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Tertiary Referral Hospital Experiences of Men Presenting With Painless Postcoital Gross Hematuria and a Suggestion for the Management Algorithm

Authors
 Dong Hyuk Kang  ;  Joo Yong Lee  ;  Dae Chul Jung  ;  Young Taik Oh  ;  Eun Suk Cho  ;  Sung Yoon Park  ;  Ki Soo Lee  ;  Kang Su Cho 
Citation
 Urology, Vol.115 : 112-118, 2018 
Journal Title
 Urology 
ISSN
 0090-4295 
Issue Date
2018
Abstract
OBJECTIVE: To review the tertiary referral hospital experiences of men presenting with painless postcoital gross hematuria (PCGH) and suggest a management algorithm. MATERIALS AND METHODS: We reviewed clinical data from 19 male patients who first visited a clinic because of PCGH between 2009 and 2016. The patients were evaluated according to our tentative management algorithm for painless PCGH. First, a general workup for painless gross hematuria (GH) was performed. If the cause of the PCGH was not identified, a vascular workup of the pelvic vasculatures for PCGH was performed, including transrectal and penile ultrasonography with Doppler study. Pelvic angiography and subsequent angioembolization were recommended at the physician's discretion. RESULTS: The median age of the patients was 47 (range: 30-67) years. The tentative management algorithm led to no abnormal findings in 7 patients and identified urologic malignancies in 2 patients. Urethrocystoscopy revealed urethral hemangioma in 3 patients. Doppler ultrasonography revealed pelvic varicosities in 3 patients, complicated cyst of Cowper glands in 1 patient, and pelvic arteriovenous malformation in 3 patients. Pelvic angiography was recommended for the 3 patients with pelvic arteriovenous malformation, and 2 of those patients were successfully treated by angioembolization. CONCLUSION: The clinical approach to painless PCGH should be different from that of painless GH. Both the general and the vascular workup for the pelvic vasculatures for painless GH are mandatory for the evaluation of patients with painless PCGH.
Full Text
https://www.sciencedirect.com/science/article/pii/S0090429518301031
DOI
10.1016/j.urology.2018.01.041
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Park, Sung Yoon(박성윤)
Oh, Young Taik(오영택) ORCID logo https://orcid.org/0000-0002-4438-8890
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Jung, Dae Chul(정대철) ORCID logo https://orcid.org/0000-0001-5769-5083
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Cho, Eun Suk(조은석)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162400
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