Asymptomatic microscopic hematuria in adults: Summary of the AUA Best Practice Policy recommendations

The American Urological Association (AUA) convened the Best Practice Policy Panel on Asymptomatic Microscopic Hematuria to formulate policy statements and recommendations for the evaluation of asymptomatic microhematuria in a dults. The recommended definition of microscopic hematuria is three or more red blood cells per high-power microscopic field in urinary sediment from two of three properly collected urinalysis specimens. This definition accou nts for some degree of hematuria in normal patients, as well as the intermi ttent nature of hematuria in patients with urologic malignancies. Asymptoma tic microscopic hematuria has causes ranging from minor findings that do no t require treatment to highly significant, life-threatening lesions. Theref ore, the AUA recommends that an appropriate renal or urologic evaluation be performed in all patients with asymptomatic microscopic hematuria who are at risk for urologic disease or primary renal disease. At this time, there is no consensus on when to test for microscopic hematuria in the primary ca re setting, and screening is not addressed in this report. However, the AUA report suggests that the patient's history and physical examination should help the physician decide whether testing is appropriate.