Evaluating posttransurethral resection of prostate hematuria severity using two methods: A cross-sectional study

Abstract Background Following transurethral resection of the prostate, postprocedure macroscopic hematuria must be evaluated. We developed a five-color table hematuria grading scale with visualized color references for health care workers to evaluate postprocedure hematuria severity and compared it with assessments made using the text hematuria grading scale. Methods Thirty hematuria samples from patients who had undergone transurethral resection of the prostate were evaluated twice by 17 doctors and 13 nurses. The main outcome was the postprocedure macroscopic hematuria severity, measured using the means obtained from the two hematuria grading methods (Meantext and Meanfive-color). Furthermore, we investigated the association between demographic factors including occupation, training years, and whether a urologist was involved in hematuria evaluation. Results The Meantext for 30 patients was 2.2489 ± 1.96*0.76862, whereas the Meanfive-color was 2.4222 ± 1.96*0.91268. The paired t test revealed a significant difference between Meantext and Meanfive-color (P = 0.00), meaning that the severity observed by medical staff was significantly milder using the text compared with the five-color hematuria grading scale. The Wilcoxon signed rank test between the variances of the two hematuria grading scales showed a Z score of −1.127 and p value of 0.026 without significant difference. Conclusions Our findings reveal that hematuria grading is method-dependent. Hematuria severity in patients who had undergone transurethral resection of the prostate with macroscopic hematuria assessed using a hematuria grading scale without visualized color references may be underestimated in clinical practice. With visualized color references, consistent counts did not negatively correlate to fewer years of experience in the surgery department.