UpdateEvaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy—part I: definition, detection, prevalence, and etiology1
Section snippets
Detection and definition of asymptomatic microscopic hematuria
Red blood cells (RBCs) in the urine are not always a sign of underlying disease. Previous studies have reported that between 9% and 18% of apparently normal individuals have some degree of hematuria.2, 3, 4, 5, 6, 7 However, the actual number of erythrocytes that can be excreted under “normal” conditions is difficult to determine. Different methods used by different investigators to determine the presence of hematuria, different definitions of the “normal” population among studies, the
Prevalence of asymptomatic microscopic hematuria
The prevalence of asymptomatic microscopic hematuria has been estimated in both unselected, population-based studies and in screening or referral-based studies examining selected patient populations. Woolhandler and colleagues11 reviewed five population-based cohort studies with patient populations ranging from 1000 to 95,200. The estimated prevalence of asymptomatic microscopic hematuria varied in these studies from 0.19% to 16.1%. Such wide variations reflect the differences in the age and
Etiology
The proportion of patients with asymptomatic microscopic hematuria who are subsequently diagnosed with significant urologic disease reflects both the patient population under investigation and the extent of the urologic evaluation that is performed. Most studies in which patients with asymptomatic microscopic hematuria have undergone full urologic evaluation have included referral-based populations. A full evaluation in these studies often included a repeated urinalysis, urine culture, upper
Acknowledgements
To Lisa Cowen, Ph.D. and Carol Schwartz, M.P.H.
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The Asymptomatic Microscopic Hematuria in Adults Best Practice Policy has been published in summary format in American Family Physician, Volume 63, March 15, 2001.