Routine urine cytology has no role in hematuria investigations..
Microscopic hematuria refers to the detection of blood on urinalysis or urine microscopy.
Hematuria can be intermittent or persistent.
Hematuria is defined as the presence of at least 5 red blood cells/HPF in 3 of 3 consecutive centrifuged specimens obtained at least 7 days apart..
The urine dipstick test is currently one of the most useful and sensitive tools in detecting hematuria.
This test is based on the peroxidase activity of hemoglobin.
It can detect trace amounts of hemoglobin (rather than the presence of RBCs) and myoglobin..
Recently, the American Urological Association guidelines have not recommended the use of urine cytology as part of the routine evaluation of patients with asymptomatic microhematuria as a result of the above-mentioned minimal net benefit compounded with increased associated costs.
Urological referral is recommended for all patients with gross haematuria, while patients presenting with microscopic haematuria should undergo a risk-stratified approach (Figure 1).
Appropriate early investigation and management of haematuria in the primary care setting is important for timely referral of patients suspected of having serious underlying pathology while avoiding over-investigation in those patients prone to transient and benign causes.
