To the Editor.—
I read with interest the article by Mohr et al1 and admire their extensive review of patient records and the literature. Unfortunately, they do not present hard evidence to support their conclusion that complete urologic evaluation of all adult patients with asymptomatic microscopic hematuria is not necessary.They claim "complete follow-up" for 677 of 781 cases of asymptomatic hematuria. The 55 autopsy cases certainly do represent complete follow-up. Among the 656 living patients, however, "complete follow-up" was simply defined as at least one physician contact three or more years after first finding microhematuria. The percent-age of patients undergoing urologic evaluation, such as excretory urography, cystoscopy, renal function studies, and urine cultures, is not given. The fact that one is alive and asymptomatic three years later does not mean one has no urologic disease. Even "moderately serious" and "serious" diseases (the authors' words), such as neoplasms, stones,
Heller JE. Asymptomatic Microhematuria and Urologic Disease. JAMA. 1986;256(19):2674. doi:10.1001/jama.1986.03380190044011
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