To the Editor.—
The article by George S. Benson, MD, and Eileen D. Brewer, MD, which addresses the issue of evaluation of hematuria in the adult (1981;246:993), fails to mention the cytological examination of the sediment of voided urine. This essential, noninvasive, and completely harmless procedure must be considered in the treatment of any adult patient with either microscopic or gross hematuria. The sediment may show the presence of an inflammatory process, may indicate the presence of a causative agent, and, most important, may indicate the presence of an occult cancer either in the bladder or elsewhere in the lower urinary tract. In fact, only by the use of this key laboratory method can one identify the nonpapillary carcinoma in situ of the bladder with its essentially negative cystoscopic findings and ominous prognosis.1,2The collections of the voided urine samples on three consecutive mornings (100 to 200 mL in
Koss LG. Evaluation of Hematuria. JAMA. 1982;247(9):1274. doi:10.1001/jama.1982.03320340032013
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