The value of cystoscopy as an initial diagnostic modality for asymptomaticmicroscopic hematuria

For the patients who visit outpatient clinics due to asymptomatic microscop ic hematuria, cystosoopy has been looked upon as rather invasive compared t o other diagnostic methods. We tried to elucidate the actual diagnostic val ue of cystoscopy in the initial evaluation of asymptomatic microscopic hema turia. We reviewed the results of cystoscopic examinations in 213 patients who visited our hospital due to asymptomatic microscopic hematuria. No defi nite lesion that could explain the microscopic hematuria was detected by me ans of IVP, urine cytology, and other nephrologic evaluations for all the p atients. Among the abnormal cystoscopic findings in 55 patients, the lesion s suspected to be directly related to microscopic hematuria were classified as 'significant lesions' (31 patients, 17.6%) which include entities such as bladder cancer (1.31%). 27 of 31 patients with significant lesions (85.2 %) were over 50 yr old, and furthermore, 3 patients who were diagnosed as b ladder tumor by cystoscopy were over 60 yr, Cystoscopy should be utilized a s initial diagnostic modality in older patients with asymptomatic microscop ic hematuria to rule out any possibility of bladder cancer occurrence. Furt her studies are needed to justify implementation of cystoscopy as an initia l diagnostic modality in younger patients with asymptomatic microscopic hem aturia.