Non-Visible Haematuria Pathway - Adult Leeds
This pathway has been developed jointly by the Leeds CCG planned care leads, Continence Urology and Colorectal Service (CUCS)
and consultants from Urology, Urogynaecology and Elderly Medicine within LTHT.
Developed November 2014
People > 65 years: do not treat asymptomatic bacteriuria; it is common but is not associated with increased morbidity 1
1 Abrutyn E, Mossey J, Berlin JA, Boscia J, Levison M, Pitsakis P, Kaye D. Does asymptomatic bacteriuria predict mortality and does antimicrobial treatment reduce mortality in elderly ambulatory women? Ann Int Med 1994:827-33. A cohort study and a controlled
trial found that bacteriuria was not an independent risk factor for mortality in elderly women without catheters, and that its treatment did not lower the mortality rate.
The presence of non-visible haematuria on 2 out of 3 occasions in the absence of a urinary tract infection.
2+ or 3+ on dipstick urinalysis has a good positive predictive value for haematuria and does not need confirming with microscopy. Trace or 1+ should be confirmed on microscopy and 10 RBC / microlitre is regarded as significant.
LTHT One Stop Haematuria Clinic
Single visit process will include:
- Flexible Cystoscopy
The following tests are recommended to accompany referral:
- U&E, creatinine, eGFR, HbA1C
- PSA (male) - (see note 1 below)
- Blood pressure
Please note if you are referring to an alternative provider please review provider guidance about required pre-referral tests (e.g. Ultrasound) prior to making referral.
PSA should be checked in male patients (after counselling):
- Above the age of 50 years old, with greater than 10 years life expectancy
- Between 40-50 years old with family history of prostate cancer or of African decent
- With an abnormal feeling prostate
Published: 18-Dec-2014, by Leeds
Valid until: 01-Dec-2016