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We do not routinely use cytological examination of the urinary sediment in the evaluation of patients with hematuria. Patients with carcinoma in situ of the urinary bladder and hematuria may have "essentially negative cystoscopic findings," if "essentially negative" is defined as the absence of recognizable bladder cancer. We believe that the bladder mucosa in these patients with hematuria is not visually normal, however, and will undergo biopsy by the experienced endoscopist.
George S. Benson, Eileen D. Brewer. Evaluation of Hematuria-Reply. JAMA. 1982;247(9):1274. doi:10.1001/jama.1982.03320340032014