Evaluation of Hematuria In The Primary Care Setting. Randall B. Meacham, MD. 1. Discuss potential etiologies of hematuria
|
|
- Camron Carson
- 7 years ago
- Views:
Transcription
1 Evaluation of Hematuria In The Primary Care Setting Randall B. Meacham, MD Objectives: 1. Discuss potential etiologies of hematuria 2. Implement a plan for evaluating the patient with gross or microscopic hematuria 3. Understand when it is appropriate to refer a patient with hematuria for care by a specialist 4. Structure a plan for followup for the patients with hematuria 1
2 Prevalence of Microscopic Hematuria In 6 population based studies, incidence ranged from 0.18% to 16.1% 20% of Urology clinic visits in the Kaiser Permanente system Definition of Hematuria Gross: Visible blood in the urine Microscopic: 3 or more RBC/hpf Absence of a clear benign cause Positive dipstick does NOT constitute MH AUA Best Practice Guidelines,
3 Positive Dipstick UA Indicates the need for performance of a microscopic UA Limited specificity (65 to 99%) for 2 to 5 RBC / HPF Factors that can cause a falsepositive result on a dipstick test include hemoglobinuria, myoglobinuria, concentrated urine Most Common Causes of Hematuria UTI BPH Nephrolithiasis Genitourinary cancer 3
4 Other Causes of Hematuria Radiation cystitis Arteriovenous malformation Medical renal disease Trauma Renal cystic disease Exerciseinduced hematuria Coagulopathy Benign familial/essential hematuria Papillary necrosis Nonbloody red urine Beets Blackberries Drugs (pyridium) 4
5 Odds of Finding Significant Pathology 4090% of gross hematuria 510% of microscopic hematuria At least 40% of the time no etiology is found for asymptomatic microscopic hematuria History of Present Illness Dysuria? Frequency? Menstruation? Previous episodes, workup 5
6 Medications Pyridium Analgesic abuse Social History Smoking Exposure to dyes, chemicals Exercise patterns 6
7 Physical Examination Age (cancer risk) Pain suprapubic, flank (infection) DRE (BPH) Laboratory Evaluation UA, microscopy Urine culture CBC Serum Creatinine 7
8 Evaluation of Microscopic Hematuria MH Repeat UA after treatment of other cause(s) Release from Care Treatment Followup as indicated by diagnosis. Reevaluate for MH after resolution of identified condition Assess for other potential causes (infection, menstruation, recent urologic procedures) Renal Function Testing, Cystoscopy, * Imaging (CTU) Follow up with at least one UA/micro yearly for at least 2 years Release from Care Consider nephrologic evaluation if proteinuria, acanthocytes, red cell casts, renal failure Follow persistent MH with annual UA, consider nephrologic eval. Repeat anatomic eval within 35 yrs. Or sooner if clinically indicated Cystoscopy optional in nonhigh risk patients < 35 y/o * High Risk Patients Age > 35 years Occupational exposure to chemicals or dyes (benzenes of aromatic amines) History of gross hematuria History of irritative voiding symptoms History of pelvic irradiation Analgesic abuse History of UTI History of urologic disorder or disease 8
9 Best Upper Tract Study CT Urogram 3 phases Noncontrast to r/o calculi Contrast to evaluate parenchyma Excretion phase to evaluate GU lining Lower Tract Evaluation Depends on age and risk factors Cystoscopy (CT misses many bladder tumors) Is typically an office procedure 9
10 Case Studies 42 yo mother of oneyearold twins noted to have 510 RBC s per HPF on 2 UAs History and Physical Exam No dysuria/frequency/pain No h/o respiratory infection or stones No history of coagulopathy/non menstrual No history of radiation or surgery x c/s Nonsmoker no chemical exposure 10
11 Laboratory Evaluation UA shows RBC s No cellular casts or proteinuria CBC normal Creatinine normal No UTI on culture Now what? Evaluation of Microscopic Hematuria MH Repeat UA after treatment of other cause(s) Release from Care Treatment Followup as indicated by diagnosis. Reevaluate for MH after resolution of identified condition Assess for other potential causes (infection, menstruation, recent urologic procedures) Renal Function Testing, Cystoscopy, * Imaging (CTU) Follow up with at least one UA/micro yearly for at least 2 years Release from Care Consider nephrologic evaluation if proteinuria, acanthocytes, red cell casts, renal failure Follow persistent MH with annual UA, consider nephrologic eval. Repeat anatomic eval within 35 yrs. Or sooner if clinically indicated Cystoscopy optional in nonhigh risk patients < 35 y/o * 11
12 Upper and Lower Tract Imaging US showed no abnormality of the kidneys Bladder US was unclear Now what? Outcome: No additional evaluation performed. Patient developed gross hematuria 6 months later. Ultimately was found to have bladder cancer on cystoscopy and required cystectomy 12
13 Case 2 59 yo male Gross hematuria with flank pain Now what? History and Physical No dysuria/frequency/pain No h/o respiratory infection No history of coagulopathy No history of radiation or surgery Nonsmoker no chemical exposure Now what? 13
14 Laboratory Evaluation UA shows RBC s CBC normal Creatinine normal No UTI on culture PSA done 3 months ago: 2.3ng/dl Now what? Evaluation of Microscopic Hematuria MH Repeat UA after treatment of other cause(s) Release from Care Treatment Followup as indicated by diagnosis. Reevaluate for MH after resolution of identified condition Assess for other potential causes (infection, menstruation, recent urologic procedures) Renal Function Testing, Cystoscopy, * Imaging (CTU) Follow up with at least one UA/micro yearly for at least 2 years Release from Care Consider nephrologic evaluation if proteinuria, acanthocytes, red cell casts, renal failure Follow persistent MH with annual UA, consider nephrologic eval. Repeat anatomic eval within 35 yrs. Or sooner if clinically indicated Cystoscopy optional in nonhigh risk patients < 35 y/o * 14
15 Upper and Lower Tract Imaging CT scan abd shows L kidney stone 1x1cm Cytologies are atypical Now what? What Happened Pt had his kidney stone treated with shockwave lithotripsy Meanwhile a bladder tumor grew in his bladder for a year One year later, he underwent cystoscopy, biopsy, and eventually cystectomy 15
16 Case 3 52 year old male noted total gross, painless hematuria at completion of a 2 hr. totally in your face, badass, that s right who s your daddy now? mountain bike ride. No prior history of hematuria, no other GU complaints. Only one episode of hematuria. History and Physical Moderately overweight otherwise completely benign Medications include only Viagra, Lipitor and Magnum Man (purchased via the internet) No history of coagulopathy No history of radiation or surgery No chemical exposure Smoked a little reefer in college Feels fine not enthusiastic about additional screwing around with this 16
17 UA unremarkable HCT 39% Creatinine 0.9 Now what? Evaluation of Microscopic Hematuria MH Repeat UA after treatment of other cause(s) Release from Care Treatment Followup as indicated by diagnosis. Reevaluate for MH after resolution of identified condition Assess for other potential causes (infection, menstruation, recent urologic procedures) Renal Function Testing, Cystoscopy, * Imaging (CTU) Follow up with at least one UA/micro yearly for at least 2 years Release from Care Consider nephrologic evaluation if proteinuria, acanthocytes, red cell casts, renal failure Follow persistent MH with annual UA, consider nephrologic eval. Repeat anatomic eval within 35 yrs. Or sooner if clinically indicated Cystoscopy optional in nonhigh risk patients < 35 y/o * 17
18 Upper and Lower Tract Evaluation Cystoscopy? Thank You 18
Hematuria in Primary Care: The Bloody Truth
Hematuria in Primary Care: The Bloody Truth Ashlyn Bruning, MMS, PA-C NCAPA Summer Conference Disclosure: I Have No Financial or Non-financial Relationships or Conflicts of Interest to Disclose OBJECTIVES
More informationBlood in the urine (hematuria)
Blood in the urine (hematuria) Hematuria refers to the presence of blood in the urine. It is important to investigate the cause of hematuria because rarely, it is caused by a serious condition, such as
More informationOpen the Flood Gates Urinary Obstruction and Kidney Stones. Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke
Open the Flood Gates Urinary Obstruction and Kidney Stones Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke Nephrology vs. Urology Nephrologist a physician who has been trained in the diagnosis
More informationPrimary Care Management of Male Lower Urinary Tract Symptoms. Matthew B.K. Shaw Consultant Urological Surgeon
Primary Care Management of Male Lower Urinary Tract Symptoms Matthew B.K. Shaw Consultant Urological Surgeon NICE LUTS Guidelines Lower Urinary Tract Symptoms (LUTS) in men. NICE Clinical Guideline 97
More informationBlood in the Urine (Haematuria)
Kidney Health Information Blood in the Urine (Haematuria) What is blood in the urine? Sometimes blood in the urine can be seen, but at other times it is present in such small quantities that it is not
More information1. What is the prostate-specific antigen (PSA) test?
1. What is the prostate-specific antigen (PSA) test? Prostate-specific antigen (PSA) is a protein produced by the cells of the prostate gland. The PSA test measures the level of PSA in the blood. The doctor
More informationEarly Prostate Cancer: Questions and Answers. Key Points
CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Early Prostate Cancer:
More informationCancer of the Cervix
Cancer of the Cervix WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 A woman's cervix (the opening of the uterus) is lined with cells. Cancer of the cervix occurs when those cells change,
More informationChapter 31: Lower Urinary Tract Conditions in Elderly Patients
Chapter 31: Lower Urinary Tract Conditions in Elderly Patients Damon Dyche and Jay Hollander William Beaumont Hospital, Royal Oak, Michigan As our population ages, the number of patients presenting to
More informationFour Important Facts about Kidney Cancer
Volume Article.13-11 Publish Date: 24th June 2013 Author(s): MPUH - CRS Team Four Important Facts about Kidney Cancer ARTICLE hhh Muljibhai Patel Urological Hospital (MPUH) Centre For Robotic Surgery (CRS)
More informationPCA3 DETECTION TEST FOR PROSTATE CANCER DO YOU KNOW YOUR RISK OF HAVING CANCER?
PCA3 DETECTION TEST FOR PROSTATE CANCER DO YOU KNOW YOUR RISK OF HAVING CANCER? PCA3 DETECTION TEST FOR PROSTATE CANCER There is a range of methods available to your healthcare professional to verify the
More informationDisease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200
GUIDE TO ASBESTOS LUNG CANCER What Is Asbestos Lung Cancer? Like tobacco smoking, exposure to asbestos can result in the development of lung cancer. Similarly, the risk of developing asbestos induced lung
More informationPSA Screening for Prostate Cancer Information for Care Providers
All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits
More informationHEALTH NEWS PROSTATE CANCER THE PROSTATE
HEALTH NEWS PROSTATE CANCER THE PROSTATE Prostate comes from the Greek meaning to stand in front of ; this is very different than prostrate which means to lie down flat. The prostate is a walnut-sized
More informationProstate Cancer. There is no known association with an enlarged prostate or benign prostatic hyperplasia (BPH).
Prostate Cancer Definition Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-sized structure that makes up part of a man's reproductive system. It wraps around
More informationUrinary Tract Infections
Urinary Tract Infections Overview A urine culture must ALWAYS be interpreted in the context of the urinalysis and patient symptoms. If a patient has no signs of infection on urinalysis, no symptoms of
More information.org. Metastatic Bone Disease. Description
Metastatic Bone Disease Page ( 1 ) Cancer that begins in an organ, such as the lungs, breast, or prostate, and then spreads to bone is called metastatic bone disease (MBD). More than 1.2 million new cancer
More informationBLADDER HEALTH. Non-Muscle Invasive Bladder Cancer: A Patient Guide
BLADDER HEALTH Non-Muscle Invasive Bladder Cancer: A Patient Guide What is the Bladder? What is Cancer? The bladder is a balloon-shaped organ in your pelvic* area that stores urine and is made up of four
More informationPyelonephritis: Kidney Infection
Pyelonephritis: Kidney Infection National Kidney and Urologic Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is pyelonephritis? Pyelonephritis
More informationMedical Tests for Prostate Problems
Medical Tests for Prostate Problems National Kidney and Urologic Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is the prostate? The
More informationCorrect Coding to Maximize Reimbursements: Common Urological Coding and Billing Errors. Michael A. Ferragamo, MD, FACS
Correct Coding to Maximize Reimbursements: Common Urological Coding and Billing Errors Michael A. Ferragamo, MD, FACS Coding and Reimbursement Consultant; Assistant Clinical Professor of Urology, University
More informationAmylase and Lipase Tests
Amylase and Lipase Tests Also known as: Amy Formal name: Amylase Related tests: Lipase The Test The blood amylase test is ordered, often along with a lipase test, to help diagnose and monitor acute or
More information6/3/2011. High Prevalence and Incidence. Low back pain is 5 th most common reason for all physician office visits in the U.S.
High Prevalence and Incidence Prevalence 85% of Americans will experience low back pain at some time in their life. Incidence 5% annual Timothy C. Shen, M.D. Physical Medicine and Rehabilitation Sub-specialty
More informationProstate Cancer Screening. A Decision Guide
Prostate Cancer Screening A Decision Guide This booklet was developed by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). Is screening right for you?
More informationKidney Cancer OVERVIEW
Kidney Cancer OVERVIEW Kidney cancer is the third most common genitourinary cancer in adults. There are approximately 54,000 new cancer cases each year in the United States, and the incidence of kidney
More informationUTI in children. Quick reference guide. Issue date: August 2007. Urinary tract infection in children: diagnosis, treatment and long-term management
Issue date: August 2007 UTI in children Urinary tract infection in children: diagnosis, treatment and long-term management Developed by the National Collaborating Centre for Women s and Children s Health
More informationNICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.
Initial assessment and investigation of urinary incontinence bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used
More informationGuideline for Microalbuminuria Screening
East Lancashire Diabetes Network Guideline for Microalbuminuria Screening Produced by: Task and Finish Group, Clinical Standards Group Produced: August 2006 Approved by: East Lancashire Diabetes Network
More informationA PRINTED copy of this guideline may not be the most recent version. The OFFICIAL version is located on IHNET at the Policies & Procedures Home Page
A PRINTED copy of this guideline may not be the most recent version. The OFFICIAL version is located on IHNET at the Policies & Procedures Home Page IX0200: Prevention & Control of Catheter Associated
More informationProstate Cancer Screening. A Decision Guide for African Americans
Prostate Cancer Screening A Decision Guide for African Americans This booklet was developed by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). Published
More information190.12 - Urine Culture, Bacterial Summary Information Highlighted items indicate most frequently used codes.
Medicare National Coverage Determination (NCD) (Jan 2011) Source: CMS: Centers for Medicare & Medicaid Services To view full document: www.cms.gov/coveragegeninfo. Select Lab NCDs, then select NCD Coding
More informationAcute Pancreatitis. Questionnaire. if yes: amount (cigarettes/day): since when (year): Drug consumption: yes / no if yes: type of drug:. amount:.
The physical examination has to be done AT ADMISSION! The blood for laboratory parameters has to be drawn AT ADMISSION! This form has to be filled AT ADMISSION! Questionnaire Country: 1. Patient personal
More informationThe PSA Test for Prostate Cancer Screening:
For more information, please contact your local VA Medical Center or Health Clinic. U.S. Department of Veterans Affairs Veterans Health Administration Patient Care Services Health Promotion and Disease
More informationNicole Kounalakis, MD
Breast Disease: Diagnosis and Management Nicole Kounalakis, MD Assistant Professor of Surgery Goal of Breast Evaluation The goal of breast evaluation is to classify findings as: normal physiologic variations
More informationRegistered Charity No: 326679 Caring for those with a rare, complex and lifelong disease www.behcets.org.uk
Registered Charity No: 326679 Caring for those with a rare, complex and lifelong disease www.behcets.org.uk Behçet s Disease and the Kidneys How are the kidneys affected by Behçet s disease? Kidney disease
More informationSpine University s Guide to Vertebral Osteonecrosis (Kummel's Disease)
Spine University s Guide to Vertebral Osteonecrosis (Kummel's Disease) 2 Introduction Kummel's disease is a collapse of the vertebrae (the bones that make up the spine). It is also called vertebral osteonecrosis.
More informationCT scans and IV contrast (radiographic iodinated contrast) utilization in adults
CT scans and IV contrast (radiographic iodinated contrast) utilization in adults At United Radiology Group, a majority of CT exams are performed either with IV contrast or without while just a few exams
More informationUnderstanding. Pancreatic Cancer
Understanding Pancreatic Cancer Understanding Pancreatic Cancer The Pancreas The pancreas is an organ that is about 6 inches long. It s located deep in your belly between your stomach and backbone. Your
More informationDisclosures. Definitions. CDC Website
Disclosures Deborah Grady, MD, MPH Professor of Medicine Deputy Editor, JAMA Internal Medicine Co-Director, Center for Healthcare Value Co-Director, Clinical and Translational Science Institute Salary
More informationAbnormal Uterine Bleeding FAQ Sheet
Abnormal Uterine Bleeding FAQ Sheet What is abnormal uterine bleeding? Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period. Bleeding that occurs between
More informationExamples of good screening tests include: mammography for breast cancer screening and Pap smears for cervical cancer screening.
CANCER SCREENING Dr. Tracy Sexton (updated July 2010) What is screening? Screening is the identification of asymptomatic disease or risk factors by history taking, physical examination, laboratory tests
More information2008 All rights reserved.
BCAN provides this information as a service. Publication of this information is not intended to take the place of medical care or the advice of your doctor. BCAN strongly suggests consulting your doctor
More informationX-Plain Chemotherapy for Breast Cancer - Adriamycin, Cytoxan, and Tamoxifen Reference Summary
X-Plain Chemotherapy for Breast Cancer - Adriamycin, Cytoxan, and Tamoxifen Reference Summary Introduction Breast cancer is a common condition that affects one out of every 11 women. Your doctor has recommended
More informationLCD for Prostate Specific Antigen (PSA)
LCD for Prostate Specific Antigen (PSA) Applicable CPT Code(s): 84152 Prostate Specific Antigen (PSA); Complexed (Direct Measurement) 84153 Prostate Specific Antigen (PSA); Total 84154 Prostate Specific
More informationMesothelioma. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com ocft0101 Last reviewed: 03/21/2013 1
Mesothelioma Introduction Mesothelioma is a type of cancer. It starts in the tissue that lines your lungs, stomach, heart, and other organs. This tissue is called mesothelium. Most people who get this
More informationNORTH OF TYNE AND GATESHEAD GUIDELINES FOR MANAGEMENT OF COMMON UROLOGICAL CONDITIONS IN ADULTS 18 YEARS. July 2013
NORTH OF TYNE AND GATESHEAD GUIDELINES FOR MANAGEMENT OF COMMON UROLOGICAL CONDITIONS IN ADULTS 18 YEARS July 2013 1 CONTENTS Page Introduction 3 Scrotal lumps 4 Haematuria 5 Urinary tract infection 6
More informationTHINGS TO BE AWARE OF ABOUT PROSTATE AND LUNG CANCER. Lawrence Lackey Jr., M.D. Internal Medicine 6001 W. Outer Dr. Ste 114
THINGS TO BE AWARE OF ABOUT PROSTATE AND LUNG CANCER Lawrence Lackey Jr., M.D. Internal Medicine 6001 W. Outer Dr. Ste 114 WHAT IS CANCER? The body is made up of hundreds of millions of living cells. Normal
More informationNEPHROLITHIASIS Diagnosis & Treatment
Learning Objectives NEPHROLITHIASIS Diagnosis & Treatment Jai Radhakrishnan, MD, MS Professor of Clinical Medicine Columbia University Management of the first episode of renal colic: Optimal Imaging Treatment
More informationUrinary Tract Infection among Clean-Room Workers
J Occup Health 2002; 44: 329 333 Journal of Occupational Health Urinary Tract Infection among Clean-Room Workers Jian-Nan WANG 1, Shih-Bin SU 2, 3 and How-Ran GUO 3 1 Department of Family Medicine, Chie-Mei
More informationA Practical Guide to Diagnosis and Treatment of Infection in the Outpatient Setting Diagnosis and Treatment of Urinary Tract Infections
A Practical Guide to Diagnosis and Treatment of Infection in the Outpatient Setting Diagnosis and Treatment of Urinary Tract Infections By Gary R. Skankey, MD, FACP, Infectious Disease, Las Vegas, NV Sponsored
More informationUrinary Tract Infection Update Kim Gibson, MD Joseph Toscano, MD
82 Urinary Tract Infection Update Kim Gibson, MD Joseph Toscano, MD Abstract Urinary tract infections are commonly treated in urgent care practice. Clinicians need to be aware of the advantages and limitations
More informationPalm Beach Obstetrics & Gynecology, PA
Palm Beach Obstetrics & Gynecology, PA 4671 S. Congress Avenue, Lake Worth, FL 33461 561.434.0111 4631 N. Congress Avenue, Suite 102, West Palm Beach, FL 33407 Urinary Tract Infection About one of every
More informationBladder Health Promotion
Bladder Health Promotion Community Awareness Presentation Content contributions provided by the Society of Urologic Nurses (SUNA) National Association for Continence (NAFC) Simon Foundation for Continence
More informationNEOPLASMS OF KIDNEY (RENAL CELL CARCINOMA) And RENAL PELVIS (TRANSITIONAL CELL CARCINOMA)
NEOPLASMS OF KIDNEY (RENAL CELL CARCINOMA) And RENAL PELVIS (TRANSITIONAL CELL CARCINOMA) Merat Esfahani, MD Medical Oncologist, Hematologist Cancer Liaison Physician SwedishAmerican Regional Cancer Center
More informationThe American Academy of Pediatrics
Revised AAP Guideline on UTI in Febrile Infants and Young Children KENNETH B. ROBERTS, MD, University of rth Carolina School of Medicine, Chapel Hill, rth Carolina In 2011, the American Academy of Pediatrics
More informationTO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER
TO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER DILEMMA Thomas J Stormont MD January 2012 http://www.youtube.com/watch?v=8jd 7bAHVp0A&feature=related related INTRODUCTION A government health panel (the
More informationLearning about Mouth Cancer
Learning about Mouth Cancer Creation of this material was made possible in part by a pioneering grant from CBCC-USA. Distributed by India Cancer Initiative What is mouth cancer? Our bodies are made up
More informationThese rare variants often act aggressively and may respond differently to therapy than the more common prostate adenocarcinoma.
Prostate Cancer OVERVIEW Prostate cancer is the second most common cancer diagnosed among American men, accounting for nearly 200,000 new cancer cases in the United States each year. Greater than 65% of
More informationBladder Health Promotion
Bladder Health Promotion Community Awareness Presentation endorsed by the Society of Urologic Nurses (SUNA) National Association for Continence( NAFC) Simon Foundation for Continence This presentation
More informationThere are many different types of cancer and sometimes cancer is diagnosed when in fact you are not suffering from the disease at all.
About Cancer Cancer is a disease where there is a disturbance in the normal pattern of cell replacement. The cells mutate and become abnormal or grow uncontrollably. Not all tumours are cancerous (i.e.
More informationHow to Find Out What s Wrong A BASIC GUIDE TO MALE. A doctor s guide for patients developed by the American Urological Association, Inc.
A BASIC GUIDE TO MALE How to Find Out What s Wrong A doctor s guide for patients developed by the American Urological Association, Inc. Based on the AUA Best Practice Policy and ASRM Practice Committee
More informationProstate Cancer Information and Facts
Prostate Cancer Information and Facts Definition Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnutsized structure that makes up part of a man's reproductive system.
More informationMetastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy
Metastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy Sarah Hutto,, MSIV Marc Underhill, M.D. January 27, 2009 Past History 45 yo female
More informationBladder Cancer What is bladder cancer?
Bladder Cancer What is bladder cancer? Bladder cancer begins when cells in the urinary bladder start to grow uncontrollably. As more cancer cells develop, they can form a tumor and spread to other areas
More informationBreast Imaging Made Brief and Simple. Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA
Breast Imaging Made Brief and Simple Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA What women are referred for breast imaging? Two groups of women are referred for
More informationUrinary Tract Infections
1 Infections in the urinary tract are relatively common. These infections are often referred to as bladder infections. They are also known as UTI s or urinary tract infections. When an infection is confined
More informationImproving access and reducing costs of care for overactive bladder through a multidisciplinary delivery model
Improving access and reducing costs of care for overactive bladder through a multidisciplinary delivery model Trafford Crump, Ph.D. Department of Surgery, University of Calgary Presentation to: Canadian
More information* * * This matter was opened before the New Jersey State. Board of Medical Examiners (the "Board") upon its receipt of a
. FILED October 31, 2011 NEW JERSEY STATE BOARD OF MEDICAL EXAMINERS STATE OF NEW JERSEY DEPARTMENT OF LAW & PUBLIC SAFETY DIVISION OF CONSUMER AFFAIRS STATE BOARD OF MEDICAL EXAMINERS In the Matter of:
More informationMANAGEMENT OF PROSTATE ENLARGEMENT/BPH
MANAGEMENT OF PROSTATE ENLARGEMENT/BPH J E S S I C A E. P A O N E S S A, M. D. A S S I S T A N T P R O F E S S O R D E P A R T M E N T O F U R O L O G Y S U N Y U P S T A T E M E D I C A L U N I V E R
More informationLYMPHOMA IN DOGS. Diagnosis/Initial evaluation. Treatment and Prognosis
LYMPHOMA IN DOGS Lymphoma is a relatively common cancer in dogs. It is a cancer of lymphocytes (a type of white blood cell) and lymphoid tissues. Lymphoid tissue is normally present in many places in the
More informationUrinary Tract Infections in Children
Urinary Tract Infections in Children National Kidney and Urologic Diseases Information Clearinghouse National Institute of Diabetes and Digestive and Kidney Diseases NATIONAL INSTITUTES OF HEALTH Urinary
More informationUrinary Incontinence in Women. Susan Hingle, M.D. Department of Medicine
Urinary Incontinence in Women Susan Hingle, M.D. Department of Medicine Background Estimated 13 million Americans with urinary incontinence Women are affected twice as frequently as men Only 25% will seek
More informationAFTER DIAGNOSIS: PROSTATE CANCER Understanding Your Treatment Options
AFTER DIAGNOSIS: PROSTATE CANCER Understanding Your Treatment Options INTRODUCTION This booklet describes how prostate cancer develops, how it affects the body and the current treatment methods. Although
More informationCorporate Medical Policy Urinary Tumor Markers for Bladder Cancer
Corporate Medical Policy Urinary Tumor Markers for Bladder Cancer File Name: Origination: Last CAP Review: Next CAP Review: Last Review: urinary_tumor_markers_for_bladder_cancer 5/2011 11/2015 11/2016
More informationSmoking and misuse of certain pain medicines can affect the risk of developing renal cell cancer.
Renal cell cancer Renal cell cancer is a disease in which malignant (cancer) cells form in tubules of the kidney. Renal cell cancer (also called kidney cancer or renal adenocarcinoma) is a disease in which
More informationRenal Cysts What should I do now?
Renal Cysts What should I do now? Dr Edmund Chiong Asst. Professor & Consultant Department of Urology National University Hospital What are renal cysts? Fluid-filled structures in the kidney that are not
More informationTHE URINALYSIS REAGENT STRIPS
THE URINALYSIS REAGENT STRIPS Alfred Ricks Jr., M.D. Copyright 2010 Alfred Ricks Jr., M.D. All rights reserved. This document may not be reproduced in any form or by any electronic or mechanical means,
More informationCARE PROCESS STEP EXPECTATIONS RATIONALE
URINARY INCONTINENCE CARE PROCESS STEP EXPECTATIONS RATIONALE ASSESSMENT/PROBLEM RECOGNITION 1. Did the staff and physician seek and document risk factors for urinary incontinence and any history of urinary
More informationRecurrent Kidney Stones
Recurrent Kidney Stones Sean A. Pierre, MD; and Darren T. Beiko, MD, FRCSC As presented at the College of Canadian Family Physicians Annual Family Medicine Forum, Toronto, Ontario. Family physicians are
More informationProtocol for Macroscopic and Microscopic Urinalysis and Investigation of Urinary Tract Infections
Protocol for Macroscopic and Microscopic Urinalysis and Investigation of Urinary Tract Infections Reprinted 2004 Scope The purpose of this protocol is to avoid unnecessary testing in routine cases while
More information150640_Brochure_B 4/12/07 2:58 PM Page 2. Patient Information. Freedom From an Enlarged Prostate
150640_Brochure_B 4/12/07 2:58 PM Page 2 Patient Information Freedom From an Enlarged Prostate 150640_Brochure_B 4/12/07 2:58 PM Page 3 GreenLight Laser Therapy 1 150640_Brochure_B 4/12/07 2:58 PM Page
More informationCONTENTS: WHAT S IN THIS BOOKLET
Q Questions & A & Answers About Your Prostate Having a biopsy test to find out if you may have prostate cancer can bring up a lot of questions. This booklet will help answer those questions. CONTENTS:
More informationProstate Cancer Screening
Prostate Cancer Screening The American Cancer Society and Congregational Health Ministry Team June Module To access this module via the Web, visit www.cancer.org and type in congregational health ministry
More informationPap smears, cytology and CCHC lab work and follow up
Pap smears, cytology and CCHC lab work and follow up What is a Pap Smear? A Pap smear (also known as the Pap test) is a medical procedure in which a sample of cells from a woman's cervix (the end of the
More informationAssociates in Pediatric & Adult Urology, PA A division of Garden State Urology 282 Route 46 PO Box 1160 Denville, NJ 07834
Associates in Pediatric & Adult Urology, PA A division of Garden State Urology 282 Route 46 PO Box 1160 Denville, NJ 07834 Dear New Patient: Welcome to Associates in Pediatric and Adult Urology, PA, a
More informationProstate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40.
A.D.A.M. Medical Encyclopedia. Prostate cancer Cancer - prostate; Biopsy - prostate; Prostate biopsy; Gleason score Last reviewed: October 2, 2013. Prostate cancer is cancer that starts in the prostate
More informationA Summary of the Guideline for the Diagnosis and Management of. Urinary Tract Infections in Long Term Care
A Summary of the Guideline for the Diagnosis and Management of Urinary Tract Infections in Long Term Care Exclusions Community acquired UTIs UTIs in acute care Prevention Limit use of catheters Ensure
More informationTopic review: Clinical presentation and diagnosis of urinary incontinence in the elderly. Prapa Pattrapornpisut 7 June 2012
1 Topic review: Clinical presentation and diagnosis of urinary incontinence in the elderly Prapa Pattrapornpisut 7 June 2012 2 Urinary incontinence Definition the complaint of any involuntary leakage of
More informationMultiple Myeloma Understanding your diagnosis
Multiple Myeloma Understanding your diagnosis Multiple Myeloma Understanding your diagnosis When you first hear that you have cancer you may feel alone and afraid. You may be overwhelmed by the large amount
More informationRefer to Coaptite Injectable Implant Instructions for Use provided with product for complete instructions for use.
Questions for my Doctor Refer to Coaptite Injectable Implant Instructions for Use provided with product for complete instructions for use. INDICATIONS: Coaptite Injectable Implant is indicated for soft
More informationDefinition, Prevalence, Pathophysiology and Complications of CKD. JM Krzesinski CHU Liège-ULg Core curriculum Nephrology September 28 th 2013
Definition, Prevalence, Pathophysiology and Complications of CKD JM Krzesinski CHU Liège-ULg Core curriculum Nephrology September 28 th 2013 KI supplements January 2013 Objectives of the course on CKD:
More informationIdentifying and treating long-term kidney problems (chronic kidney disease)
Understanding NICE guidance Information for people who use NHS services Identifying and treating long-term kidney problems (chronic kidney disease) NICE clinical guidelines advise the NHS on caring for
More informationA912: Kidney, Renal cell carcinoma
A912: Kidney, Renal cell carcinoma General facts of kidney cancer Renal cell carcinoma, a form of kidney cancer that involves cancerous changes in the cells of the renal tubule, is the most common type
More informationUrinalysis and Body Fluids CRg. Automation: Introduction. Urine Automation. published by Bayer. Unit 3. Chemical Examination of Urine
Urinalysis and Body Fluids CRg Unit 3 Chemical Examination of Urine Part 7, Automation, Function Tests, and Calculi Automation: Introduction Advantages Saves time Allows for standardization of procedures
More informationThe PSA Controversy: Defining It, Discussing It, and Coping With It
The PSA Controversy: Defining It, Discussing It, and Coping With It 11 TH ANNUAL SYMPOSIUM ON MEN S HEALTH June 12, 2013 The PSA Controversy Defining It, Discussing It and Coping With It As of May 2012,
More informationDiabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria.
Kidney Complications Diabetic Nephropathy Diabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria. The peak incidence of nephropathy is usually 15-25 years
More informationScreening for Prostate Cancer
Cancer Expert Working Group on Cancer Prevention and Screening Screening for Prostate Cancer Information for men and their families 1 What is the prostate? 2 What is prostate cancer? prostate The prostate
More informationPSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj.
PSA Testing 101 Stanley H. Weiss, MD Professor, UMDNJ-New Jersey Medical School Director & PI, Essex County Cancer Coalition weiss@umdnj.edu September 23, 2010 Screening: 3 tests for PCa A good screening
More informationCommon Breast Complaints:
: Palpable mass Abnormal mammogram with normal physical exam Vague thickening or nodularity Nipple Discharge Breast pain Breast infection or inflammation The physician s goal is to determine whether the
More informationTitle: Microbiology Urine Screening Effective date: 05/08/2013. Summary of Significant Changes at this Revision
COPY Summary of Significant Changes at this Revision Add maintenance procedure and not doing dipstick from urine collected into boric acid Purpose and Scope Items Required The purpose of this process is
More information