A prospective study on the cystoscopic findings in the initial evaluation of gross haematuria at Kenyatta National Hospital (KNH)
Design: A prospective observational study over a duration of 6 months. Objective: To document the main cystoscopic findings in the initial evaluation of gross haematuria. Setting: Kenyatta National Hospital, a Teaching and Referral Hospital situated in Nairobi City - the Capital of Kenya. DuratIon: From 31 st May 2005 - 30 November 2005 (Inclusive) Study Group: Patients aged 13 years and above presenting with gross haematuria from whom an informed consent was obtained. Method: Approval was obtained from the Hospitals Ethics and Research committee. Patients underwent evaluation consisting of demographics, basic blood tests, analysis of urine, imaging by ultrasonography. IVU was performed in some cases. The results were entered into a data sheet and statistical analysis was performed using SPSS version 10. Results: Sixty patients were recruited into the study the male to female ratio was 2:1. The mean age was 42.4 years with a range of 18 to 84 years. Cystoscopy was diagnostic in 95% of the cases. Malignancies were detected in 46.6% of the cases with a peak at 60 to 70 years. Most bladder tumours were located on the lateral walls and all primary bladder tumours were transitional cell carcinomas. No malignancy was detected below the age of 35 years. Conclusion:1) Cystoscopy and ultrasonography are the most useful investigations in the evaluation of gross haematuria and patients above 40 years of age stand a high risk of being diagnosed with a malignancy. Recommendations: All patients presenting with gross haematuria should undergo cystoscopy and ultrasonography.