The microhematuria guideline just changed. Here’s what clinicians need to know. In this episode of BackTable Urology, Dr. Daniel Barocas (Vanderbilt University) joins host Dr. Ruchika Talwar to break down the 2025 updates to the American Urological Association (AUA) Microhematuria Guideline and why these changes matter in everyday practice.

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SYNPOSIS

They walk through the evidence driving the updates, including revised risk stratification and the expanding role of urinary biomarkers. The conversation highlights how these recommendations affect patient evaluation, imaging decisions, and shared decision-making, with an emphasis on balancing cancer detection, patient burden, and responsible use of healthcare resources.

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TIMESTAMPS

00:00 - Introduction
01:33 - What Prompted the Guidelines Update?
02:59 - Challenges of a Negative Microhematuria Evaluation
06:21 - Initial Evaluation Guidelines
07:58 - Risk Stratification
18:11 - Imaging in Hematuria Workups
21:16 - Use of Urinary Biomarkers
33:25 - Potential Future Guideline Updates
37:17 - Takeaways for Urologists

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RESOURCES

AUA/SUFU Microhematuria Guideline
https://www.auanet.org/guidelines-and-quality/guidelines/microhematuria