以尿液紅血球與白血球比值在膀胱急躁症患者作為潛在病因的預測因子
陳俞安1 黃旭澤1 彭宗信1 廖俊厚12 姜秉鈞1
1天主教耕莘醫院 泌尿外科; 2輔仁大學 醫學系
To Predict Underlying Pathology among Patients with Bladder Irritative Symptoms and Hematuria with Urine RBC and WBC Ratio
Chen Yu-An1, Huang Shu-Che1, Chung-Hsin Pong1 ,Yu-Wei Chou1 , Chun-Hou Liao12, Bing-Juin Chiang1
1 Division of Urology, Department of Surgery, Cardinal Tien Hospital, Taipei, Taiwan
2 School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
Purpose: The objective of this study was to evaluate the role of urological sonography in patients with symptomatic hematuria in order to detect underlying lesions need surgical intervention. In addition, we aimed to identify patients who required a urological sonography earlier.
Materials and Methods: Between September 2012 and 2013, 203 consecutive adult patients with bladder irritative symptoms and hematuria visiting the out-patient clinic were enrolled. Each patient underwent urinalysis and received antibiotics at the first visit. They again underwent urinalysis and renal and urinary bladder sonography during the second visit. Patients with flank pain, fever, pregnancy, urological malignancy, and untreated urolithiasis were excluded. Patients with persistent symptoms during the second visit were also excluded. The initial symptoms, past medical history, urinalysis results, and sonography findings were recorded and analyzed.
Results: Among these patients, 15 (7.4%) had urolithiasis, and six (3.0%) had bladder cancer. The presence of urolithiasis or bladder tumor in patients with symptomatic hematuria was significantly correlated with sex, dysuria, red/white blood count ratio > 1 . Among the patients with urolithiasis or malignancy, five patients had no microscopic hematuria during the second visit and 12 patients had improved microscopic hematuria.
Conclusions: For some patients with symptomatic hematuria, particularly for those with RBC/WBC ratio > 1, renal and bladder sonography may be performed earlier for early detection of underlying bladder tumors or stone lesions that need further surgical intervention.