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American Urological Association Releases Microhematuria Guideline Amendment

BALTIMORE, Feb. 27, 2025 (GLOBE NEWSWIRE) -- Today, the American Urological Association (AUA), in partnership with the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU), released the 2025 amendment to the Microhematuria (MH) Guideline.

This guideline provides a clinical framework for the diagnosis, evaluation and follow-up of MH. The amendment discusses, evaluates and updates the multiple diagnostic and treatment options for patients with MH.

"Microscopic blood in the urine (MH) can be a sign of important urologic conditions, including bladder cancer. Evaluating people for a source of the bleeding involves cystoscopy (looking in the bladder), which is safe but somewhat invasive, and imaging, such as ultrasound or CT scan. However, the chance of finding cancer on evaluation is fairly low, ranging from nearly zero for those with minimal risk factors for bladder cancer to over 6% for those with significant risk factors,” said Guideline Amendment Chair Dr. Daniel A. Barocas, associate professor and executive vice chair of Urology at Vanderbilt University Medical Center. “The AUA/SUFU Microhematuria Guideline update aims to refine the risk-stratified approach to MH by minimizing the number and intensity of evaluations in those at lower risk for malignancy and maintaining the sensitivity of evaluation for those at higher risk."

This Guideline has 25 recommendations and serves as a useful reference on effective evidence-based care in relation to MH.

The Guideline amendment includes:

  • Updated and expanded guidance to include specific risk factor assessments.
  • Refinement of the risk stratification system and risk-based evaluation recommendations to align with the findings of new validation studies.
  • New discussion of urine cytology and urine-based tumor markers in the detection of urothelial carcinoma.
  • New discussion and guidance regarding the frequency of repeat urinalysis based on risk evaluation.
  • Updated future directions discussing continued refinement of risk stratification and ongoing developments in the field.

Dr. J. Quentin Clemens, president of SUFU and professor and associate chair for research in the Department of Urology at the University of Michigan Medical Center, stated that “SUFU was happy to partner with the AUA for the new MH Guideline Amendment. MH is one of the most common reasons why patients are referred to see urologists. This updated document incorporates the most recent scientific evidence to help urologists and other clinicians manage this condition.”

The full guideline is now available on the AUA website at Microhematuria: AUA/SUFU Guideline (2020, Amended 2025).

A summary of the Guideline also appears at Barocas DA, Lotan Y, Matulewicz RS, Raman JD, Westerman ME, Kirkby E, Pak L, Souter L. Updates to Microhematuria: AUA/SUFU Guideline (2025). J Urol. 0(0). doi: 10.1097/JU.0000000000004490

https://www.auajournals.org/doi/10.1097/JU.0000000000004490

About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 26,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy.

Attachment


Corey Del Bianco
American Urological Association
443-689-4033
cdelbianco@auanet.org

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