Give an overview about the assessment of microhematuria.
Asymptomatic microhematuria is less commonly associated with cancer than gross hematuria.
Patients should be evaluated for glomerular causes; if present patients should be additionally worked up by nephrology.
Assessment for urinary tract cancer is based on risk stratification.
Risk stratification (table).
Describe the risk-based assessment of microhematuria (low, intermediate, high).
Low risk: either of the following, selected using shared decision-making.
Repeat urinalysis within 6 months.
OR evaluate with renal bladder ultrasound and refer for cystoscopy.
Intermediate risk: Order a renal bladder ultrasound and refer for cystoscopy.
High risk: Order CT urography and refer for cystoscopy.
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