Skip to main content

Advertisement

SpringerLink
Log in

A comparison between transabdominal ultrasonographic and cystourethroscopy findings in adult Sudanese patients presenting with haematuria

  • Urology – Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

Gross and microscopic haematuria both are a common cause of referral to urology clinics. It has a wide spectrum of differential. In many occasions, it is a presentation of underlining serious urological problems. Evaluation of gross and significant microscopic haematuria is of paramount importance. This study was conducted to assess and compare the findings and diagnostic competency of transabdominal ultrasonography (US) versus cystourethroscopy in patients with haematuria of lower urinary tract origin.

Methods

Prospective hospital-based study done at Ibn Sina Specialized and Omdurman Military Hospitals from June 2012 to March 2013. The study included 109 patients. Structured questionnaires were used to gather data from patients. All patients were evaluated by transabdominal US before cystourethroscopy examination.

Results

One hundred and nine patients were studied. Patients’ mean (SD) age was 57.9 (18.8) years. Fifty-four patients (49.5 %) presented with macroscopic haematuria, while 55 patients presented with microscopic haematuria. The sensitivity and specificity of the US in detecting prostate enlargement, vesical stones, bladder wall tumour, cystitis and schistosomiasis were [(84, 80 %); (82.6, 97.7 %); (64.7, 92.1 %); (15.3, 96.8 %); and (15.3, 98.9 %)], respectively, as compared to cystoscopic finding as the gold standard.

Conclusions

Ultrasonography is accepted only as a first-line imaging tool for evaluation of haematuria in poor settings, but cannot replace or became as good as cystoscopy, which remains the gold standard.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Yeoh M, Lai NK, Anderson D, Appadurai V (2013) Macroscopic haematuria a urological approach. Aust Fam Physician 42(3):123–126

    PubMed  Google Scholar 

  2. Renal Association and British Association of Urological Surgeons (2008) Joint consensus statement on the initial assessment of haematuria

  3. Yun EJ, Meng MV, Carroll PR (2004) Evaluation of the patient with hematuria. Med Clin N Am 88:329–343

    Article  PubMed  Google Scholar 

  4. Birch DF, Fairley KF (1979) Haematuria—Glomerular or non-glomerular? Lancet 2(8147):845–846

    Article  CAS  PubMed  Google Scholar 

  5. Van der Molen AJ, Hovius MC (2012) Hematuria: a problem based imaging algorithm illustrating the recent Dutch guidelines on hematuria. Am J Roentgenol 198(6):1256–1265

    Article  Google Scholar 

  6. Jimbo M (2010) Evaluation and management of hematuria. Prim Care 37(3):461–472

    Article  PubMed  Google Scholar 

  7. Yafi FA, Aprikian AG, Tanguay S, Kassouf W (2011) Patients with microscopic and gross hematuria : practice and referral patterns among primary care physicians in a universal health care system. Can Urol Assoc J 5(2):97–101

    Article  PubMed Central  PubMed  Google Scholar 

  8. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (2006) Campbell-Walsh urology 9 edition. Saunders, Philadelphia

  9. Fenlon HM, Bell TV, Ahari HK, Hussain S (1997) Virtual cystoscopy: early clinical experience. Radiology 205(1):272–275

    Article  CAS  PubMed  Google Scholar 

  10. Khadra MH, Pickard RS, Charlton M, Powell PH, Neal DE (2000) A prospective analysis of 1,930 patients with hematuria to evaluate current diagnostic practice. J Urol 163(2):524–527

    Article  CAS  PubMed  Google Scholar 

  11. Stav K, Leibovici D, Goren E, Livshitz A, Siegel YI, Lindner A, Zisman A (2004) Adverse effects of cystoscopy and its impact on patients’ quality of life and sexual performance. Isr Med Assoc J 6(8):474–478

    PubMed  Google Scholar 

  12. Zhang ZS, Tang L, Wang XL, Xu CL, Sun YH (2011) Seeing is believing: a randomized controlled study from China of real-time visualization of flexible cystoscopy to improve male patient comfort. J Endourol 25:1343–1346

    Article  PubMed  Google Scholar 

  13. Jones S, Richards D (1998) Imaging investigation of the urogenital tract. In: Sutton D (ed) Textbook of radiology and imaging, 6th edn. Churchill Livingstone, New York, pp 1113–1129

    Google Scholar 

  14. Pavlica P, Gaudiano C, Barozzi L (2004) Sonography of the bladder. World J Urol 22(5):328–334

    Article  PubMed  Google Scholar 

  15. World Bank Database. http://data.worldbank.org/country/sudan

  16. Deribe K, Eldaw A, Hadziabduli S, Kailie E, Omer MD, Mohammed AE, Jamshed T, Mohammed EA, Mergani A, Ali GA, Babikir K, Adem A, Hashim F (2011) High prevalence of urinary schistosomiasis in two communities in South Darfur: implication for interventions. Parasit Vectors 4:14

    Article  PubMed Central  PubMed  Google Scholar 

  17. Sharfi AR, Hassan O (1994) Evaluation of haematuria in Khartoum. East Afr Med J 71(1):29–31

    CAS  PubMed  Google Scholar 

  18. Harper R, Reeves B (1999) Reporting of precision of estimates for diagnostic accuracy: a review. BMJ 318(7194):1322–1323

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Cariou G, Maaraoui N, Cortesse A (1997) Can the combination of bladder ultrasonography and urinary cytodiagnosis replace cystoscopy in the diagnosis and follow-up of tumors of the bladder? Prog Urol 7(1):51–55

    CAS  PubMed  Google Scholar 

  20. Francica G, Bellini SA, Scarano F, Miragliuolo A, De Marino FA, Maniscalco M (2008) Correlation of transabdominal sonographic and cystoscopic findings in the diagnosis of focal abnormalities of the urinary bladder wall: a prospective study. J Ultrasound Med 27(6):887–894

    PubMed  Google Scholar 

  21. Stamatiou K, Papadoliopoulos I, Dahanis S, Zafiropoulos G, Polizois K (2009) The accuracy of ultrasonography in the diagnosis of superficial bladder tumors in patients presenting with hematuria. Ann Saudi Med 29(2):134–137

    Article  PubMed Central  PubMed  Google Scholar 

  22. Lopes RI, Nogueira L, Albertotti CJ, Takahashi DY, Lopes RN (2008) Comparison of virtual cystoscopy and transabdominal ultrasonography with conventional cystoscopy for bladder tumor detection. J Endourol 22(8):1725–1729

    Article  PubMed  Google Scholar 

  23. Abu-Yousef MM, Narayana AS, Franken EA Jr, Brown RC (1984) Urinary bladder tumors studied by cystosonography, part I: detection. Radiology 153(1):223–226

    Article  CAS  PubMed  Google Scholar 

  24. Vallancien G, Veillon B, Charton M, Brisset JM (1986) Can transabdominal ultrasonography of the bladder replace cystoscopy in the followup of superficial bladder tumors? J Urol 136(1):32–34

    CAS  PubMed  Google Scholar 

  25. Brun B, Gammelgaard J, Christoffersen J (1984) Transabdominal dynamic ultrasonography in detection of bladder tumors. J Urol 132(1):19–20

    CAS  PubMed  Google Scholar 

  26. Szabó V, Sobel M, Légrádi J, Balogh F (1976) Estimation of the size of prostatic adenoma by ultrasonography. A preliminary report. Eur Urol 2(5):226–228

    PubMed  Google Scholar 

  27. Roehrborn CG, Chinn HK, Fulgham PF, Simpkins KL, Peters PC (1986) The role of transabdominal ultrasound in the preoperative evaluation of patients with benign prostatic hypertrophy. J Urol 135(6):1190–1193

    CAS  PubMed  Google Scholar 

  28. Yuen JS, Ngiap JT, Cheng CW, Foo KT (2002) Effects of bladder volume on transabdominal ultrasound measurements of intravesical prostatic protrusion and volume. Int J Urol 9(4):225–229

    Article  PubMed  Google Scholar 

  29. Mohammed EH, Eltayeb M, Ibrahim H (2006) Haematological and biochemical morbidity of Schistosoma haematobium in school children in Sudan. Sultan Qaboos Univ Med J 6:59–64

    PubMed Central  PubMed  Google Scholar 

  30. Ahmed AA, Afifi AA, Adam I (2009) High prevalence of Schistosoma haematobium infection in Gereida Camp, in southern Darfur, Sudan. Ann Trop Med Parasitol 103(8):741–743

    Article  CAS  PubMed  Google Scholar 

  31. Deribe K, Eldaw A, Hadziabduli S, Kailie E, Omer MD, Mohammed AE, Jamshed T, Mohammed EA, Mergani A, Ali GA, Babikir K, Adem A, Hashim F (2011) High prevalence of urinary schistosomiasis in two communities in South Darfur: implication for interventions. Parasit Vectors 4:14

    Article  PubMed Central  PubMed  Google Scholar 

  32. Degremont A, Burki A, Burnier E, Schweizer W, Meudt R, Tanner M (1985) Value of ultrasonography in investigating morbidity due to Schistosoma haematobium infection. Lancet 1(8430):662–665

    Article  CAS  PubMed  Google Scholar 

  33. Abdel-Wahab MF, Ramzy I, Esmat G, el Kafass H, Strickland GT (1992) Ultrasound for detecting Schistosoma haematobium urinary tract complications: comparison with radiographic procedures. J Urol 148(2 Pt 1):346–350

    CAS  PubMed  Google Scholar 

  34. Elmadani AE, Hamdoun AO, Monis A, Karamino NE, Gasmelseed N (2013) Ultrasound findings in urinary shistosomaisis infection in school children in the Gezira State Central Sudan. Saudi J Kidney Dis Transpl 24(1):162–167

    Article  PubMed  Google Scholar 

  35. Doehring-Schwerdtfeger E, Kardorff R (1995) Ultrasonography in schistosomiasis in Africa. Mem Inst Oswaldo Cruz 90(2):141–145

    Article  CAS  PubMed  Google Scholar 

  36. Andrews SJ, Brooks PT, Hanbury DC, King CM, Prendergast CM, Boustead GB, McNicholas TA (2002) Ultrasonography and abdominal radiography versus intravenous urography in investigation of urinary tract infection in men: prospective incident cohort study. BMJ 324(7335):454–456

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  37. Mitterberger M, Aigner F, Pallwein L, Pinggera GM, Neururer R, Rehder P, Frauscher F (2009) Sonographic detection of renal and ureteral stones. Value of the twinkling sign. Int Braz J Urol 35(5):532–539

    Article  PubMed  Google Scholar 

  38. Park SJ, Yi BH, Lee HK, Kim YH, Kim GJ, Kim HC (2008) Evaluation of patients with suspected ureteral calculi using sonography as an initial diagnostic tool: How can we improve diagnostic accuracy? J Ultrasound Med 27(10):1441–1450

    PubMed  Google Scholar 

  39. Abu-Yousef MM, Narayana AS, Brown RC (1984) Catheter induced cystitis: evaluation by cystosonography. Radiology 151(2):471–473

    Article  CAS  PubMed  Google Scholar 

  40. Benchekroun A, el Alj HA, Zannoud M, Jira H, Essayegh H, Nouini Y, Marzouk M, Faik M (2003) Enterovesical fistula secondary to Crohn’s disease manifested by inflammatory pseudotumor of the bladder. Ann Urol (Paris) 37(4):180–183

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors are very grateful to all the patients for their co-operation. The study receives no fund.

Conflict of interest

The authors declare that they have no conflicts in this manuscript.

Author information

Authors and Affiliations

  1. Department of General Surgery, Faculty of Medicine, Al-Neelain University, P.O. Box 12702, Khartoum, Sudan

    Feras O. Ahmed & Hani B. Abdelgalil

  2. Department of Biochemistry and Molecular Biology, Faculty of Medicine, Al-Neelain University, P.O. Box 12702, Khartoum, Sudan

    Hamdan Z. Hamdan

  3. Department of Urology, Soba University Hospital, P.O. Box 102, Khartoum, Sudan

    Hani B. Abdelgalil & Abdulrauf A. Sharfi

Authors
  1. Feras O. Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hamdan Z. Hamdan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hani B. Abdelgalil
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Abdulrauf A. Sharfi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hamdan Z. Hamdan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ahmed, F.O., Hamdan, H.Z., Abdelgalil, H.B. et al. A comparison between transabdominal ultrasonographic and cystourethroscopy findings in adult Sudanese patients presenting with haematuria. Int Urol Nephrol 47, 223–228 (2015). https://doi.org/10.1007/s11255-014-0869-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-014-0869-9

Keywords

Search

Navigation