If nonglomerular bleeding persists, what test is typically performed?

When nonglomerular bleeding is suspected, a cystoscopy is typically performed to directly visualize the bladder and urethra. This procedure involves inserting a thin tube with a camera (cystoscope) into the bladder through the urethra, allowing for the examination of the lower urinary tract for sources of bleeding, such as tumors, calculi, or inflammation.

In cases of persistent hematuria where the origin is not clearly identified, cystoscopy provides a more direct assessment compared to other methods. A urinalysis can provide initial information about the presence of blood, but does not pinpoint the source of the bleeding. A CT scan can be useful to assess the kidneys and other structures in the urinary tract, but it may not directly locate issues within the bladder or urethra. A kidney biopsy is more invasive and is generally reserved for cases where glomerular disease is suspected and would not be the first step in evaluating isolated hematuria.