Approach to Microscopic Hematuria Microscopic hematuria is often incidental but may be associated with urologic malignancy. Despite this risk, 39-90% of persons on screening urinalysis received no follow-up testing. Dysmorphic RBC's, cellular casts, proteinuria, elevated creatinine, or HTN in the presence of microscopic hematuria require prompt referral. Definition of Microscopic Hematuria: - ≥ 3 RBC/TIPF on microscopic evaluation of a single, properly collected urine specimen. - Not by positive dipstick testing alone Risk Stratification: • Low-Risk: Repeat urinalysis in 6 months or proceed with cystoscopy & renal ultrasound. • Intermediate-High Risk: Perform cystoscopy & upper tract imaging. Satyendra Dhar, MD @DharSaty #Hematuria #Microscopic #diagnosis #management #urology
