[Asymptomatic microhematuria in the adult]

There is some controversy with respect to the attitudes that should be adopted when microhematuria is detected in asymptomatic subjects. The prevalence of MH ranges from 1 to 13%. The diagnostic evaluations conducted by different study groups suggest that the most frequent lesions are (in decreasing order) prostatic benign hypertrophy, followed by urinary tract infections, urolithiasis and neoplasias. Reactive straps are useful for the detection of hematuria. If the test is positive, a microscopical exploration of the urinary sediment is recommended, because it will confirm the results and sometimes it will provide some information about the cause of bleeding. The clinical evaluation should start with a detailed basic blood and urine analysis and other analytical test, depending on the clinical suspicion. The structural study of the urinary tract should start with an intravenous urography and/or simple echography + radiography. Personal predilections and the medical setting will be the major factors determining the election of one or other type of exploration. If after the first diagnostic study, the cause of hematuria is still unknown, there is no need to repeat again such study. Just in case of developing some symptomatology, the strategy to follow should have to be reconsidered on an individual basis.