Saif-ud Din Awan, Ahmad Nawaz Bhatti, Amer Fakhr, Ayesha Noureen Awan, Hina Fiyyaz.
Frequency of urological carcinomas presenting as gross haematuria in Punjab Pakistan and recommendation for its early diagnosis.
Pak Armed Forces Med J Jan ;68(2):363-68.

Objective: To determine the frequency of various causes of gross Haematuria presenting in our hospital and recommend a working protocol to young doctors. Study Design: Prospective descriptive study. Place and Duration of Study: Urology Department, District Headquarter and Teaching Hospital, Sargodha Medical College, from Mar 2012 to Mar 2014. Material and Method: All fresh patients reporting to the hospital with complaints of ‘blood in urine’ were included in the study, while patients presenting with Microscopic haematuria were excluded. The patients, after being managed by the urology registrar, were given a questionnaire to fill, assisted by a resident, a reference number allotted for follow-up. A request for urine routine examination and urine microscopy/cytology was made to confirm haematuria and exclude malignant cells. Followed by ultrasound, X-Ray KUB, cystoscopy and IVU/CTU scan, as required. The results obtained were recorded and analyzed. Results: A total of 391 patients presented with complaints of ‘blood in urine’. Trauma: was the most frequent cause seen in 21.7% (n=85), followed by Urinary tract infections (21.0%, n=82), Urolithasis (20.2%, n=79) and Urological tumors seen 19.4% (n=76) cases. About two thirds of the patients (56.6%, n=43) with urological tumors were not investigated, at primary health care level, to ascertain the cause and presented with advanced disease. Conclusion: General practitioners should be encouraged to request ultrasound scan for patients presenting with gross haematuria, as urothelial tumours, if detected early, can be managed effectively with better long term outcome.

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