[Diagnosis of urothelial carcinoma by the general practitioner--significance of haematuria].

In general practice, physicians are confronted with a newly diagnosed bladder cancer patient less than once a year. The role of general practitioners is restricted to just the initial phase of diagnosis and sometimes to the final, palliative stage of the disease. The diagnostic phase, as described in the guideline on urothelial carcinoma of the bladder, is hampered by the absence of clear signs and signals of bladder cancer. Painless gross haematuria is the most important clinical sign with a high predictive value, especially in older men. The value of microscopic haematuria is unclear and most patients with microscopic haematuria do not have a malignancy. Yet despite this, current guidelines still advise additional tests for all types of haematuria. However, we recommend that these patients are not subjected to such tests until their added value has been demonstrated.