Individual‐risk‐score for urinary tract malignancy in patients with microscopic hematuria

Abstract

Microscopic hematuria (MH) is defined as 3 or more red blood cells per high-power field (RBC/HPF) on microscopic evaluation. 1 It may occur due to the patient's nephrologic, gynecologic, and urologic conditions. The urological conditions include nephrolithiasis, benign prostatic hyperplasia, urinary tract infection, urethral strictures, and rarely, urinary tract malignancies. 2 Indeed, urinary tract malignancy has been diagnosed in only 3% of the patients evaluated for MH. 3,4 The previous MH evaluation algorithm suggested evaluation using cystoscopy and radiological imaging for nearly all patients with MH. This, however, may lead to an increase in the number of unnecessary invasive and costly diagnostic procedures conducted. 5 Therefore, the American Urological Association (AUA)/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction's (SUFU) panelists stated that there was a need for updated, evidence-based guideline recommendations for the evaluation of patients with MH that limit the unnecessary adverse events and costs associated with the diagnostic procedures for patients with a low risk for