TY - JOUR
T1 - Association of Severe Microscopic Hematuria with Successful Conservative Treatment of Single Uncomplicated Ureteral Calculus
T2 - A Multicenter Cohort Study
AU - Katayama, Satoshi
AU - Yoshioka, Takashi
AU - Sako, Tomoko
AU - Murao, Wataru
AU - Araki, Motoo
AU - Watanabe, Toyohiko
AU - Takenaka, Tadasu
N1 - Funding Information:
Financial disclosures: Takashi Yoshioka certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Takashi Yoshioka received a research grant from the Okayama Urological Research Group for language editing.
Funding Information:
Funding/Support and role of the sponsor: This study was supported by the Okayama Urological Research Group (grant number: 201911). The funders had no role in the study design, data collection, statistical analysis, decision to publish, and preparation of the manuscript, except for language editing.
Funding Information:
Acknowledgments: This study was supported by the Okayama Urological Research Group (grant number: 201911). We thank all the urologists and cytotechnologists at Japanese Red-Cross Okayama Hospital and Himeji St. Mary’s Hospital for their clinical services. In addition, we thank all the members of the Department of Urology at Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences for their valuable advice.
Publisher Copyright:
© 2020
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background: Although detection of microscopic hematuria is a well-known diagnostic method for urolithiasis, its ability to predict urolithiasis treatment outcomes in adults is unknown. Objective: To evaluate the role of microscopic hematuria in conservative treatment of ureteral calculus. Design, setting, and participants: This cohort study involved 482 patients who were diagnosed with a single uncomplicated ureteral calculus (≤10 mm) using computed tomography and underwent conservative therapy at two Japanese community hospitals between 2013 and 2018. Patients were divided into three groups according to the severity of microscopic hematuria (no, ≤4; mild to moderate, 5–99; and severe, ≥100 red blood cells per high-power field) and as determined during the first emergency department or urologic outpatient clinic visit. Outcome measurements and statistical analysis: A multivariate logistic regression analysis was performed to estimate the odds ratio for successful conservative therapy at 28 d after the diagnosis. Statistical significance was set at p < 0.05. Results and limitations: Of the 482 patients, 81 (16.8%), 209 (43.4%), and 192 (39.8%) had no, mild to moderate, and severe microscopic hematuria, respectively. After adjustments for six relevant confounders, severe microscopic hematuria showed a significant association with successful conservative therapy at 28 d (adjusted odds ratio, 1.91; 95% confidence interval, 1.02–3.57; p = 0.043), whereas mild to moderate microscopic hematuria did not (adjusted odds ratio, 1.05; 95% confidence interval, 0.57–1.93; p = 0.872) when compared with no microscopic hematuria. Conclusions: Severe microscopic hematuria was significantly associated with successful conservative therapy for single uncomplicated ureteral calculus. Patient summary: Microscopic hematuria might have predictive value for conservative treatment of a single uncomplicated ureteral calculus. Using the presence or absence of blood in urine and other predictive factors, clinicians may lead patients with a single uncomplicated ureteral calculus to successful conservative therapy. Microscopic hematuria might have predictive value for conservative treatment of a single uncomplicated ureteral calculus, in addition to its diagnostic value. Of note, severe microscopic hematuria, defined as 100 red blood cells high power field, might provide useful information when considering conservative therapy.
AB - Background: Although detection of microscopic hematuria is a well-known diagnostic method for urolithiasis, its ability to predict urolithiasis treatment outcomes in adults is unknown. Objective: To evaluate the role of microscopic hematuria in conservative treatment of ureteral calculus. Design, setting, and participants: This cohort study involved 482 patients who were diagnosed with a single uncomplicated ureteral calculus (≤10 mm) using computed tomography and underwent conservative therapy at two Japanese community hospitals between 2013 and 2018. Patients were divided into three groups according to the severity of microscopic hematuria (no, ≤4; mild to moderate, 5–99; and severe, ≥100 red blood cells per high-power field) and as determined during the first emergency department or urologic outpatient clinic visit. Outcome measurements and statistical analysis: A multivariate logistic regression analysis was performed to estimate the odds ratio for successful conservative therapy at 28 d after the diagnosis. Statistical significance was set at p < 0.05. Results and limitations: Of the 482 patients, 81 (16.8%), 209 (43.4%), and 192 (39.8%) had no, mild to moderate, and severe microscopic hematuria, respectively. After adjustments for six relevant confounders, severe microscopic hematuria showed a significant association with successful conservative therapy at 28 d (adjusted odds ratio, 1.91; 95% confidence interval, 1.02–3.57; p = 0.043), whereas mild to moderate microscopic hematuria did not (adjusted odds ratio, 1.05; 95% confidence interval, 0.57–1.93; p = 0.872) when compared with no microscopic hematuria. Conclusions: Severe microscopic hematuria was significantly associated with successful conservative therapy for single uncomplicated ureteral calculus. Patient summary: Microscopic hematuria might have predictive value for conservative treatment of a single uncomplicated ureteral calculus. Using the presence or absence of blood in urine and other predictive factors, clinicians may lead patients with a single uncomplicated ureteral calculus to successful conservative therapy. Microscopic hematuria might have predictive value for conservative treatment of a single uncomplicated ureteral calculus, in addition to its diagnostic value. Of note, severe microscopic hematuria, defined as 100 red blood cells high power field, might provide useful information when considering conservative therapy.
KW - Conservative treatment
KW - Hematuria
KW - Urolithiasis
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U2 - 10.1016/j.euf.2020.04.004
DO - 10.1016/j.euf.2020.04.004
M3 - Article
AN - SCOPUS:85084053785
JO - European Urology Focus
JF - European Urology Focus
SN - 2405-4569
ER -