Microscopic haematuria Examine urinary deposite before cystoscopy

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6951.409 (Published 06 August 1994) Cite this as: BMJ 1994;309:409
  1. J R C Bowen

    EDITOR, - The algorithm of diagnostic tests for microscopic haematuria in Fritz H Schroder's editorial is illogical.1 Once microscopic haematuria has been detected and infection excluded the next stage is to locate the site of bleeding. Practically this is either renal or urological, and the distinction can be made by light microscopy of a freshly provided centrifuged urinary deposit. Phase contrast microscopy can help distinguish dysmorphic from non-dysmorphic erythrocytes in difficult cases. The recommendation to perform cystoscopy before this simple, non-invasive, cheap, and effective procedure will condemn many patients with readily demonstrable glomerular haematuria to an unpleasant, uninformative, and unnecessary investigation. This is especially important in the younger age group, in which glomerular disease causes haematuria in a higher proportion of cases.

    The detection of microscopic haematauria of …

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