults.

Authors:  William H Tu; Linda D Shortliffe
Journal:  Nat Rev Urol       Date:  2010-03-09       Impact factor: 14.432

5.  Immunocytology is a strong predictor of bladder cancer presence in patients with painless hematuria: a multicentre study.

Authors:  Eugene K Cha; Lenuta-Ancuta Tirsar; Christian Schwentner; Paul J Christos; Christine Mian; Joerg Hennenlotter; Thomas Martini; Arnulf Stenzl; Armin Pycha; Shahrokh F Shariat; Bernd J Schmitz-Dräger
Journal:  Eur Urol       Date:  2011-09-09       Impact factor: 20.096

6.  Variation in the intensity of hematuria evaluation: a target for primary care quality improvement.

Authors:  David F Friedlander; Matthew J Resnick; Chaochen You; Jeffrey Bassett; Vidhush Yarlagadda; David F Penson; Daniel A Barocas
Journal:  Am J Med       Date:  2014-01-28       Impact factor: 4.965

7.  High-risk patients with hematuria are not evaluated according to guideline recommendations.

Authors:  Keren Elias; Robert S Svatek; Samir Gupta; Richard Ho; Yair Lotan
Journal:  Cancer       Date:  2010-06-15       Impact factor: 6.860

8.  Application of Electronic Algorithms to Improve Diagnostic Evaluation for Bladder Cancer.

Authors:  Daniel R Murphy; Ashley N D Meyer; Viralkumar Vaghani; Elise Russo; Dean F Sittig; Kyle A Richards; Li Wei; Louis Wu; Hardeep Singh
Journal:  Appl Clin Inform       Date:  2017-03-22       Impact factor: 2.342

9.  Screening for bladder cancer: the best opportunity to reduce mortality.

Authors:  Yves Fradet
Journal:  Can Urol Assoc J       Date:  2009-12       Impact factor: 1.862

10.  A noninvasive multianalyte urine-based diagnostic assay for urothelial cancer of the bladder in the evaluation of hematuria.

Authors:  R Jeffrey Karnes; Cecilia A Fernandez; Anthony P Shuber
Journal:  Mayo Clin Proc       Date:  2012-08-09       Impact factor: 7.616

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