Thesis (MSc.Med.(Urology))--University of the Witwatersrand, Faculty of Health Sciences, 2014. / Bladder cancer is the second commonest urological malignancy and haematuria is the
commonest symptom. Cystoscopy and urine cytology are integral for the investigation
of haematuria, while the role of molecular markers such as the NMP22 BladderChek
test is still being defined. The BladderChek is a qualitative point of care test
developed for the detection of the elevated urinary levels of NMP22 associated with
bladder cancer. No studies have been performed in South Africa using the
BladderChek nor considered using this test to increase the efficiency of the workup of
patients with gross haematuria. The primary aim was to establish the percentage of
office cystoscopies done as part of a gross haematuria workup at Charlotte Maxeke
Johannesburg Academic Hospital that are unnecessary and may be avoided if the
BladderChek is positive under defined conditions. A cross-sectional study of the
BladderChek test using prospective consecutive sampling, with special care to limit
false positives and negatives, of 64 patients with a history of gross haematuria was
conducted. The sensitivity, specificity, positive predictive value and negative
predictive value for the BladderChek and the urine cytology were 78.9%, 84.4%,
68.2%, 90.5% and 36.8%, 93.0%, 70.0%, 76.9% respectively. The performance of the
BladderChek was not affected by the history of gross haematuria, the stage nor grade of
malignancy. Urine cytology detected only one malignancy missed by the
BladderChek. Approximately 12.6% of office cystoscopies may be avoided and
78.9% of bladder tumours detected if the BladderChek is selectively applied as in this
study. This may “fast-track” patients for transurethral resection of bladder tumour.
The BladderChek may be a cost-effective alternative to urine cytology.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/15309 |
| Date | 27 August 2014 |
| Creators | Purdy, Mark Richard |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf |
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