Evaluation of asymptomatic microscopic hematuria

Asymptomatic microscopic hematuria is a common cause for urologic referral. However, there continues to be considerable disagreement in the literature as to the proportion of patients with asymptomatic microscopic hematuria who will eventually be found to have significant urologic disease. Consequently, recommendations regarding whether or not to initiate a urologic evaluation in these patients, and the type of evaluation that should be performed are conflicting. The purpose of this article is to define the etiology and the incidence of asymptomatic microscopic hematuria and to summarize recommendation from the literature regarding the appropriate initial evaluation and surveillance of a patient who is found to have asymptomatic microscopic hematuria.