Microhematuria assessment an IBCN consensus-Based upon a critical review of current guidelines

Schmitz-Draeger BJ, Kuckuck EC, Zuiverloon TCM, Zwarthoff EC, Saltzman A, Srivastava A, Hudson MA, Seiler R, Todenhoefer T, Vlahou A, Grossman HB, Schoenberg MP, Sanchez-Carbayo M, Bruenn LA, Van Rhijn BWG, Goebell P, Kamat AM, Roupret M, Shariat SF, Kiemeney LA (2016)

Publication Type: Journal article

Publication year: 2016

Journal

Urologic Oncology-Seminars and Original Investigations Elsevier

Book Volume: 34

Pages Range: 437-51

Journal Issue: 10

DOI: 10.1016/j.urolonc.2016.05.030

Abstract

Assessment of patients with asymptomatic microhematuria (aMh) has been a challenge to urologists for decades. The aMh is a condition with a high prevalence in the general population and also an established diagnostic indicator of bladder cancer. Acknowledging aMh needs to be assessed within a complex context, multiple guidelines have been developed to identify individuals at high risk of being diagnosed with bladder cancer.This structured review and consensus of the International Bladder Cancer Network (IBCN) identified and examined 9 major guidelines. These recommendations are partly based on findings from a long-term study on the effects of home dipstick testing, but also on the assumption that early detection of malignancy might be beneficial.Despite similar designs, these guidelines differ in a variety of parameters including definition of aMh, rating of risks, use of imaging modalities, and the role of urine cytology. In addition, recommendations for further follow-up after negative initial assessment are controversial. In this review, different aspects for aMh assessment are analyzed based upon the evidence currently available.We question whether adherence to the complicated algorithms as recommended by most guidelines is practical for routine use. Based upon a consensus, the authors postulate a need for better tools. New concepts for risk assessment permitting improved risk stratification and prepone cystoscopy before refined imaging procedures (computed tomography scan and magnetic resonance imaging) are suggested.

Authors with CRIS profile

Peter Goebell Urologische Klinik

Involved external institutions

University of Texas MD Anderson Cancer Center US United States (USA) (US) Erasmus University Medical Center (MC) NL Netherlands (NL) Medizinische Universität Wien AT Austria (AT) University of Paris 6 - Pierre et Marie Curie / Université Paris VI Pierre et Marie Curie (UPMC) FR France (FR) Antoni van Leeuwenhoek NL Netherlands (NL) St. Franziskus-Hospital Münster DE Germany (DE) University of Basque Country / Universidad del Pais Vasco (UPV) / Euskal Herriko Unibersitatea (EHU) ES Spain (ES) Montefiore Medical Center US United States (USA) (US) University of British Columbia CA Canada (CA) Universität Bern CH Switzerland (CH) Diagnostic Clinic of Longview US United States (USA) (US) Louisiana State University US United States (USA) (US) Schön Klinik Nürnberg Fürth DE Germany (DE) Academy of Athens / Ακαδημία Αθηνών GR Greece (GR)

How to cite

APA:

Schmitz-Draeger, B.J., Kuckuck, E.C., Zuiverloon, T.C.M., Zwarthoff, E.C., Saltzman, A., Srivastava, A.,... Kiemeney, L.A. (2016). Microhematuria assessment an IBCN consensus-Based upon a critical review of current guidelines. Urologic Oncology-Seminars and Original Investigations, 34(10), 437-51. https://doi.org/10.1016/j.urolonc.2016.05.030

MLA:

Schmitz-Draeger, Bernd J., et al. "Microhematuria assessment an IBCN consensus-Based upon a critical review of current guidelines." Urologic Oncology-Seminars and Original Investigations 34.10 (2016): 437-51.

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