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Thank you to all for some interesting viewpoints & references on this subject. I'm not sure however what the value of regular urinalysis would be. I would think that haematuria needs an explanation at any level. I asked the question (about a real patient by a real doctor) because one sometimes wonders if what we do as 'routine' is always necessary & so warrants review & peer opinion - A healthy 50+ male having had 2 negative tests...is it really necessary to proceed to cystoscopy? I think that I will go with my original plan of RBC morphology to distinguish between glomerular bleeding vs other urinary tract blood loss. A referral for cystoscopy if normal or nephrology if showing dysmorphic RBCs. Regards Dr Marcus Hawkins BM BS Nottm, FRNZCGP Auckland, New Zealand