Is Cytoscopy necessary for occasional asymptomic hematuria?

Patient

Q: My mother is 75 yr old in very good health. 20 yrs ago, she had a procedure to stop vaginal bleeding during menopause. Since then, she noticed she has brownish discharge once in a while. She ignored it and it will go away for a long time and come back and go away again. Recently, she mentioned to her MD and he referred her to a Gynecologist who ran all tests and ruled out any gynecological problem. Urine test however showed blood in urine. The urologist wants to do a Cytoscopy. My mom is worried about the risk of the invasive procedure. Especially, she has this symptom on and off past 20 yrs. She has normal urination and no pain at all. She reads up the risk of Cytoscopy and doesn't want to do it. What do you suggest? Thanks

Doctor

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