In evaluating extraglomerular hematuria, which statement is true?

• A. Noncontrast CT is useless for excluding stones and masses
• B. Urine cytology is always negative
• C. Cystoscopy is never indicated
• D. Urine culture is used to rule out infection

Answer: (D)

In evaluating extraglomerular hematuria, the goal is to identify causes outside the glomerulus, with infection being a key, treatable option. A urine culture directly tests for bacteria in the urinary tract; a negative result helps rule out infection as a cause, while a positive result confirms infection that may explain the hematuria and guides treatment. This makes the statement true. Noncontrast CT is actually highly useful for excluding stones and masses, so saying it’s useless is incorrect. Urine cytology is not always negative and can be positive when there is urothelial pathology, so that claim isn’t universally true. Cystoscopy is not never indicated; it’s considered in persistent or risk-factor–associated hematuria to evaluate the bladder and urethra.