SavedAdd your journal

Journals / Endoüroloji Bülteni / 2026 / Cilt: 18 Sayı: 1

Urological Evaluation Processes of Patients with Microscopic Hematuria Identified in Primary Healthcare Services: A Retrospective Analysis

Birinci Basamak Sağlık Hizmetlerinde Mikroskobik Hematüri Saptanan Hastaların Ürolojik Değerlendirme Süreçleri: Retrospektif Analiz

Mehmet Uçar(MUS ALPARSLAN UNIVERSITY)0000-0002-7769-8828
Halil İbrahim İvelik(KÜTAHYA SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ)0000-0001-5298-0045
Duygu İvelik0000-0002-9222-2254
Pages
12–19
Publication Date
2026-01-29
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Nurses in primary care play a vital role in the early identification and triage of such patients by interpreting urinalysis findings using a risk-based approach and ensuring timely specialist referrals.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: This study aimed to investigate the diagnostic evaluation pathways, referral rates for advanced testing, final diagnoses, and follow-up outcomes of patients with microscopic hematuria (MH) identified through routine urinalysis in primary care settings.
📊
Key Findings & Data:Materials and Methods: In this retrospective cross-sectional study, clinical data were reviewed for 73 patients who presented to primary healthcare centers between 2022 and 2023 and had ≥3 red blood cells per high-power field (RBC/HPF) on urinalysis.
💡
Conclusion & Impact:Nurses in primary care play a vital role in the early identification and triage of such patients by interpreting urinalysis findings using a risk-based approach and ensuring timely specialist referrals.
🔬Design:Review & Systematic Survey
📍Scope:2022 Verileri
⚙️Variables:birinci basamak sağlık hizmetleri · hemşirelik · hematüri

Abstract

Objective: This study aimed to investigate the diagnostic evaluation pathways, referral rates for advanced testing, final diagnoses, and follow-up outcomes of patients with microscopic hematuria (MH) identified through routine urinalysis in primary care settings. Materials and Methods: In this retrospective cross-sectional study, clinical data were reviewed for 73 patients who presented to primary healthcare centers between 2022 and 2023 and had ≥3 red blood cells per high-power field (RBC/HPF) on urinalysis. Data included demographic characteristics, medical history, laboratory findings, imaging studies, specialist consultations, and treatment outcomes. Results: The mean age of participants was 39.6 ± 14.3 years, with 63% being female. MH was classified as benign in 80.8% of cases. Urolithiasis accounted for 13.7%, while glomerular pathology and malignancy were each identified in 2.7% of patients. A follow-up-only approach was adopted in 60.3% of cases. During follow-up, hematuria resolved spontaneously in 84.9% of patients. The presence of malignancy was more common among high-risk individuals, particularly older adults and smokers. Conclusion: Microscopic hematuria is most often benign but may signal serious underlying conditions in high-risk patients. Nurses in primary care play a vital role in the early identification and triage of such patients by interpreting urinalysis findings using a risk-based approach and ensuring timely specialist referrals.

Özet

Amaç: Bu araştırma birinci basamak sağlık hizmetlerinde rutin tam idrar tahlili sırasında mikroskobik hematüri (MH) saptanan bireylerin tanısal değerlendirme süreçlerini, ileri tetkiklere yönlendirme oranlarını, son tanılarını ve izlem sonuçlarını değerlendirmek amacıyla yapılmıştır. Yöntem: Bu retrospektif kesitsel çalışmada, 2022–2023 yılları arasında birinci basamak sağlık hizmetine başvuran ve tam idrar tahlilinde ≥3 RBC/HPF saptanan toplam 73 bireyin klinik verileri incelendi. Demografik özellikler, tıbbi öykü, laboratuvar bulguları, yapılan görüntüleme ve konsültasyonlar ile tanı ve tedavi süreçleri değerlendirildi. Bulgular: Katılımcıların yaş ortalaması 39,6 ± 14,3 yıl olup %63’ü kadın idi. MH olgularının %80,8’i benign olarak değerlendirildi. Taş hastalığı %13,7, glomerüler nedenler ve malignite ise %2,7 oranında saptandı. Hastaların %60,3’ü yalnızca izlem ile takip edildi. İzlemde hematürinin %84,9’unda geçici olduğu gözlendi. Riskli bireylerde (ileri yaş, sigara kullanımı) malignite görülme olasılığı daha yüksekti. Sonuç: Mikroskobik hematüri genellikle benign nedenlere bağlı olmakla birlikte, özellikle risk grubundaki bireylerde ciddi patolojilerle ilişkili olabilir. Birinci basamak sağlık hizmetlerinde görev yapan hemşirelerin TİT sonuçlarını risk temelli şekilde değerlendirmesi ve gerekli yönlendirmeleri yapması, erken tanı açısından kritik öneme sahiptir.

🔖

Cite This Article

Uçar, M., İvelik, H. İ., İvelik, D. (2026). Urological Evaluation Processes of Patients with Microscopic Hematuria Identified in Primary Healthcare Services: A Retrospective Analysis. Endoüroloji Bülteni, Cilt: 18 Sayı: 1, 12–19. https://doi.org/10.54233/endourolbull-1744058

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (23)

  1. Barocas DA, Boorjian SA, Alvarez RD, Downs TM, Grossfeld GD, et al. Microhematuria: AUA/SUFU guideline. J Urol. 2020;204(4):778–86. https://doi.org/10.1097/JU.0000000000001297
  2. Birken SA, Matulewicz R, Pathak R, Wagi CR, Peluso AG, et al. Toward the deimplementation of computed tomography urogram for patients with low- to intermediate-risk microscopic hematuria: a mixed-method study of factors influencing continued use. Urol Pract. 2023;10(5):511–19. https://doi.org/10.1097/UPJ.0000000000000429
  3. Elterman D, Li W, Hatiboglu G, Relle J, Zorn KC, et al. Relief of lower urinary tract symptoms after MRI-guided transurethral ultrasound ablation for localized prostate cancer: subgroup analyses in patients with concurrent cancer and benign prostatic hyperplasia. J Endourol. 2021;35(4):497–505. https://doi.org/10.1089/end.2020.0511
  4. Hayden JP, Nelson J, Frankenberger E, Vanni AJ. Risk of hematuria-related complications associated with anticoagulant and antiplatelet medications: a single-institution retrospective cohort study. Urology. 2025;197:12–17. https://doi.org/10.1016/j.urology.2024.11.003
  5. Heers H, Gut JM, Hofmann R, Flegar L, Derigs M, et al. Pilot study for bladder cancer detection with volatile organic compounds using ion mobility spectrometry: a novel urine-based approach. World J Urol. 2024;42(1):353. https://doi.org/10.1007/s00345-024-05047-5
  6. Saha MK, Massicotte-Azarniouch D, Reynolds ML, Tsampalieros AK, Wald R, et al. Glomerular hematuria and the utility of urine microscopy: a review. Am J Kidney Dis. 2022;80(3):383–92. https://doi.org/10.1053/j.ajkd.2022.03.377
  7. Lisanti CJ, Graeber A, Syed H, Moeck A, Rittel AG, et al. What is the relative risk of urologic malignancy in microscopic hematuria patients after negative evaluation? A long-term population-based retrospective analysis of 8465 patients. Abdom Radiol (NY). 2023;48(3):1011–19. https://doi.org/10.1007/s00261-022-03793-x
  8. Sancı A, Oktar A, Gokce MI, Süer E, Gülpinar O, et al. Comparison of Microscopic Hematuria Guidelines as Applied in 1018 Patients With Microscopic Hematuria. Urology. 2021; 154:28-32. https://doi.org/10.1016/j.urology.2021.04.031
  9. Lee CU, Song W, Koo MJ, Boo Y, Chung J-H, et al. Utility of contemporary health screening in the diagnosis of bladder cancer. Diagnostics (Basel). 2022;12(5):1040. https://doi.org/10.3390/diagnostics12051040
  10. Batha O, Aldolly A, Alsaffaf Y, Hamsho S, Atia M, et al. Carcinoma in situ within the bladder trigone with an isolated metastasis to the prostate without involvement of prostatic urethra: a unique case report. BMC Urol. 2024;24(1):127. https://doi.org/10.1186/s12894-024-01516-6
  11. Rai BP, Dominguez Escrig JL, Vale L, Kuusk T, Capoun O, et al. Systematic review of the incidence of and risk factors for urothelial cancers and renal cell carcinoma among patients with haematuria. Eur Urol. 2022;82(2):182–92. https://doi.org/10.1016/j.eururo.2022.03.027
  12. Jarimba R, Quaresma V, Pedroso Lima J, Eliseu M, Tavares da Silva, E, et al. Predicting bladder cancer risk in patients with hematuria: a single-centre retrospective study. Arch Ital Urol Androl. 2023;95(1):11026. https://doi.org/10.4081/aiua.2023.11026
  13. Joukar F, Hassanipour S, Atefi A, Shafiee A, Gholipour K, et al. Prevalence and associated factors for asymptomatic microscopic hematuria in adults in the PERSIAN Guilan cohort study (PGCS). Sci Rep. 2024;14(1):3452. https://doi.org/10.1038/s41598-024-52162-6
  14. Latta K, Boeckhaus J, Weinreich I, Borisch A, Müller D, et al. Clinical practice guideline: microhematuria in children and young adults. Dtsch Arztebl Int. 2024;121(14):461–466. https://doi.org/10.3238/arztebl.m2024.0147
  15. Arafa SH, Alshehri WA, Organji SR, Elbanna K, Obaid NA, et al. Antimicrobial resistance, virulence factor-encoding genes, and biofilm-forming ability of community-associated uropathogenic Escherichia coli in western Saudi Arabia. Pol J Microbiol. 2022;71(3):325–39. https://doi.org/10.33073/pjm-2022-029
  16. Parsons JK, Dahm P, Köhler TS, Lerner LB, Wilt TJ. Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline amendment 2020. J Urol. 2020;204(4):799–804. https://doi.org/10.1097/JU.0000000000001298
  17. Lucocq J, Ali A, Harrison W, Khalil T, Powar G, et al. Does non-visible haematuria require urgent assessment? A retrospective cohort study from a university teaching hospital. World J Urol. 2021;39(9):3393–33. https://doi.org/10.1007/s00345-021-03670-0
  18. Leslie SW, Hamawy K, Saleem MO. Gross and microscopic hematuria. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.
  19. Barclay ME, Renzi C, Harrison H, Harrison H, Torralbo A, et al. Cancer incidence and competing mortality risk following 15 presenting symptoms in primary care: a population-based cohort study using electronic healthcare records. BMJ Oncol. 2024;3(1):e000500. https://doi.org/10.1136/bmjonc-2024-000500
  20. Ben Muvhar R, Paluch R, Mekayten M. Recent advances and emerging innovations in transurethral resection of bladder tumor (TURBT) for non-muscle invasive bladder cancer: a comprehensive review of current literature. Res Rep Urol. 2025;17:69–85. https://doi.org/10.2147/RRU.S386026
  21. Takeuchi M, McDonald JS, Takahashi N, Kline TL, Vrtiska TJ, et al. Cancer prevalence and risk stratification in adults presenting with hematuria: a population-based cohort study. Mayo Clin Proc Innov Qual Outcomes. 2021;5(2):308–19. https://doi.org/10.1016/j.mayocpiqo.2021.01.002
  22. An C, Jeong J, Chiu C, Gaston E, Kennedy A, et al. Risk stratification and diagnostic evaluation of patients found to have microscopic hematuria by their primary care providers. J Gen Fam Med. 2024;26(1):73-78. https://doi.org/10.1002/jgf2.740
  23. Gold SA, Kenigsberg AP, Lotan Y. Diagnostic and cost implications of the 2020 AUA microhematuria guidelines: modeling impact in a large public health care system. J Urol. 2022;207(1):52–60. https://doi.org/10.1097/JU.0000000000002175