{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:19:01Z","timestamp":1783948741580,"version":"3.55.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Gross hematuria often requires continuous bladder irrigation (CBI) to prevent clot retention. Decisions to initiate, adjust, or discontinue CBI rely on subjective visual assessment, causing practice variability. This study aimed to develop a consensus-based visual hematuria scale to guide CBI management and improve communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Ten simulated hematuria specimens (20%\u20130.04% hematocrit) were prepared using packed red blood cells and normal saline. Urologists and residents (\u22651 year CBI experience) evaluated specimens in person or through photographs. Participants identified threshold specimens for four actions: (1) notifying an urologist, (2) increasing CBI rate, (3) decreasing CBI rate, and (4) stopping CBI. Data were analyzed using mode, interquartile range (IQR), and appropriate exact tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 150 respondents, 145 met the inclusion criteria (54.5% residents, 45.5% urologists). Modes (IQR) for each action were: Notify \u2013 1 (IQR = 2), Increase rate \u2013 5 (IQR = 2), Decrease rate \u2013 8 (IQR = 2), and Stop \u2013 9 (IQR = 2). Exact agreement ranged from 26.2% to 44.8%, while adjacent agreement (within \u00b1 1 grade) demonstrated strong consensus, ranging from 61.4% to 93.1%. Responses did not differ significantly between urologists and residents. On-site and online responses differed slightly regarding the \u201cincrease rate\u201d threshold (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This multi-center survey identified consensus thresholds for a 4-point visual hematuria grading scale. This scale is intended to serve as a communication aid to standardize the language in CBI management. While this consensus provides a foundation, further studies are needed to validate the proposed grading system in real-world settings and incorporate additional clinical parameters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ua.ua_176_25","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:00:32Z","timestamp":1783947632000},"page":"253-258","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Visualizing grades of hematuria for communication enhancement and continuous bladder irrigation guidance"],"prefix":"10.4103","volume":"18","author":[{"given":"Thanapat","family":"Layangool","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Urology, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanisorn","family":"Pattanasuwon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weerayut","family":"Wiriyabanditkul","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarayut","family":"Kanjanatarayon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nattapong","family":"Binsri","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satit","family":"Siriboonrid","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittaya","family":"Jiraanankul","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"R1-20260713","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1016\/j.juro.2012.09.078","article-title":"Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline","volume":"188","author":"Davis","year":"2012","journal-title":"J Urol"},{"key":"R2-20260713","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.surge.2013.06.003","article-title":"A review of inpatient urology consultations in an Irish tertiary referral centre","volume":"11","author":"Sullivan","year":"2013","journal-title":"Surgeon"},{"key":"R3-20260713","first-page":"e10668","article-title":"The hidden work of urology residents \u2013 A cross-sectional study","volume":"12","author":"Kazmi","year":"2020","journal-title":"Cureus"},{"key":"R5-20260713","first-page":"422","article-title":"Haematuria investigation based on a standard protocol: Emphasis on the diagnosis of urological malignancy","volume":"47","author":"Alishahi","year":"2002","journal-title":"J R Coll Surg Edinb"},{"key":"R6-20260713","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1464-410X.2006.05976.x","article-title":"A prospective analysis of the diagnostic yield resulting from the attendance of 4020 patients at a protocol-driven haematuria clinic","volume":"97","author":"Edwards","year":"2006","journal-title":"BJU Int"},{"key":"R7-20260713","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.urology.2020.10.054","article-title":"A visual scale for improving communication when describing gross hematuria","volume":"148","author":"Stout","year":"2021","journal-title":"Urology"},{"key":"R8-20260713","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s11255-006-6662-7","article-title":"A novel method for evaluating and expressing the degree of macroscopic hematuria","volume":"38","author":"Sakuma","year":"2006","journal-title":"Int Urol Nephrol"},{"key":"R9-20260713","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.urology.2013.04.048","article-title":"Hematuria grading scale: A new tool for gross hematuria","volume":"82","author":"Lee","year":"2013","journal-title":"Urology"},{"key":"R10-20260713","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/01.spv.0000190450.68700.d2","article-title":"Would you put it in the fridge? 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