Asymptomatic microhematuria and urologic disease. A population-based study.

Area of Science:

• Urology
• Nephrology
• Oncology

Background:

• Asymptomatic microhematuria is frequently observed in adult men and postmenopausal women.
• Previous guidelines recommended extensive urologic evaluations for all patients with this condition.
• These recommendations were based on studies of referred, rather than general, populations.

Purpose of the Study:

• To determine the actual frequency of serious urologic diseases in a general population experiencing asymptomatic microhematuria.
• To evaluate the necessity of comprehensive urologic investigations for asymptomatic microhematuria.

Main Methods:

• A population-based study was conducted in Rochester, Minn.
• The study analyzed the prevalence of serious urologic conditions in individuals with asymptomatic microhematuria.

Main Results:

• Serious urologic disease was found in only 2.3% of patients with asymptomatic microhematuria.
• Bladder or renal cell carcinoma was identified in a mere 0.5% of cases.
• Urologic malignancies were more common in elderly individuals, and a trend suggested more severe disease with higher hematuria grades.

Conclusions:

• Routine, complete urologic investigation for all patients with asymptomatic microhematuria is not recommended.
• Further evaluation should be guided by the presence of additional risk factors.
• Selective investigation based on risk stratification is a more appropriate approach.