American Urological Association

View all recommendations from this society

May 13, 2017

Don’t obtain urine cytology or urine markers as a part of the routine evaluation of the asymptomatic patient with microhematuria.

Insufficient evidence exists for the use of urine cytology and urine markers in the routine evaluation of the asymptomatic patient with microhematuria, including bladder tumor antigen (BTA) assays, nuclear matrix protein (NMP) assays, and fluorescent in situ hybridization (FISH) assays to detect chromosomal alterations. The psychological stress and unnecessary diagnostic procedures that could result from a false positive test outweigh the potential benefits to these patients.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

1–5: The American Urological Association (AUA) established a committee to review evidence from the association’s guidelines and identify potential topics for nomination to the AUA’s Choosing Wisely list. The committee reviewed a number of recommendations and through a consensus process identified the five tests or procedures that should be questioned. These recommendations were reviewed and approved by the AUA Board of Directors.

6–10: Following its previous successful participation in Choosing Wisely in 2013, the American Urological Association (AUA) established a new committee in 2014 to develop a second list of recommendations. The group sought input from the AUA membership in addition to drafting potential suggestions after studying evidence from the association’s evidence-based clinical practice guidelines and other clinical documents. The committee reviewed all recommendations and narrowed them to a list of fifteen possibilities. Again, the committee sought AUA member input by asking members to vote for their top five selections from the list of candidate recommendations. After the votes were tallied, the list of five recommendations was determined. These recommendations were reviewed and approved by the AUA Board of Directors in February 2015.

11-15: To continue its successful participation in Choosing Wisely, the American Urological Association (AUA) established a new committee in 2016 to develop a third list of recommendations. The group sought input from the AUA membership in addition to drafting potential suggestions after studying evidence from the association’s evidence-based clinical practice guidelines and other clinical documents. The committee reviewed all recommendations and narrowed them to a list of twelve possibilities. Again, the committee sought AUA member input by asking members to vote for their top five selections from the list of candidate recommendations. After the votes were tallied, the list of five recommendations was determined. These recommendations were reviewed and approved by the AUA Board of Directors in March 2017.

AUA’s disclosure and conflict of interest policy can be found at www.auanet.org.