LINTHICUM, MD USA (PRESS RELEASE) - May 23, 2012 - A single positive urinalysis with microscopy for asymptomatic microhematuria (blood in the urine) is enough to warrant a complete urological examination, according to a new clinical guideline released today by the American Urological Association (AUA).
This guidance updates previous recommendations that a full exam be completed only after two of three properly collected samples test positive for microhematuria on microscopy.
Asymptomatic microhematuria, defined in the guideline as ‘three or more red blood cells per high-powered field on a properly collected urinary specimen in the absence of an obvious benign cause” (e.g., infection, trauma or renal disease) may be indicative of more serious conditions. Though only a small subset of patients with microhematuria will ultimately be diagnosed with a urologic malignancy, benign conditions that can cause microhematuria (including stricture and stone disease) can benefit from active clinical management and/or follow up.
Assessment for asymptomatic patients presenting with microhematuria includes a careful history as well as a physical examination and laboratory testing, including an estimate of renal function and, for patients over age 35 (or those with risk factors for urinary tract malignancies, such as a history of tobacco use or chemical exposure), a cystoscopy. The initial evaluation for microhematuria should also include a radiologic evaluation to rule out tumors in the kidney and to evaluate the upper urinary tract urothelium.
“Urinary tract conditions that cause bleeding are often ‘silent’ and present with few symptoms until the disease is advanced or causes more serious symptoms,” said Dr. Rodney Davis, who chaired the panel that developed the guideline. “For most patients, microhematuria may be the earliest warning to health care providers of urinary tract disease, so it is important that we evaluate these patients to prevent serious problems later.” A full copy of the guideline, Diagnosis, Evaluation and Follow-up of Asymptomatic Microhematuria in Adults is available online at www.AUAnet.org and is an update to the document published by the AUA in 2001.
About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 18,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy.
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American Urological Association
