UNC Urology is proud to spotlight the leadership of Dr. Mary Beth Westerman in the 2025 amendment to the American Urological Association (AUA)/SUFU Guideline on Microhematuria. As one of five expert panelists, Dr. Westerman played a pivotal role in shaping national guidance for the diagnosis and evaluation of one of the most common urologic conditions.
Her appointment to the panel followed her selection to the AUA’s Practice Guidelines Committee, a key subcommittee of the Science & Quality Council, underscores her growing influence in national urologic leadership and reaffirming UNC Urology’s commitment to evidence-based care and clinical excellence.
The guideline amendment was also featured prominently in the July/August issue of AUANews.
Enhancing Risk-Based, Patient-Centered Care
The updated guideline builds upon the original 2020 AUA framework by refining how clinicians stratify risk and make diagnostic decisions for patients with microhematuria. Among the significant updates championed by the 2025 panel:
- Updated Risk Categories: Clearer delineation of low-, intermediate-, and high-risk profiles based on individualized malignancy risk factors.
- More Nuanced Evaluation Pathways: Revised guidance on the timing and use of cystoscopy, imaging, and urinary biomarkers—especially for patients with repeat hematuria or underlying genetic risk factors like Lynch Syndrome.
- Shared Decision-Making Emphasis: Additional clarity on follow-up for patients with negative evaluations, supporting a more tailored and patient-centered approach to care.
These amendments reflect both evolving evidence base and the panel’s focus on aligning diagnostic intensity with actual clinical need, minimizing unnecessary procedures in low-risk populations while ensuring timely detection in high-risk cases.
UNC Urology’s Expanding Leadership in National Guidelines
Dr. Westerman’s selection to the AUA Practice Guidelines Committee places her among the organization’s most trusted voices in the development of national clinical standards. Her appointment not only reflects her individual expertise but also reinforces UNC Urology’s expanding influence within the AUA’s Science and Quality governance structure. She joins a distinguished group of departmental colleagues: Dr. David Friedlander (Quality Improvement and Patient Safety Committee), Dr. Hung-Jui (Ray) Tan (Chair, Data Committee), and Dr. Matthew Nielsen, who serves as Chair of the AUA’s Science and Quality Council.
Dr. Westerman’s contributions build upon this strong foundation of leadership. UNC Urology’s Chair and Professor of Urology and member of the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill, Dr. Nielsen, was a panelist and contributing author for the original 2020 AUA Guideline on Microhematuria—a foundational shift that introduced risk-based evaluation strategies and helped reframe national thinking around cost, safety, and diagnostic precision. As Chair of the Science and Quality Council, Dr. Nielsen continues to lead national efforts in patient safety, quality improvement, and clinical guideline development, paving the way for the next generation of leaders like Dr. Westerman.