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.
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Defining and Evaluating Hematuria
- Microscopic hematuria is defined as three or more red blood cells per high power field.
- Dipstick hematuria (positive hemoglobin or blood reactant) should prompt microscopic evaluation, not further urinary tract tests.
Gross vs. Microscopic Hematuria
- Gross hematuria is more alarming than microscopic hematuria due to a higher likelihood of malignancy (13% vs. 3%).
- However, benign causes are still more common for both.
Hematuria and Anticoagulation
- Evaluate patients with microscopic hematuria based on risk stratification, regardless of anticoagulant/antiplatelet use.
- Don't automatically attribute hematuria to these medications.