What is the most appropriate evaluation for gross hematuria in an adult?
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For patients with gross hematuria, US and CTU are extremely sensitive tests for detecting UUT pathology. The IVP is less sensitive for upper tract disease. For the evaluation of the LUT, cystoscopy remains the gold standard (although CT, US, and IVP all find some lower tract disease). Cytology is moderately useful to confirm malignancy, but a negative test does not rule it out. Currently, none of the tumor markers is useful for diagnosing or excluding malignancy.
Evidence Based Practice 13(3): 01+.