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Microhematuria: AUA/SUFU Guideline.
Daniel A Barocas1, Stephen A Boorjian2, Ronald D Alvarez1
1Vanderbilt University Medical Center, Nashville, Tennessee.
The Journal of Urology
|July 24, 2020
Summary
Patients with microhematuria require a personalized diagnostic strategy. A new risk classification system helps identify those at high risk for genitourinary malignancy, guiding tailored evaluations.
Area of Science:
- Urology
- Oncology
- Diagnostic Medicine
Background:
- Microhematuria presents a diverse patient group with varying risks of genitourinary malignancy.
- Patient-specific factors significantly influence the likelihood of underlying malignant conditions.
Purpose of the Study:
- To establish a personalized diagnostic testing strategy for patients with microhematuria.
- To stratify patients based on their risk for genitourinary malignancy.
Main Methods:
- A systematic review of evidence from January 2010 to December 2019 was conducted.
- Evidence-based statements were developed by an expert Panel, considering evidence strength and clinical judgment.
- A risk classification system (low, intermediate, high) was created based on clinical factors.
Main Results:
- Microhematuria is defined as ≥ 3 red blood cells per high power field.
- Risk stratification incorporates age, sex, smoking history, degree/persistence of microhematuria, and prior gross hematuria.
- Diagnostic evaluation (cystoscopy, upper tract imaging) is recommended based on risk stratification and shared decision-making.
Conclusions:
- Patients with microhematuria should be risk-classified for genitourinary malignancy.
- A risk-based evaluation strategy is essential for appropriate patient management.
- Further high-quality research is needed to enhance care for these patients.
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