Urological Carcinomas in Patients Presented with Gross Hematuria
Urological Carcinomas with Gross Hematuria
DOI:
https://doi.org/10.54393/pjhs.v6i5.2847Keywords:
Gross Hematuria, Urological Carcinoma, Urinary Tract Infection, CystoscopyAbstract
Gross hematuria is a common urological symptom associated with both benign and malignant conditions. It is often a presenting feature of urological carcinomas, necessitating timely evaluation and diagnosis to improve outcomes. Objectives: To determine the prevalence of urological carcinomas and assess their association with demographic and clinical variables among patients presenting with gross hematuria. Methods: This descriptive cross-sectional study was conducted at the DHQ Teaching Hospital Mardan (KP) from July 2024 to January 2025. A total of 209 patients presenting with gross hematuria were included. Detailed demographic and clinical data, including age, gender, family history of cancer, anticoagulant use, urinary tract infections, history of stones, and prior urological surgeries, were recorded. All patients underwent urine cytology, ultrasound, X-ray KUB, computed tomography (CT) scan, and cystoscopy when required. Data analysis was performed using SPSS-25, and the Chi-square test was applied to determine associations. Results: Urological carcinoma was diagnosed in 41 (19.6%) patients. Higher prevalence was observed in older age groups (24.6% in 60–80 years) but showed no significant association with gender (p=0.333) or other clinical variables such as urinary tract infections (p=0.527) and anticoagulant use (p=0.997). Benign causes, including urinary tract infections (17.8%) and trauma, were common. Conclusions: It was concluded that urological carcinomas were prevalent in patients with gross hematuria, particularly in older age groups, highlighting the need for structured diagnostic evaluations. Early imaging, cytology, and cystoscopy are recommended to differentiate malignant from benign causes and improve outcomes.
References
Fernández-Pello S, Rodríguez G, JJ SP, PJ SS. Gross Hematuria and Usefulness of Urinary Cytology: Experience at Hematuria One Stop Clinic. Archivos Espanoles de Urologia. 2021 Jun; 74(5): 470-6.
Jaumdally J, Sinha S, Lazarus J, Jaumdally SZ, Sinha S, Pinto G. One-stop hematuria clinic: First experience in South Africa. South African Medical Journal. 2019 Nov; 109(11): 850-3. doi: 10.7196/SAMJ.2019.v109i11.13827. DOI: https://doi.org/10.7196/SAMJ.2019.v109i11.13827
Turner R, Powari M, Stevenson T. From Hematuria to Nephroureterectomy via Urine Cytology—A Case Study. Cytopathology. 2023 Sep; 34(5): 494-6. doi: 10.1111/cyt.13271. DOI: https://doi.org/10.1111/cyt.13271
Pandey S, Gupta V, Salu FF, Prateek B, Kumar S, Kalra P. Comparative Study of Ultrasound Abdomen and Pelvis with CT Urography in Diagnosis of Benign Causes of Hematuria. International Journal of Frontiers in Medicine and Surgery Research. 2023; 3(2). doi: 10.53294/ijfmsr.2023.3.2.0067. DOI: https://doi.org/10.53294/ijfmsr.2023.3.2.0067
Sengupta S, Basu S, Ghosh K. Transitional Cell Carcinoma of the Upper Urinary Tract: A Puzzle. International Journal of Advances in Medicine. 2020 Oct; 7(10): 1585. doi: 10.18203/2349-3933.ijam20204078. DOI: https://doi.org/10.18203/2349-3933.ijam20204078
Pal M, Chaudhary A, Srinivas V. Amyloidosis-A Rare but Mystifying Differential of Urothelial Cell Carcinoma of Urinary Bladder: A Case Report. Urology and Nephrology Open Access Journal. 2019; 07(2): 34-36. doi: 10.15406/unoaj.2019.07.00239. DOI: https://doi.org/10.15406/unoaj.2019.07.00239
Brooks ER, Siriruchatanon M, Prabhu V, Charytan DM, Huang WC, Chen Y et al. Chronic Kidney Disease and Risk of Kidney or Urothelial Malignancy: Systematic Review and Meta-Analysis. Nephrology Dialysis Transplantation. 2024 Jun; 39(6): 1023-33. doi: 10.1093/ndt/gfad249. DOI: https://doi.org/10.1093/ndt/gfad249
Nielsen TK and Røder MA. Case of the Month from Rigs Hospitalet, Copenhagen, Denmark: Unexplained Gross Hematuria. British Journal of Urology International. 2022 Nov; 130(6): 744. doi: 10.1111/bju.15843. DOI: https://doi.org/10.1111/bju.15843
Uscanga-Yépez J, Segovia-Sandoval K, Wilbert SS, Barrera-Juárez E. Synchronous Multilocular Renal Carcinoma with Ipsilateral Papillary Urothelial Carcinoma. Journal of Clinical Urology. 2019 Sep; 12(5): 401-3. doi: 10.1177/2051415818773677. DOI: https://doi.org/10.1177/2051415818773677
Arshad Z and Zaidi SZ. Urothelial Carcinoma in Children, Case Report with Review of Literature. The Journal of the Pakistan Medical Association. 2019 May; 69(5): 720-1.
Rai SK and Moudgil K. Heparin-Induced Gross Hematuria: A Case Study. International Journal of Research in Pharmaceutical Sciences. 2019; 10(3). doi: 10.26452/ijrps.v10i3.1440. DOI: https://doi.org/10.26452/ijrps.v10i3.1440
Hernandez N, Desroches B, Peden E, Satkunasivam R. Uretero-Iliac Artery Fistula: A Rare Cause of Haematuria. British Medical Journal Case Reports CP. 2020 Sep; 13(9): e232189. doi: 10.1136/bcr-2019-232189. DOI: https://doi.org/10.1136/bcr-2019-232189
Rao K and Sengupta S. Haematuria. In the Book: Textbook of Surgery. 2019 Nov. doi: 10.1002/9781119468189.ch74. DOI: https://doi.org/10.1002/9781119468189.ch74
Soomro AS, Mustafa G, Mahar NA, Mahmood A. Examine the Frequency of Urological Carcinomas in Patients Presented with Gross Hematuria. Age (Years). 2021; 30(20): 8-51.
Hamid H, Ghani A, Farooq K, Ullah R, Begum F, Khan I. Frequency of Urological Carcinoma in Patients Presenting with Gross Hematuria. Biological and Clinical Sciences Research Journal. 2023; 4(1): 471. doi: 10.54112/bcsrj.v2023i1.471. DOI: https://doi.org/10.54112/bcsrj.v2023i1.471
Malik MR, Saleem A, Patujo YH, Khan SA. Frequency of Urological Carcinomas in Patients with Gross Hematuria. Pakistan Journal of Medical and Health Sciences. 2022 Oct; 16(08): 872-. doi: 10.53350/pjmhs22168872. DOI: https://doi.org/10.53350/pjmhs22168872
Rai BP, Escrig JL, Vale L, Kuusk T, Capoun O, Soukup V et al. Systematic Review of the Incidence of and Risk Factors for Urothelial Cancers and Renal Cell Carcinoma Among Patients with Hematuria. European Urology. 2022 Aug; 82(2): 182-92. doi: 10.1016/j.eururo.2022.03.027. DOI: https://doi.org/10.1016/j.eururo.2022.03.027
Takeuchi M, McDonald JS, Takahashi N, Frank I, Thompson RH, King BF et al. Cancer Prevalence and Risk Stratification in Adults Presenting with Hematuria: A Population-Based Cohort Study. Mayo Clinic Proceedings: Innovations, Quality and Outcomes. 2021 Apr; 5(2): 308-19. doi: 10.1016/j.mayocpiqo.2020.12.001. DOI: https://doi.org/10.1016/j.mayocpiqo.2020.12.001
Khadhouri S, Gallagher KM, MacKenzie KR, Shah TT, Gao C, Moore S et al. Developing A Diagnostic Multivariable Prediction Model for Urinary Tract Cancer in Patients Referred with Hematuria: Results from the IDENTIFY Collaborative Study. European Urology Focus. 2022 Nov; 8(6): 1673-82. doi: 10.1016/j.euf.2022.06.001 DOI: https://doi.org/10.1016/j.euf.2022.06.001
Rysankova K, Vrtkova A, Grepl M, Filipkova V, Vesela A, Krhut J. Risk of Genitourinary Malignancy in Patients That Receive Anticoagulant or Antiplatelet Therapy. Bratislava Medical Journal/Bratislavské Lekárske Listy. 2023 Oct1; 24(10). doi: 10.4149/BLL_2023_112. DOI: https://doi.org/10.4149/BLL_2023_112
Tan WS, Ahmad A, Feber A, Mostafid H, Cresswell J, Fankhauser CD et al. Development and Validation of a Hematuria Cancer Risk Score to Identify Patients at Risk of Harboring Cancer. Journal of Internal Medicine. 2019 Apr; 285(4): 436-45. doi: 10.1111/joim.12868. DOI: https://doi.org/10.1111/joim.12868
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Health Sciences

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments