What is the purpose of investigating microscopic hematuria during incontinence evaluation?

• A. It may indicate bladder or urethral pathology requiring further workup.
• B. It always indicates cancer.
• C. It has no clinical significance.
• D. It is expected in all patients with incontinence.

Answer: (A)

Screening for microscopic hematuria during an incontinence evaluation is done to detect potential bladder or urethral pathology that would require further assessment. The presence of red blood cells in the urine, even when the patient only reports leakage, can signal conditions such as infection, stones, inflammatory or benign lesions, or more serious issues like bladder or urethral tumors. Discovering this finding prompts targeted follow-up—often urinalysis confirmation, imaging, or cystoscopy—to identify and treat the underlying cause.

It isn’t a sign of cancer in every case, and many times the cause is benign. But because microscopic hematuria can be the first clue to clinically significant problems, it has real clinical significance and should not be dismissed. It also isn’t a universal finding in all patients with incontinence, so its presence should lead to appropriate evaluation rather than assuming nothing needs to be checked.