Microhematuria assessment an IBCN consensus—Based upon a critical review of current guidelines

Abstract Rationale Assessment of patients with asymptomatic microhematuria (aMh) has been a challenge to urologists for decades. The aMh is a condition with a high prevalence in the general population and also an established diagnostic indicator of bladder cancer. Acknowledging aMh needs to be asses...

Full description

Saved in:
Bibliographic Details
Published in:Urologic oncology 2016-10, Vol.34 (10), p.437-451
Main Authors: Schmitz-Dräger, Bernd J., M.D., Ph.D, Kuckuck, Eva C., M.D, Zuiverloon, Tahlita C.M., M.D, Zwarthoff, Ellen C., Ph.D, Saltzman, Amanda, M.D, Srivastava, Abhishek, M.D, Hudson, M’Liss A., M.D, Seiler, Roland, M.D, Todenhöfer, Tilmann, M.D, Vlahou, Antonia, Ph.D, Grossman, H. Barton, M.D, Schoenberg, Mark P., M.D, Sanchez-Carbayo, Marta, Ph.D, Brünn, Lenuta-A., M.D, van Rhijn, Bas W.G., M.D, Goebell, Peter J., M.D, Kamat, Ashish M., M.D, Roupret, Morgan, M.D, Shariat, Sharokh F., M.D, Kiemeney, Lambertus A., Ph.D
Format: Article
Language:English
Subjects:
Asymptomatic Diseases
Biomarkers - urine
Bladder cancer
Consensus
Cystoscopy
Diagnosis
Disease management
Guidelines
Hematuria - diagnostic imaging
Hematuria - epidemiology
Hematuria - pathology
Hematuria - urine
Humans
Microhematuria
Practice Guidelines as Topic
Prevalence
Risk Assessment - methods
Symptom Assessment - standards
Tomography, X-Ray Computed
Ultrasonography
Urinary Bladder Neoplasms - complications
Urinary Bladder Neoplasms - diagnosis
Urinary Bladder Neoplasms - epidemiology
Urine - cytology
Urine markers
Urography
Urology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Rationale Assessment of patients with asymptomatic microhematuria (aMh) has been a challenge to urologists for decades. The aMh is a condition with a high prevalence in the general population and also an established diagnostic indicator of bladder cancer. Acknowledging aMh needs to be assessed within a complex context, multiple guidelines have been developed to identify individuals at high risk of being diagnosed with bladder cancer. Material & Methods This structured review and consensus of the International Bladder Cancer Network (IBCN) identified and examined 9 major guidelines. These recommendations are partly based on findings from a long-term study on the effects of home dipstick testing, but also on the assumption that early detection of malignancy might be beneficial. Results Despite similar designs, these guidelines differ in a variety of parameters including definition of aMh, rating of risks, use of imaging modalities, and the role of urine cytology. In addition, recommendations for further follow-up after negative initial assessment are controversial. In this review, different aspects for aMh assessment are analyzed based upon the evidence currently available. Discussion We question whether adherence to the complicated algorithms as recommended by most guidelines is practical for routine use. Based upon a consensus, the authors postulate a need for better tools. New concepts for risk assessment permitting improved risk stratification and prepone cystoscopy before refined imaging procedures (computed tomography scan and magnetic resonance imaging) are suggested.
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2016.05.030