Madaan Anika, Kuusk Teele, Hamdoon Musaab, Elliott Angela, Pearce Dianne, Madaan Sanjeev
Faculty of Medicine Imperial College London London UK.
Department of Urology and Nephrology Dartford and Gravesham NHS Trust Dartford UK.
BJUI Compass. 2021 Jun 12;2(6):385-394. doi: 10.1002/bco2.100. eCollection 2021 Nov.
Objective of this study is to report the results of nurse led hematuria clinic service outcome of 2,714 patients.
We conducted a retrospective, single center review of 2714 patients with visible and nonvisible hematuria managed by a well-trained nurse specialist in a rapid access clinic (RAC) between 2014 and 2020. All patients received a full review, flexible cystoscopy performed by a nurse, and ultrasound of urinary tracts. After investigations, patients were reassured and discharged or referred for rigid cystoscopy, TURBT, and CT urography.
In total, 2714 patients attended the RAC between October 2014 and March 2020. Of these, 1684 (62%) were males and 1030 (38%) females. The median age of patients was 68.3 (IQR 58-79). Of the 1030 females, 500 (48.5%) presented with nonvisible hematuria (NVH), and 530 (51.5%) presented with visible hematuria (VH). The median age was 66 (IQR 56-76). The number of females diagnosed with any form of malignancy was 72 (7% of all females). Of the 1684 males, 288 (17.1%) presented with NVH, and 1396 (82.9%) presented with VH. The median age was 72 (IQR 59-81). The number of males diagnosed with some form of malignancy was 258 (15.3% of all males). Overall, 1926 patients presented with VH and 788 patients presented with NVH. After investigations, 290 patients (15.1%) with VH and 40 (5.1%) patients with NVH had some form of malignancy. The highest number of malignancies found in VH was bladder cancer (n = 222, 11.5%), followed by prostate (n = 28, 1%), renal (n = 23, 0.8%), UT urothelial (n = 17, 0.6%), gynaecological (n = 7, 0.3%), and gastrointestinal (n = 5, 0.2%) cancer. The highest number of pathologies found in NVH was infection (n = 44, 5.6%). Cancer detection rate for symptomatic NVH was more than double that of asymptomatic NVH, 6.5% versus 3.1%, respectively.
Overall, 15.1% with VH and 5.1% with NVH present with malignancy. Nurse-led rapid access hematuria clinic and flexible cystoscopy investigation by trained nurse is safe and feasible.
本研究的目的是报告由护士主导的血尿门诊对2714例患者的服务结果。
我们对2014年至2020年间在快速通道诊所（RAC）由训练有素的护士专科医生管理的2714例肉眼血尿和非肉眼血尿患者进行了一项回顾性单中心研究。所有患者均接受了全面检查、护士进行的软性膀胱镜检查以及泌尿系统超声检查。检查后，患者得到安心并出院，或被转诊进行硬性膀胱镜检查、经尿道膀胱肿瘤切除术（TURBT）和CT尿路造影。
2014年10月至2020年3月期间，共有2714例患者就诊于RAC。其中，1684例（62%）为男性，1030例（38%）为女性。患者的中位年龄为68.3岁（四分位间距58 - 79岁）。在1030例女性中，500例（48.5%）表现为非肉眼血尿（NVH），530例（51.5%）表现为肉眼血尿（VH）。中位年龄为66岁（四分位间距56 - 76岁）。被诊断患有任何形式恶性肿瘤的女性患者有72例（占所有女性的7%）。在1684例男性中，288例（17.1%）表现为NVH，1396例（82.9%）表现为VH。中位年龄为72岁（四分位间距59 - 81岁）。被诊断患有某种形式恶性肿瘤的男性患者有258例（占所有男性的15.3%）。总体而言，1926例患者表现为VH，788例患者表现为NVH。检查后，290例（15.1%）VH患者和40例（5.1%）NVH患者患有某种形式的恶性肿瘤。VH中发现恶性肿瘤数量最多的是膀胱癌（n = 222，11.5%），其次是前列腺癌（n = 28，1%）、肾癌（n = 23，0.8%）、上尿路尿路上皮癌（n = 17，0.
