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PRACTICE: Sylvia A O’Keeffe, Sorcha McNally, and Mary T Keogan Investigating painless haematuria BMJ 2008; 337: a260 [Full text]

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The commonest cause of Painless Hematuria in West Bengal is Genito urinary Tuberculosis

Professor Pranab Kumar Bhattacharya, BhattacharyaRupak,Bsc(cal), Msc(JU) 7/51Purbapalli Sodepur Kol-110, Bhattacharya Upasana, DasguptaJayantaDM(cal)Gastro-Asso.Prof,Gastro, Chakraborty Anindya ,Ghosh Sukumar DM(cardio) ICVS, Prof. Anup Kundu MS,Mch(Uro) cal,Prof. Urosurgery IPGMERKol-20,W.B   (18 October 2008)

The commonest cause of Painless Hematuria in West Bengal is Genito urinary Tuberculosis 18 October 2008
Professor Pranab Kumar Bhattacharya, Professor of Pathology, Incharge of Histopathology, Cytogenetics,Blood Bank &VCTC Institute of Post Graduate Medical Education & Research,244a AJC Bose Road, Kolkata-20, W.B , India, BhattacharyaRupak,Bsc(cal), Msc(JU) 7/51Purbapalli Sodepur Kol-110, Bhattacharya Upasana, DasguptaJayantaDM(cal)Gastro-Asso.Prof,Gastro, Chakraborty Anindya ,Ghosh Sukumar DM(cardio) ICVS, Prof. Anup Kundu MS,Mch(Uro) cal,Prof. Urosurgery IPGMERKol-20,W.B Send response to journal: Re: The commonest cause of Painless Hematuria in West Bengal is Genito urinary Tuberculosis	In provinces like West Bengal, India, as poverty is more then 59%[ per capita, per month income >Rs 1500/=--- Rs2000/= in Indian currency] and percentage of population living bellow poverty line {BPL}is 27.9%[ having per capita per month income RS<1500/= in Indian currency i. e< 1Us$ per capita per day income] ,incidence of tuberculosis is more amongst the population west Bengal particularly amongst slums rural and suburban areas amongst the unemployed, aged and Childs. So a person [male or female, diabetic or non diabetic] when presents with pain less hematuria, one should consider also genito urinary Tuberculosis also and must exclude Tuberculosis, before considering a tumor in form of TCC of bladder or in renal pelvis or in ureter or a renal malignancy like RCC. The basic investigations needed in that case keeping a temperature chart in evening, a USG of lower abdomen at least looking the kidney , pelvis ,ureter, bladder , urine routine examination for pus cells, casts, urine cytology with H&E and PAP stain for malignant cells for consecutive 3 days, and AFB stain of centrifuge deposit of urine & AFB culture for 3 consecutive urine voided & collected in laboratory to avoid contamination. Yield of positive of AFB stain in urine is very low however. so exclusion rests on AFB culture. Competing interests: None declared