Choosing Wisely Recommendations
Don’t routinely perform cystoscopy or imaging in asymptomatic, never-smoking women younger than 50 years with microscopic hematuria who have less than 25 RBC per high power field.
Rationale and Comments
Asymptomatic hematuria in women is common but less likely to be associated with a urinary tract malignancy compared with men. Data support changing the evaluation requirements for microscopic hematuria in this low-risk group of women. Organizations that do not risk-stratify based on gender may continue to recommend more aggressive diagnostic evaluation in low-risk women.
Sponsoring Organizations
- American Urogynecologic Society
Sources
Disciplines
References
- Committee on Gynecologic Practice, American Urogynecologic Society. Committee opinion no. 703: asymptomatic microscopic hematuria in women. Obstet Gynecol. 2017;129(6):1153-1154.
- Jeppson PC, Jakus-Waldman S, Yazdany T, et al. American Urogynecologic Society Systematic Review: Microscopic Hematuria as a Screening Tool for Urologic Malignancies in Women [published online ahead of print, 2019 Apr 12]. Female Pelvic Med Reconstr Surg. 2019;10.1097/SPV.0000000000000726.
- Davis R, Jones JS, Barocas DA, et al. Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol. 2012;188(6 Suppl):2473-2481. (reviewed and reaffirmed in 2016)
- Lippmann QK, Slezak JM, Menefee SA, Ng CK, Whitcomb EL, Loo RK. Evaluation of microscopic hematuria and risk of urologic cancer in female patients. Am J Obstet Gynecol. 2017;216:146.e1-146.e7.
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7-30.
