Cytologic findings in adult patients presenting with haematuria in urology clinic at Kenyatta National Hospital.

Abstract

Haematuria is a common rinding in patients presenting with urologic problems. Therefore, the aim of this study was to describing the cytologic findings in patients presenting with haematuria in the urology clinic at Kenyatta National Hospital. Objective: To describe the cytologic findings in patients presenting with haematuria in the urology clinic at Kenyatta National Hospital. Design: Cross - sectional descriptive study Settings: Kenyatta National Hospital Urology Clinic. Analysis was done in the UON/ KNH cytology laboratory. Methods: Voided random urine samples were cyto-centrifuged and then stained using Papanicolaou stains. Cytologic findings were categorized as benign, atypical, malignant and reactive lesions. The quantitative data such prevalence of cytological findings and demographic characteristics were presented in proportions. Factors associated with the type of haematuria were determined using chi-square. The correlation between socio-demographic characteristics and risk factors were determined using chi square test of association. Association between urothelial malignancies and socio-demographic characteristics (tobacco use, alcohol use, application of hair-dyes and skin lighteners) was determined using odds ratio with 95% CI. All statistical tests were performed at 5% significant level, (p = < 0.05). Results: The overall prevalence of malignant urothelial neoplasia was 4%; (highly suspicious urothelial neoplasia 1.3%, malignant neoplasia 2% and anaplastic carcinoma 0.7%). Acute cystitis 69.3%, chronic inflammatory cystitis 5.3%, reactive urothelial changes 4.7 %, atypical urothelial cells 2%, and negative for lesions 14.7%. Malignant urothelial neoplasia (66.7%) and nonneoplastic lesions (77.9%) were more commonly associated with micro-haematuria than gross haematuria. Association between exposure to different risk factors and urothelial neoplasia was not statistically significant (p>0.05). However, age, sex and occupation were important as male patients in 6th and 7th decade in farming industry yielded 66.7% of urothelial malignancies reported. Conclusions: Acute cystitis is the commonest cause of haematuria. Malignant urothelial neoplasia was common among male farmers' in 6th and 7th decade presenting with micro-haematuria. Non-neoplastic lesions were more frequently associated with micro- haematuria than macrohaematuria. The association between urothelial neoplasia and risk factors was not statistically significance. Recommendations: Cytological screening of micro-haematuria for urothelial neoplasia among male farmers in 6th and 7th decade of life should be emphasized.