Assessment of hematuria

The most common causes of hematuria in adults include urinary tract infections, urolithiasis, benign prostatic enlargement, and urologic malignancy. Once hematuria is confirmed, its cause should be investigated through a comprehensive history, a focused physical examination, laboratory studies, an image-based assessment of the upper urinary tract, and a cystoscopic evaluation of the lower urinary system. Prompt evaluation and appropriate referral of patients with documented hematuria should be initiated in the primary care setting according to the proposed guidelines, and aimed at cost-effective and early detection of urologic abnormality.