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Microhaematuria in general practice: is urine microscopy misleading?
1Department of General Practice, St James's University Hospital, Leeds.
Summary
Urinary dipstick tests for microscopic haematuria in men over 60 showed poor agreement with hospital microscopy. Relying solely on dipstick results may miss significant findings requiring further investigation.
Area of Science:
- Urology
- Clinical Diagnostics
Background:
- Microscopic haematuria is a common finding in men aged 60 and over.
- Screening programs often utilize urinary dipstick tests for initial detection.
Purpose of the Study:
- To evaluate the diagnostic accuracy of urinary dipstick tests for microscopic haematuria.
- To compare dipstick results with laboratory microscopy in an elderly male population.
Main Methods:
- Retrospective comparison of 58 patients' urinary dipstick results with immediate and routine urine microscopy.
- Analysis of agreement between dipstick tests and hospital laboratory microscopy findings.
Main Results:
- Only 18 out of 58 cases (31%) showed agreement between a positive dipstick test and red blood cells detected by routine hospital microscopy.
- Significant discordance was observed between screening dipstick results and definitive laboratory analysis.
Conclusions:
- Urinary dipstick testing for microscopic haematuria in elderly men has limited diagnostic value.
- Routine urine microscopy results from general practice should not be the sole basis for further investigation decisions.