Choosing Wisely:

Don’t obtain urine cytology or urine markers as a part of the routine evaluation of the asymptomatic patient with microhematuria.

Rationale and Comments: Insufficient evidence exists for the use of urine cytology and urine markers in the routine evaluation of the asymptomatic patient with microhematuria, including bladder tumor antigen assays, nuclear matrix protein assays, and fluorescent in situ hybridization assays to detect chromosomal alterations. The psychological stress and unnecessary diagnostic procedures that could result from a false positive test outweigh the potential benefits to these patients.
Sponsoring Organizations:
  • American Urological Association
  • Sources:
  • American Urological Association guidelines
  • Disciplines:
  • Urologic
  • References: • Diagnosis, Evaluation and Follow-Up of Asymptomatic Microhematuria (AMH) in Adults: American Urological Association Guideline, 2012. Available from:

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