Which adult patients with asymptomatic microscopic hematuria require further evaluation to rule out occult malignancy?. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: Barroso, Violeta; Nissen, Elise; Shaver, Julia
• Is Part Of: Evidence-based practice. Volume 21:Issue 1(2018)
• Publication Date: 2018-01
• DOI: 10.1097/01.EBP.0000541934.49882.96
• Languages: English
• ISSNs: 1095-4120

Abstract

Abstract : EVIDENCE‐BASED ANSWER : A validated risk index for asymptomatic microscopic hematuria (AMH) that incorporates age, sex, history of gross hematuria, history of smoking, and degree of hematuria (<25 or >25 red blood cells per high‐power field [RBC/HPF]) can identify a low‐risk group of patients with a 0.2% risk of urinary tract malignancy, suggesting that these low‐risk patients may not benefit from further evaluation (SOR: B, prospective cohort study). The American Urological Association (AUA) recommends computed tomography (CT) urography as the imaging test of choice, but also acknowledges that serious causes of AMH in younger patients (<35 years) without risk factors are rare, and so suggests ultrasound with or without intravenous urography as an alternative (SOR: C, expert opinion).