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The role of urine cytology in the evaluation of patients with hematuria is controversial. In this study from a U.K. teaching hospital, researchers reviewed the records of consecutive patients with hematuria (65% visible, 35% microscopic) who underwent evaluations that included urine cytology, upper tract imaging, and cystoscopy.
Of 2507 patients who underwent full evaluation, 14% were ultimately diagnosed with transitional cell carcinomas. The sensitivity and specificity of abnormal cytology (malignant or atypical/suspicious) were 45% and 89%, respectively; positive and negative predictive values were 41% and 91%, respectively. During average follow-up of 7.5 years, only two patients with positive cytology but initially negative imaging and …