METHODS: 417 patients presenting with haematuria were assessed in our Urology Unit. Following confirmation of haematuria, these patients were subjected to imaging techniques and flexible cystoscopy. Parameters analysed included clinical characteristics, imaging results, flexible cystoscopy findings, time delay to diagnoses and eventual treatment and final diagnoses of all cases.
RESULTS: 390 haematuria cases were analysed from 417 consecutive patients with haematuria. After 27 cases were excluded as they had previous history, 245 microscopic and 145 macroscopic. Age range was 17 to 95 years old with predominance of 152 females to 239 males. The racial distribution included 180 Chinese, 100 Indians,95 Malays and 15 other races. The final diagnoses were benign prostatic hyperplasia (22.6%), no cause found (22.3%), other causes (18.7%), urolithiasis (11.5%), urinary tract infection UTI (10.8%), non specific cystitis (10.3%), bladder tumours (2.8%) and other genitourinary tumours (1%). 11 new cases (2.8%) of bladder cancers were diagnosed, with a mean age of 59 years. Only 3 of 245 (1.2%) patients with microscopic haematuria had newly diagnosed bladder tumour compared with 8 of 145 (5.5%) patients with frank haematuria (p=0.016). Mean time taken from onset of symptoms to diagnosis of bladder cancer was 53.3 days with definitive treatment (TURBT) in 20.1 days from diagnosis.
CONCLUSION: - This study has highlighted the common causes of haematuria in our local setting. We recommend that full and appropriate investigations be carried out on patients with frank haematuria especially those above 50 years old in order to provide earlier detection and prompt management of bladder diseases especially tumours.
MATERIALS AND METHODS: Validity and reliability were studied in patients with and without lower urinary tract symptoms. Reliability was evaluated using the test-retest method and internal consistency was assessed by Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with lower urinary tract symptoms who underwent transurethral prostate resection.
RESULTS: Internal consistency was excellent. A high degree of internal consistency was observed for each of the 7 items and for the total score (Cronbach's alpha 0.53 and greater, and 0.68, respectively). The test-retest correlation coefficients of the 7 items were highly significant. The intraclass correlation coefficient was high at 0.51 and greater. There was a high degree of sensitivity and specificity to the effects of treatment. Significant change from baseline to posttreatment scores was observed in all 8 items in the treated but not in the control group.
CONCLUSIONS: The Malay International Prostate Symptom Score is a suitable, reliable, valid instrument that is sensitive to clinical change in the Malaysian population.
PATIENTS AND METHODS: Validity and reliability were assessed in patients with lower urinary tract symptoms (LUTS) and in patients with no LUTS. Reliability was evaluated using the test-retest method and internal consistency using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate (TURP).
RESULTS: Internal consistency was excellent; there was a high degree of internal consistency for each of the seven domains and for the total score (Cronbach's alpha > or = 0.60 and > or = 0.79, respectively) in the populations studied. The test-retest correlation coefficient for the seven domain scores was highly significant. The intra-class correlation coefficient was high (> or = 0.59). There was a high level of sensitivity and specificity for the effects of treatment, with a very significant change between the seven scores domains in the treated group but not in the control group.
CONCLUSIONS: The IPSS is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.