A 39-Year-Old Man With Microscopic Hematuria
1Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
2Department of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
Rubin RN. A 39-year-old man with microscopic hematuria. Consultant. 2022;62(6):e39-e41. doi:10.25270/con.2022.06.00013
The author reports no relevant financial relationships.
Ronald N. Rubin, MD, Temple University Hospital, 3401 N Broad Street, Philadelphia, PA 19140 (email@example.com)
A 39-year-old man attended a “screening day” sponsored by his workplace. At the event, a nurse practitioner took his medical history; performed a physical examination; drew blood for lipid studies, a complete blood cell panel, and metabolic panel; collected a stool sample for occult blood screening; collected a urine sample for a urinalysis; and conducted an electrocardiography scan.
The man’s history was wonderfully negative for serious illness. He had no major medical diagnoses or surgical history. He had an administrative white-collar job, regularly went to the gym, and was in good physical shape. His examination findings were entirely within normal limits, including blood pressure (110/70 mmHg) and BMI (22 kg/m2).
However, the next day he was given a report and summary of his findings that demonstrated the urinalysis dipstick stained faintly positive for blood. A microscopic urine examination revealed 3 to 5 red blood cells per high power field (RBC/HPF). Everything else was nonremarkable and within normal limits. The summary prompted him to see a physician for further evaluation of the urine abnormality.
Which of the following statements most accurately describes the approach and management pertaining to the case presented?
- If a decision for further evaluation is made, initial optimal studies are ultrasonography and cystoscopy.
- The routine screening for urinary tract cancers via urinalysis the patient had received has been validated as an effective genitourinary tract cancer screening method.
- The finding of microscopic hematuria as described in our patient requires obligatory and prompt urologic/radiologic follow-up.
- Both microscopic and gross hematuria in adults carries high and equivalent cancer risk.
Answer and discussion on next page.
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