Patients with microscopic and gross hematuria: practice and referral patterns among primary care physicians in a universal health care system

Authors

  • Faysal A. Yafi Department of Surgery (Urology), McGill University, Montreal, QC
  • Armen G. Aprikian Department of Surgery (Urology), McGill University, Montreal, QC
  • Simon Tanguay Department of Surgery (Urology), McGill University, Montreal, QC
  • Wassim Kassouf Department of Surgery (Urology), McGill University, Montreal, QC

DOI:

https://doi.org/10.5489/cuaj.589

Abstract

Background: Hematuria is one of the most common findings on
urinalysis in patients encountered by primary care physicians. In
many instances it can also be the first presentation of a serious urological
problem. As such, we sought to evaluate current practices
adopted by primary care physicians in the workup and screening
of hematuria.

Methods: Questionnaires were mailed to all registered primary care
physicians across Quebec. Questions covered each physician’s
personal approach to men and postmenopausal women with painless
gross hematuria or with asymptomatic microscopic hematuria,
as well as screening techniques, general knowledge with regards
to urine collection and sampling, and referral patterns.

Results: Of the surveys mailed, 599 were returned. Annual routine
screening urinalysis on all adult male and female patients was
performed by 47% of respondents, regardless of age or risk factors.
Of all the respondents, 95% stated microscopic hematuria was
associated with bladder cancer. However, in an older male with
painless gross hematuria, only 64% of respondents recommended
further evaluation by urology. On the other hand, in a postmenopausal
woman with 2 consecutive events of significant microscopic
hematuria, only 48.6% recommended referral to urology. Findings
were not associated with the gender of the respondent, experience
or geographic location of practice (urban vs. rural).

Interpretation: There seems to be reluctance amongst primary care
physicians to refer patients with gross or significant microscopic
hematuria to urology for further investigation. A higher level of
suspicion and further education should be implemented to detect
serious conditions and to offer earlier intervention when possible.

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Author Biographies

Faysal A. Yafi, Department of Surgery (Urology), McGill University, Montreal, QC

Armen G. Aprikian, Department of Surgery (Urology), McGill University, Montreal, QC

Simon Tanguay, Department of Surgery (Urology), McGill University, Montreal, QC

Wassim Kassouf, Department of Surgery (Urology), McGill University, Montreal, QC

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How to Cite

Yafi, F. A., Aprikian, A. G., Tanguay, S., & Kassouf, W. (2013). Patients with microscopic and gross hematuria: practice and referral patterns among primary care physicians in a universal health care system. Canadian Urological Association Journal, 5(2), 97–101. https://doi.org/10.5489/cuaj.589

Issue

Vol. 5 No. 2 (2011): April

Section

Original Research

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