Comparison of Ultrasonography and Cystoscopy in the Evaluation of Hematuria

Objective:Every day, many patients visit hospital due to hematuria. Ultrasonography and/or cystoscopy are performed in the initial evaluation and management. In this study, we compared ultrasonography and cystoscopy in the evaluation of microscopic or macroscopic hematuria.Materials and Methods:A total of 55 patients, who presented to our clinic with the complaint of hematuria between July 2016 and October 2017, were enrolled in this study. After obtaining informed consent, the patients were directed to urinary ultrasonography and cystoscopy for the evaluation of hematuria.Results:Ultrasonography showed 45 (81.8%) normal bladder and 10 (18.2%) masses, and cystoscopy detected 39 (70.9%) normal bladder and 16 (29.1%) masses in the bladder (p=0.001). Ultrasonography was able to report only 8 (50%) of 16 masses detected via cystoscopy. Two (20%) of 10 masses reported by ultrasonography were not confirmed through cystoscopy. The sensitivity and specificity of ultrasonography in detecting and excluding masses in the bladder were calculated to be 50% and 94.9%, respectively. Ultrasonography failed to detect lesions at the posterior, dome and right side and bladder neck. The cut-off value for blood cell count in urine to refer the patient to a cystoscopy procedure was detected to be 15 with 60% sensitivity and 50% specificity.Conclusion:With low sensitivity, ultrasonography could not offer enough knowledge about the bladder masses as sufficient as cystoscopy