Gross hematuria for 3 weeks intermittent pelvic pain abnormal wbcs, nitrite, protein found in urine but no growth urine culture ct scan w/ contrast and ultrasound were unremarkable why is cystoscopy now needed by urologist?

It is absolutely indicated for ruling out bladder lesion(s) as the etiology of gross hematuria because of negative urine culture and unremarkable findings by imaging tests. I assume your kidney function remains stable but kidney biopsy may be necessary if cystoscopy does not reveal bladder lesion(s). Good luck.

not all pathology causing gross bleeding . specially early stage, shows up on tests and imaging. So it is a good idea and normal protoclo to have it done. Good luck