Hematuria is a common complication of transurethral electrosurgical procedures especially in the immediate post-operative period. The attending urologist and medical personnel should be always watchful of the color of the urine output because unattended hematuria can cause further bleeding and clot formation. If left untreated, these may cause obstruction of urine flow, abdominal pain and distention. Presently, there is no standard diagnostic tool that can determine the degree of hematuria among post-operative catheterized patients. An innovative way of assessing the degree of hematuria is thru the use of the Hematuria Meter Application (HMA), a mobile device software program. The general objective of this study is to determine if HMA can be a reliable diagnostic tool in assessing the degree of hematuria in post-operative TURP and TURBT patients. The specific objectives are to describe the demographics of post-TURP and post-TURBT patients and to determine if there is inter-observer agreement in using the application.
Post-operatively, the color of the urine is observed by the patients/patients’ relative, a resident, an intern and a nurse. Presence of hematuria was then graded using the HMA as a gauge. Urine specimen is sent to the laboratory from each patient for quantitative manual RBC counting under the microscope. Summary statistics were presented in tables and reported as median (IQR) on age and n (%) on gender, indications for surgery, type of surgery and ranges of RBC/high power field (hpf). Intraclass Correlation Coefficient (ICC) is used to determine inter-observer agreement among the observers and agreement of HMA grading with RBC/hpf.
There were a total of 159 patients, with an average age of 69 years (range: 47-83 years), underwent transurethral procedures. Majority were males (91%). While 74% (118 of 159) underwent TURP, 26% (41) underwent TURBT. Patients were diagnosed with Benign Prostatic Hyperplasia (115), Bladder Tumor (41) and Prostate cancer (3). The median age who underwent TURP was 68 (range of 53-83 years) while patients who underwent TURBT, the median age were 66 (range was 47-79). The HMA’s grading and its agreement with the RBC count/hpf had a significant ICC at immediately and second post-operative periods. Also, there was a significant ICC with respect to the inter-observer agreement at immediately and second post-operative periods.
The Hematuria Meter Application can be a reliable diagnostic tool in assessing the degree of hematuria in post-TURP and post-TURBT patients. There was inter-observer agreement in using the application software.