68y/o male w/ hematuria

[steppII]

so it was 3+ "microscopic" hematuria prompted by urgency and frequency of urniation: would one jump right away to investigate bladder cancer by doing a cystoscopy? is there any role of pelvic ultrasound sonogram or intravenous pyelogram in this patient to see if something less malignant may be the cause?

[Statia Graduate]

I assume this isn't a patient with some sort of trauma like a traumatic foley placement.

So anyway, first order UA and cultures, and urine cytology. While waiting for those results, consult GU for cystoscopy. Sometimes GU want the IVP done first, sometimes after. It just depends on the attending.

Example case:

64 yoAAM has on routine labs 4 RBCs on urine microscopy. Peripheral CBC has mild normocytic anemia. Urine culture is negative. Cystoscopy showed mass in the bladder=transitional cell CA.

This is a case from my clinic. All hematuria, no matter how small should be worked up.