Question

A 67-year-old man is found to have asymptomatic microscopic haematuria on a routine urine dipstick performed for a health check. He has no other urinary symptoms and his renal function is normal. What is the most appropriate initial investigation pathway according to NICE guidelines?

Accepted Answer

Refer urgently for flexible cystoscopy and upper renal tract imaging (CT urogram or ultrasound).

Answer

Repeat urine dipstick in 4 weeks and if still positive, refer.

Answer

Treat with a course of antibiotics for presumed UTI.

Answer

Reassure the patient as it is likely benign.

Answer

Check PSA level and refer to urology if elevated.

Practice question

A 67-year-old man is found to have asymptomatic microscopic haematuria on a routine urine dipstick performed for a health check. He has no other urinary symptoms and his renal function is normal. What is the most appropriate initial investigation pathway according to NICE guidelines?