DAY-CASE HEMATURIA DIAGNOSTIC SERVICE - USE OF ULTRASONOGRAPHY AND FLEXIBLE CYSTOSCOPY

Objectives. To assess the efficacy of a day case diagnostic service em ploying ultrasonography and flexible cystoscopy in the evaluation of p atients presenting with painless gross hematuria. Methods. From July 1 994 to June 1997 a prospective study was conducted for 312 consecutive patients presenting with painless gross hematuria. They were evaluate d in a day case diagnostic service setting, where ultrasonography and flexible cystoscopy were performed together with other laboratory inve stigations. Intravenous urography was subsequently performed for possi ble additional diagnostic information. Results, Eighty-one urinary mal ignancies were detected in 78 patients; 51 were carcinoma of the bladd er, and the next most common was renal cell carcinoma (n = 15). Defini tive diagnoses were made in 68 patients and an abnormality was noted i n 9 other patients after the day case workup. The day case diagnostic workup has led to highly selective use of computed tomography scans wi th high diagnostic yield; intravenous urography only added important d iagnostic information, not available from the earlier workup, in 9 pat ients. Conclusions. Day case diagnostic service is a feasible arrangem ent. By combining, ultrasonography and flexible cystoscopy, most carci nomas were diagnosed and abnormalities detected. Such a service enhanc es rapid completion of diagnostic workup, and operations for surgical conditions can be scheduled more promptly. (C) 1998, Elsevier Science Inc. All rights reserved.