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NCT06394869NARecruiting

Study to Assess the Impact of the Urine Test Cxbladder Triage Plus on the Number of Cystoscopies Performed on Patients With Invisible Blood in Their Urine.

Pacific Edge Limited

Start Date

4/29/2025

Completion Date

4/1/2028

Summary

This study includes adult patients who see a urologist because of blood in their urine. The amount is so small it can only be seen with a microscope. This is called microhematuria. There can be many reasons for microhematuria. One of them is bladder cancer. While bladder cancer is one of the biggest worries, it is only found in few of these patients. Most microhematuria patients will have a cystoscopy to look inside the bladder. During a cystoscopy, a small camera is inserted into the bladder. This is done through the urethra, the tube that passes urine from the bladder to the outside. In some patients it can cause pain or anxiety. Not all patients have a cystoscopy. Those that don't, usually return for a urine sample within 6 months. This is done to check if there is still blood in their urine. This study is conducted to find out if the use of "Cxbladder Triage Plus" changes the number of cystoscopies in microhematuria patients. Cxbladder Triage Plus is also called "Triage Plus". It is a lab test that was developed to check how likely urothelial carcinoma is present in the bladder. Urothelial carcinoma is by far the most common type of bladder cancer. For the test, the patient voids some urine into a cup. A laboratory then checks the urine of specific genetic material. Abnormalities can be a sign of urothelial carcinoma. The result indicates if the urine is more like most normal urine or more like that of urothelial carcinoma patients. The study is done to find out how Triage Plus changes the number of cystoscopies. Study participants first void urine into a cup. The urine is used for the Triage Plus test. The patients are then assigned to one of two groups. The assignment is random. This means the nobody can influence the assignment. The chance to be assigned to either group is the same. In the test group, the urologist will receive the Triage Plus result and discuss it with the patient. Together they decide whether to do a cystoscopy. In the control group, the urologist will not receive the Triage Plus result. The patient will also not get the result. The urologist and patient will follow standard of care to decide whether to do a cystoscopy. For test group patients, the study gives a recommendation whether to proceed with cystoscopy. It is based on the patient's Triage Plus result. The urologist and patient do not need to follow the recommendation. If the urologist does not follow it, they will complete a survey. The survey has only one question. It is asking for the reasons of the decision. After making their decision, patients will follow the chosen pathway. Data on the performed procedures are collected. The diagnosis will also be documented. Data will be collected for up to about 9 months. To see how Triage Plus changes the number of cystoscopies, these will be counted in each group and then compared.

Eligibility Criteria

Age Range: 18 years to 88 years

Inclusion Criteria: 1. Patient is referred for assessment of recent hematuria, defined as either: 1. Microscopic hematuria (≥3 RBC/HPF or equivalent) on urine microscopy obtained within 180 days prior to enrollment, OR 2. Hematuria detected by dipstick analysis (≥2+ blood or equivalent) at referral and confirmed on the same calendar day and prior to enrollment, with urine microscopy collected on the same day as enrollment 2. Physically able to provide a voided urine sample from a bladder that has not been surgically altered. 3. Able to give informed, written consent. 4. Able and willing to comply with study requirements. 5. Must be 19 or the legal age of consent in the jurisdiction in which the study is taking place to 88 years of age inclusive, at the time of signing the informed consent. 6. Ability to comprehend written and spoken English sufficiently to independently follow all study procedures. Or ability to comprehend Spanish with access to an English-Spanish interpreter for all study related verbal instructions and discussions. Exclusion Criteria: 1. Prior history of bladder malignancy. 2. Prior history of upper tract UC or prostatic urethral UC. 3. History of gross hematuria requiring instrumentation or hospitalization within the last 12 months 4. Reconstructed or diverted bladder (e.g., bladder augmentation, ileal conduit, Indiana pouch) 5. Indication to recommend cystoscopy other than MH (e.g., bothersome benign prostatic hyperplasia symptoms and desires a procedure, weak stream with concerns for urethral stricture). 6. Cystoscopy contraindicated due to another condition or anatomy. 7. History of pelvic radiation. 8. Currently receiving systemic chemotherapy or has had systemic chemotherapy within the last 6 weeks. 9. History of schistosomiasis. 10. History of chronic (\>3 months) indwelling Foley catheter or chronic (\>3 months) bladder stones. 11. Known current pregnancy

Interventions

DIAGNOSTIC_TEST

Cxbladder Triage Plus

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Conditions

Hematuria - Cause Not Known

Locations

Urology Centers of Alabama

Homewood, Alabama 35209

United States

Urology Associates of Mobile

Mobile, Alabama 36608

United States

Urology Associates of Central California

Fresno, California 93720

United States

Urology Group of Southern California

Los Angeles, California 90017-4007

United States

Comprehensive Urology

Los Angeles, California 90048

United States

Advanced Urology Institute - Daytona Beach

Daytona Beach, Florida 32114

United States

Urologic Specialists of Northwest Indiana

Merrillville, Indiana 46410

United States

Southern Urology

Lafayette, Louisiana 70508

United States

Chesapeake Urology Research Associates

Hanover, Maryland 21076

United States

Summit Health

Voorhees Township, New Jersey 08043

United States

Albany MED Health System

Albany, New York 12208

United States

Integrated Medical Professionals

New York, New York 11042

United States

Premier Medical Group of the Hudson Valley, P. C.

Poughkeepsie, New York 12601

United States

Dayton Physicians Network

Dayton, Ohio 45409

United States

Penn State Medical Center, Urology Research

Hershey, Pennsylvania 17033

United States

Urology Associates, P. C.

Nashville, Tennessee 37209

United States

Vanderbilt University Medical Center

Nashville, Tennessee 37232

United States

Austin Urology Institute

Austin, Texas 78758

United States

UT Southwestern Medical Center

Dallas, Texas 75390

United States

University of Wisconsin-Madison

Madison, Wisconsin 53792

United States