Sandbox:Microscopic hematuria
http://www.jurology.com/article/S0022-5347(12)04958-0/pdf
Definition
Microscopic hematuria is defined as the presence of three or greater red blood cells per high powered field on a properly collected urinary specimen in the absence of an obvious benign cause.[1]
Causes
Overview
The causes of MH are either urologic or nephrologic. The most common urological etiologies are benign prostatic enlargement, infection and urinary calculi.
Prevalence
The prevalence of microscopic hematuria varies depending on age, gender, frequency of testing, threshold used to define MH and presence of risk factors such as smoking.[1]
Diagnosis
A positive dipstick does not define MH, and evaluation should be based solely on findings from microscopic examination of urinary sediment and not on a dipstick reading. A positive dipstick reading merits microscopic examination to confirm or refute the diagnosis of MH.Patients who have a positive dipstick test but a negative specimen on microscopy should have three additional repeat tests. If at least one of the repeat tests is positive on microscopy, then work-up should be undertaken. If all three specimens are negative on microscopy, then the patient may be released from care.[1]
Because MH has been associated with underlying urologic cancer, the AUA recommends evaluation with cystoscopy and upper tract imaging, preferably with computer tomography (CT) scan, for all patients >35 years of age with this finding.
References
- ↑ 1.0 1.1 1.2 Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol 188 (6 Suppl):2473-81. DOI:10.1016/j.juro.2012.09.078 PMID: 23098784