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The Evaluation of Hematuria in Adults

Morton A. Bosniak, MD
JAMA. 1990;264(19):2504-2505. doi:10.1001/jama.1990.03450190034021.
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To the Editor.—  The radiological portion of the article entitled "Evaluation of Hematuria in Adults" by Sutton1 is quite misleading and outdated, and it is important that a more up-to-date approach to the subject be described. I am referring to the radiological workup of the patient with hematuria that is displayed in the algorithm (Fig 1) in the article. The workup shown in the algorithm concerning imaging of renal masses might have been appropriate 10 years ago but is totally inappropriate at this time.If a renal mass is studied by renal ultrasound examination and is found to be a cyst, the algorithm suggests cyst aspiration for confirmation. The use of cyst aspiration in this regard is totally unnecessary. If the ultrasound examination indicates that a renal mass is a cyst, nothing further need be done, since sonography is virtually 100% accurate in the diagnosis of renal cysts if


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