Analysis of specialized medical care to patients with gross hematuria in Moscow urological hospitals

Malhasyan V.A., Ivanov V.Yu., Hodyreva L.A., Dudareva A.A., Kupriyanov Yu.A., Red'kovich V.I., Engay V.A., Cyganov S.V., Mamaev I.E., Lasskiy I.B., Sapozhnikov I.M., Otvetchikov I.N., Zinuhov A.F., Suleymanov S.I., Gumin L.M., Motin P.I., Tahirzade T.B., Rasner P.I., Kotov S.V., Zingerenko M.B.

Introdaction and objectives: The aim of the survey was to obtain information on treatment of patients admitted to Moscow urology departments with gross hematuria (GH).

Methods: A survey was sent to 17 urologic departments within Moscow. The questionnaire contained questions on medical, technical and organizational aspects of gross hematuria management. 189 questionnaires were available for analysis.

Results: The mean age was 66.6 years, mean hospital stay was 6.5 days. Mortality rate was 0.53%. The mean hemoglobin level at the admission was 127.5. Clot retention was observed in 17 (9%) patients. In most cases GH was caused by urinary infection 25 (27.5%), bladder tumor was detected in 45 (23.81%) cases. GH was managed conservatively in 133 (70.3%) patients, 56 (29.7%) patients underwent surgery due to GH. 13 (6.9%) patients required hemotransfusion. Etamsylatum and tranexamic acid 96 (50.8%) were the mostly used medications for GH management, while recombinant factors were used only in 3 (1.6%) patients.

Conclusions: The present survey shows that the almost 70% of patients with GH do not require surgery or hemotransfusion, and could be discharged within 1-2 days. Very few patients are administered recombinant factors as a hemostatic therapy. More active recombinant factors administration may potentially decrease surgery and hemotransfusion rates. Patients with bladder tumor have highest risk to undergo surgery.

Authors declare lack of the possible conflicts of interests.

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gross hematuria, bladder tumor, hospital treatment