Mayo Clinic Talks
RE-RELEASE from Season 2: Mayo Clinic Talks "Evaluating Hematuria"
Dec 24, 2024
Urologist Aaron M. Potretzke from Mayo Clinic dives into the nuances of hematuria, shedding light on both microscopic and gross forms of this common issue. He discusses when to investigate, emphasizing that malignancy is a serious concern but not the only cause. The conversation explores risk assessment for urinary tract cancers, particularly in high-risk groups like those with Lynch syndrome. Potretzke also outlines evaluation protocols for different patient risk levels, enhancing the understanding of shared decision-making in managing this condition.
19:28
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Quick takeaways
- Microscopic hematuria, while common, warrants careful evaluation to rule out serious conditions like urinary tract malignancy while many cases are benign.
- Assessing a patient's risk for urinary malignancy requires considering factors such as age, sex, and smoking history to guide appropriate investigations.
Deep dives
Understanding Microscopic and Gross Hematuria
Microscopic hematuria is defined by the presence of three or more red blood cells per high power field in a urine specimen. This condition prompts evaluations to differentiate it from dipstick hematuria, where hemoglobin can give false positives. Often, gross hematuria is more alarming as it is associated with a higher rate of urinary malignancy, being found in about 13% of cases compared to only 3% for microscopic hematuria. However, while it is essential to investigate the causes of both types of hematuria, many instances are linked to benign conditions rather than malignancies.
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