MANAGEMENT OF HAEMATURIA IN A TERTIARY HEALTH INSTITUTION IN NIGERIA
DOI:
https://doi.org/10.47941/ijhs.953Keywords:
Haematuria, surgical, conservative, managementAbstract
Purpose: Haematuria is a very important sign and symptom of a urological disease. It may be due to a urological malignancy. Careful history, physical examination, investigation and monitoring is necessary to identify cause and adequately treat patient with haematuria. This study aims to highlight the management of haematuria in Port Harcourt, Nigeria.
Methodology: This was a retrospective study of patients who presented with visible haematuria between January 2012 and December 2021. The patients' history, physical examination findings, investigations and treatment received were analysed. The form of treatment received was noted.
Findings: Three hundred and forty-six patients were evaluated. Two hundred and fifty-six (74%), seventy-two (20.8%) and eighteen (5.2%) patients presented within a week, between two and three weeks and above 3 weeks respectively. Twenty-seven (7.81%) patients had emergency surgery for haematuria. Sixteen of these had prostatectomy, 3 had TURBT/ chemotherapy, and eight had nephrectomy. The others were managed conservatively.
Unique contribution to theory, practice and policy: Many patients with surgical haematuria present early. The commonest cause of haematuria is benign prostatic enlargement and the commonest emergency surgery is open prostatectomy. Haematuria is mainly managed conservatively. Careful monitoring of patients' vital signs is critical in identifying patients who begin to decompensate during conservative treatment. When the need arises, immediate surgical intervention should be carried out.
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References
Reynard J, Brewster S, Bier S. Oxford Handbook of Urology. Third Edition. UK: Oxford University Press,2013: 8 -14.
Bolenz C, Schröppel B, Eisenhardt A, Schmitz-Dräger BJ, Grimm MO. The investigation of hematuria. Deutsches Ärzteblatt International. 2018 Nov;115(48):801.
Badoe EA, Archampong EQ, Rocha-Afodu JT, (editors). Principles and practice of surgeryincluding pathology in the tropics 4th edition, Accra:Assemblies of God literature centre Ltd,2009: 967- 972.
Mcdonald MM, Swagerty Jr DL, Wetzel L. Assessment of microscopic hematuria in adults. American family physician. 2006 May 15;73(10):1748-54.
Chen J, Zeng R. Hematuria. In: Handbook of Clinical Diagnostics 2020 (pp. 71-73). Springer, Singapore.
Pang KH, Catto JW. Haematuria: Evaluation and Management. InUrologic Principles and Practice 2020 (pp. 281-286). Springer, Cham.
Ofuru VO. The role of dutasteride in the treatment of gross haematuria due to benign prostatic hyperplasia and adenocarcinoma of the prostate. Faculty of Surgery, 2014-dissertation.npmcn.edu.ng.
Ofuru VO, Obiorah CC. The role of dutasteride in acute prostatic haematuria. Int J Clin Med 2017; 8: 1-7.
Ofuru VO, Abhulimen V. Surgical Haematuria: An Analysis of Causes in a Southern Nigerian State. Open Journal of Urology. 2022 Jul 15;12(7):401-9.
Olasehinde N. Healthcare seeking behavior in Nigeria. Journal of Population and Social Studies [JPSS]. 2018 Jul 3;26(3):207-18.
Latunji OO, Akinyemi OO. Factors influencing health-seeking behaviour among civil servants in Ibadan, Nigeria. Annals of Ibadan postgraduate medicine. 2018 Jul 17;16(1):52-60.
Tanimola MA, Owoyemi JO. Healthcare-seeking behaviour in Anyigba, North Central, Nigeria. Research Journal of Medical Sciences. 2009;3(2):47-51.
Brieger WR, Osamor PE, Salami KK, Oladepo O, Otusanya SA. Interactions between patent medicine vendors and customers in urban and rural Nigeria. Health policy and planning. 2004 May 1;19(3):177-82.
Dawam D, Kalayi GD, Osuide JA, Muhammad I, Garg SK. Haematuria in Africa: is the pattern changing? BJU international. 2001 Mar;87(4):326-30.
Osegbe DN, Amaku EO. Haematuria in Nigerians: a prospective study. The Journal of Tropical Medicine and Hygiene. 1984 Jun 1;87(3):115-7.
Visclosky T, Hashikawa A, Kroner E. Discovery of a Hidden Schistosomiasis Endemic in the Salamat Region of Chad, Africa. Global Health: Science and Practice. 2022 Feb 28;10(1).
Mfonobong Daniel. Top 10 most educated states in Nigeria (2022). Available at: http://www.nigerianinfopedia.com.ng/most educated-states-innigeria/. (Accessed June 12,2022).
Chauncey JM, Wieters JS. Tranexamic acid. InStatPearls [Internet] 2021 Jul 28. StatPearls Publishing.
Karkhanei B, Musavi-Bahar SH, Bayat M, Kaseb K, Rezaee H, Moradi A, Moradi M. Safety and efficacy of intraoperative administration of intravenous tranexamic acid in transurethral resection of prostate: A doubleblind, randomised, placebo-controlled trial. Journal of Clinical Urology. 2020 Mar;13(2):125-31.
Samir M, Saafan AM, Afifi RM, Tawfick A. Can high-dose tranexamic acid have a role during transurethral resection of the prostate in large prostates? A randomised controlled trial. Arab Journal of Urology. 2022 Jan 2;20(1):24-9.
Sekar H, Palaniyandi V, Krishnamoorthy S, Kumaresan N. Post-transurethral resection of prostate urethral strictures: Are they often underreported? A single-center retrospective observational cohort study. Urology Annals. 2021 Oct;13(4):329.
Raphael JE, Abhulimen V. Retrospective Analysis of Complications from Prostate Cancer among Nigerians. Saudi J Med. 2022;7(2):99-104.
Liu D, Kuai Y, Zhu R, Zhou C, Tao Y, Han W, Chen Q. Prognosis of prostate cancer and bone metastasis pattern of patients: a SEER-based study and a local hospital-based study from China. Scientific reports. 2020 Jun 4;10(1):1-1.
Yu EM, Aragon-Ching JB. Advances with androgen deprivation therapy for prostate cancer. Expert Opinion on Pharmacotherapy. 2022 Feb 3:1-9.
Klotz L. The history of intermittent androgen deprivation therapy"”A Canadian story. Canadian Urological Association Journal. 2020 Jun;14(6):159.
Edmunds K, Reeves P, Scuffham P, Galvão DA, Newton RU, Jones M, Spry N, Taaffe DR, Joseph D, Chambers SK, Tuffaha H. Cost-effectiveness analysis of supervised exercise training in men with prostate cancer previously treated with radiation therapy and androgen-deprivation therapy. Applied Health Economics and Health Policy. 2020 Oct;18(5):727-37.
Shah A, Shah R, Kebede N, Mohamed A, Botteman M, Waldeck R, Hussain A. Real-world incidence and burden of adverse events among non-metastatic prostate cancer patients treated with secondary hormonal therapies following androgen deprivation therapy. Journal of Medical Economics. 2020 Apr 2;23(4):330-46.
Ugwumba FO, Aghaji AE. Testicular cancer: Management challenges in an African developing country. S Afr Med J. 2010; 100:452-5.
Abhulimen V, Raphael EJ. Testicular cancer at the University of Port Harcourt Teaching Hospital: A 10-year retrospective review. Journal of the West African College of Surgeons. 2019 Jul;9(3):21.
Ofuru VO, Obiorah CC. Pre-androgen ablation prostatic cancer patients who bleed do well with 5alpha reductase inhibitors. OJU 2018; 6:184-192.
Galgano SJ, Porter KK, Burgan C, Rais-Bahrami S. The role of imaging in bladder cancer diagnosis and staging. Diagnostics. 2020 Sep;10(9):703.
Paz MM, Zhang X, Lu J, Holmgren A. A new mechanism of action for the anticancer drug mitomycin C: mechanism-based inhibition of thioredoxin reductase. Chemical research in toxicology. 2012 Jul 16;25(7):1502-11.
Badrinath KR, Carroll PR. In: McAninch JW, Lue FT (Editors). Smith and Tanagho's General Urology. 19th edition, New York; USA: Mc Graw Hill,2020: 317 - 319.
Ogita M, Kawamori J, Yamashita H, Nakagawa K. Palliative radiotherapy for gross hematuria in patients with advanced cancer. Scientific Reports. 2021 May 5;11(1):1-9.
Tey J, Ho F, Koh WY, Chia D, Ooi KH, Tuan JK, Vellayappan B, Soon YY. Palliative radiotherapy for bladder cancer: a systematic review and metaanalysis. Acta Oncologica. 2021 May 4;60(5):635-44.
Kidd M, Beviss-Challinor KB, Pitcher RD. How useful are clinical details in blunt trauma referrals for computed tomography of the abdomen? SA Journal of Radiology. 2020 Jan 1;24(1):1-6.
Choudhury S, Ray P, Pal DK. Changing paradigms of management of isolated blunt renal trauma. Trauma. 2020 Nov 5:1460408620965446.
Padala SA, Barsouk A, Thandra KC, Saginala K, Mohammed A, Vakiti A, Rawla P, Barsouk A. Epidemiology of renal cell carcinoma. World journal of oncology. 2020 Jun;11(3):79.
Callahan CL, Schwartz K, Corley DA, Ruterbusch JJ, Zhao WK, Shuch B, Graubard BI, Rothman N, Chow WH, Silverman DT, Purdue MP. Understanding racial disparities in renal cell carcinoma incidence: estimates of population attributable risk in two US populations. Cancer Causes & Control. 2020 Jan;31(1):85-93.
Alfalahi S, Al-Ba'adani TH, Babakri M, Ghilan A. Renal Cell Carcinoma in Yemeni Patients: A Review of 67 Cases. Urol Nephrol Open Access J. 2016;3(2):00075.
Raphael JE, Abhulimen Victor. Sensitivity and resistance patterns of Gram negative uropathogens isolated from the urine of patients with upper/lower urinary obstruction in Nigeria. Journal of advances in medicine and medical research. 2022; 34(9): 11-19. https://www.sdiarticle5.com/reviewhistory/86471.
Wieder AJ. Pocket guide to Urology 4th edition,USA: J Wieder medical in association with Griffith publishing,2010: 222-228.
Shvero A, Calio B, Humphreys MR, Das AK. HoLEP: the new gold standard for surgical treatment of benign prostatic hyperplasia. Can J Urol. 2021 Aug 1;28(S2):6-10.
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