A single positive urine dipstick is not microhaematuria. Confirm it with microscopy showing three or more red cells per high-power field, ideally on a sample not taken during menstruation, after vigorous exercise or with a urinary infection. Record the red-cell count: at 25 or more per high-power field, bladder cancer risk rises meaningfully, and that number belongs in the referral letter along with age, sex and smoking history.
- Confirm dipstick haematuria with urine microscopy before referral.
- Exclude infection, menstruation and recent heavy exercise as causes.
- State the red-cell count and smoking history in the referral letter.
Why it matters
Unconfirmed dipstick results fill cystoscopy lists and delay those who need it.
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