Sharfi A R, Hassan O
Department of Surgery, Faculty of Medicine, University of Khartoum, Sudan.
East Afr Med J. 1994 Jan;71(1):29-31.
Four hundred and fifty patients with haematuria were studied over 10 years. Their mean age was 35 years. 103 (23%) patients had past histories of urinary bilharziasis. 207 (46%) patients had associated loin pain at presentation. Intravenous urography could detect the cause of the haematuria in 251 (56%) patients. Cystoscopy was diagnostic in 131 (29%) patients. Other methods of investigation included ultrasonography, selective renal angiography and renal biopsy. The commonest causes of haematuria were urinary calculi in 206 patients (46%), and carcinoma of the bladder in 47 (10%) patients. Twenty patients had squamous cell carcinoma of the urinary bladder in association with urinary bilharziasis, and all were under the age of 40 years, Other causes of haematuria included glomerular diseases in 31 patients, malignant renal tumours in 11, benign renal cysts in five, while it was due to benign prostatic hyperplasia in 31 patients, vesical calculi in 16, cystitis in nine and urethritis in nine patients. Forty two (9%) patients with undiagnosed haematuria were followed for five or more years. Repeat investigations in those with recurring haematuria were negative; except in four patients. Two of those were found to have hyperuricaemia, one renal tuberculosis; and one arterio-venous fistula. None of the patients labelled as having undiagnosed haematuria was found to have developed malignancy in the urinary tract over the subsequent five years. Accordingly, it seems that in the absence of significant signs and symptoms of urological or renal disease other than recurrent haematuria, the probability of finding a significant lesion is quite small.
在10年期间对450例血尿患者进行了研究。他们的平均年龄为35岁。103例（23%）患者有既往血吸虫性膀胱炎病史。207例（46%）患者在就诊时有腰痛。静脉肾盂造影能查出251例（56%）患者的血尿病因。膀胱镜检查确诊了131例（29%）患者。其他检查方法包括超声检查、选择性肾血管造影和肾活检。血尿最常见的病因是206例（46%）患者有尿路结石，47例（10%）患者有膀胱癌。20例患者的膀胱鳞状细胞癌与血吸虫性膀胱炎相关，且均年龄在40岁以下。血尿的其他病因包括31例肾小球疾病、11例恶性肾肿瘤、5例良性肾囊肿，31例患者是由于良性前列腺增生、16例是膀胱结石、9例是膀胱炎、9例是尿道炎。42例（9%）未确诊血尿的患者随访了5年或更长时间。对复发性血尿患者进行的重复检查均为阴性；只有4例除外。其中2例被发现有高尿酸血症，1例有肾结核，1例有动静脉瘘。在随后5年里，所有被标记为未确诊血尿的患者均未发现尿路发生恶性病变。因此，似乎除复发性血尿外，如果没有明显的泌尿系统或肾脏疾病的体征和症状，发现重大病变的可能性相当小。
