New clinical guidelines released for diagnosis of microhematuria

Microhematuria should not be defined by a positive dipstick, according to new clinical guidelines released by the American Urological Association (AUA) and the Society of Urodynamics, Female Pelvic Medicine, & Urogenital Reconstruction. Instead, clinicians should use ≥3 red blood cells per high-power field on microscopic evaluation of a single, properly collected urine specimen, to define microhematuria.

The guidelines recommend a positive urine dipstick test lead to a formal microscopic evaluation of the urine.

Microhematuria is a potential sign of a number of conditions, including urinary tract infection, kidney stones, or bladder cancer.

“The goal of the new guideline is to provide a risk-stratified approach to hematuria evaluation based on the patient’s risk factors for urinary tract cancer,” said Dr. Daniel Barocas, co-chair of the guideline panel and Associate Professor, Department of Urology at Vanderbilt University, in a statement. “We crafted the guideline with the intention of reducing the intensity of evaluation in those at low risk for malignancy, while preserving the diagnostic sensitivity of evaluation in those at higher risk.”