By vgreene, 13 November, 2020 Perform upper tract imaging if FHx of renal cell carcinoma or genetic renal tumor syndrome even if low risk1
By vgreene, 13 November, 2020 Order renal US as initial imaging per AUA 1 however ACR states renal US usually inappropriate unless pt is pregnant favors CT abd pelvis w o IV contrast 4 MR urogram w o IV contrast also an option in pregnant pts4
By vgreene, 13 November, 2020 If repeat UA in low risk pt who initially chose not to pursue cystoscopy imaging reclassify as intermediate or high risk follow corresponding recs1
By vgreene, 13 November, 2020 Discuss options w pts repeat UA in 6mo vs refer for cystoscopy imaging 1 per ACP may consider cystoscopy imaging in any pt w microhematuria no obvious cause 2 ACOG AUGS recommends against further eval for women in this group3
By vgreene, 13 November, 2020 Employ patient centered shared decision making in determining plan of care observation may be appropriate but referral for cystoscopy and imaging is also reasonable antiplatelet anticoagulant tx does not change recs
By vgreene, 13 November, 2020 If medical renal dz suspected refer to nephrology but still perform risk based eval per AUA2
By vgreene, 13 November, 2020 Stratify level of risk using the AUA Microhematuria Risk Stratification System2 table below to determine next steps for eval ask about hx of gross hematuria and refer for urologic eval if 1
By vgreene, 13 November, 2020 If dx w gyn or nonmalignant source eg menstruation UTI stones etc repeat UA after resolution tx to confirm resolution of microhematuria proceed to risk stratification if UA still 2
