Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Asymptomatic Microscopic Hematuria in Women

Obstet Gynecol; ePub 2017 Apr 3; Nager, et al

The American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice and the American Urogynecologic Society (AUGS) have issued new guidelines on when women should be evaluated and tested for urologic cancers when there is microscopic blood in their urine. The committee opinion offers the following recommendations and conclusions:

  • Urinalysis is a commonly performed test and microscopic hematuria is a common finding.
  • Renal cancer and bladder cancer are more common in men than women.
  • In low-risk, never-smoking women younger than 50 years without gross hematuria and with fewer than 25 red blood cells per high-power field, the risk of urinary tract malignancy is less than or equal to 0.5%.
  • The College and AUGS encourage organizations producing future guidelines on the evaluation of microscopic hematuria to perform sex-specific analysis of the data and produce practical sex-specific recommendations.
  • The College and AUGS recommend that asymptomatic, low-risk, never-smoking women aged 35–50 years undergo evaluation only if they have more than 25 red blood cells per high-power field.


Nager CW, Sung VW, Whiteside JL, et al. Asymptomatic microscopic hematuria in women. [Published online ahead of print April 3, 2017]. Obstet Gynecol. doi:10.1097/AOG.0000000000002059.