The prevalence of microscopic hematuria in a cohort of women with pelvic organ prolapse

Pillalamarri, Nirmala; Shalom, Dara F.; Sanidad, Sharlene; Akerman, Meredith; Lind, L.F.; Winkler, Harvey A.

doi:10.1007/s00192-014-2450-6

Cited by 18 publications

(12 citation statements)

References 16 publications

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“…Although additional studies are needed in order to assess if it is safe to forego AMH evaluations in postmenopausal women with vaginal atrophy, clinicians should perform and document a genitourinary exam to determine if treatment of vaginal atrophy is necessary. Additionally, the higher presence of AMH (up to 20.1%) 6,12,13 in women with pelvic organ prolapse, compared to the general population, despite a low risk of malignancy, has been used as an argument for separate AMH guidelines for women. Our particular population had a low rate of pelvic organ prolapse with only 11.3% of the documented exams with stage 2 or greater prolapse.…”

Section: Discussionmentioning

confidence: 99%

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Microhematuria in Postmenopausal Women: Adherence to Guidelines in a Tertiary Care Setting

et al. 2016

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Purpose In 2012, the American Urological Association released a revision of their asymptomatic microscopic hematuria (AMH) guidelines. Our objectives were to assess adherence to these guidelines and to describe the prevalence of urinary tract malignancy in postmenopausal women at our institution. Materials and Methods This is a cross-sectional analysis of women over age 55 evaluated by Urogynecology or Urology from 8/2012-8/2014 for a diagnosis of AMH. Women who underwent evaluation for ≥3 RBC/HPF on microscopic urinalysis were considered “true AMH.” Those who were evaluated after a dipstick with blood and had <3 RBC/HPF on urinalysis or no urinalysis were considered “positive dipstick.” Demographics, laboratory values, imaging results, and cystoscopy findings were extracted from electronic medical records. Results Our study population included 237 women (mean age 67.1±8.3 years). In our overall population 169/237(71.3%) had true AMH, 48/237(20.3%) had a positive dipstick, and 20/237(8.4%) underwent evaluation in the setting of a urinary tract infection. We detected 3(1.4%) urinary tract malignancies. One kidney cancer was identified in a 56 year-old, current smoker with a urine dipstick of 1+ blood. Two instances of bladder cancer were detected in women aged 58 and 64, one current and one nonsmoker with 6 and 42 RBC/HPF on urinalyses respectively. Conclusions In postmenopausal women evaluated for AMH, the overall prevalence of urinary tract malignancy was low (1.4%). In our population, 28.7% underwent evaluation without meeting guideline criteria for AMH. This demonstrates an opportunity to improve adherence to existing guidelines to provide high-quality care and avoid unnecessary, expensive testing.

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Section: Discussionmentioning

confidence: 99%

“…6 The AUA guidelines are vague as to how to consider these potentially confounding conditions in postmenopausal women and many clinicians pursue full AMH evaluations even if vaginal prolapse and atrophy are present, possibly leading to unnecessary, expensive testing and undue patient concern.…”

Section: Introductionmentioning

confidence: 99%

Microhematuria in Postmenopausal Women: Adherence to Guidelines in a Tertiary Care Setting

et al. 2016

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“…Increased prevalence of microscopic hematuria among POP (pelvic organ prolapse) patients has been disputed (5,6). POP frequently results in anatomical distortion of the neighbouring organs and loss of normal function.…”

Section: Introductionmentioning

confidence: 99%

Age May Be the Only Variable Effecting Microhematuria Prevalance in Pelvic Organ Prolapse

Karasu

Aydın

Adanir

et al. 2018

Gynecol Obstet Reprod Med

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Objective: We aimed to estimate the prevalence of microscopic hematuria in women with pelvic organ descent and compare the results in terms of severity and accompanying urinary symptoms. We hypothesized that microhematuria incidence would be higher in advanced prolapse and accompanying urinary symptoms.Study Design: Women who presented to our clinic from January 2013 to July 2016 were analyzed using our electronic medical record system. Those who were classified in the system under the "N81: female genital prolapse" code were included. Records were checked to certify that samples were acquired properly. Urogynecological examinations were performed by specialist gynecologists and documented according to the international continence society classification system. After ruling out urinary tract infections urinalysis was performed by an integrated system composed of an urine strip analyzer and a sediment autoanalyzer.Results: Gravidity, parity, menopause onset, smoking status and presence of systemic disease were similar for both groups. Women in the hematuria group were older (p<0.001). Hematuria prevalance was greater ininternational continence society Stage 3-4 anterior prolapse and total prolapse (p=0.03) compared to early stage prolapse. However after logistic regression analysis; age was the only factor left in association with hematuria.Conclusions: Women who were older and with advanced stage prolapse ( ≥ international continence society stage 3) were more likely to have microscopic hematuria. Urine tests are requested routinely in the work-up of urogynecological patients. As the prevalance is microhematuria is high in this population; we believe that evidence based algorithms should be set as guidelines when hematuria is encountered in patients with organ prolapse.

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“…[45] Significance of microscopic hematuria, especially during early pregnancy, is still unclear, and in some studies, association between the microscopic hematuria and pregnancy complications has been doubtful.…”

Section: Introductionmentioning

confidence: 99%

Investigation of the relationship between idiopathic microscopic hematuria (in the first and second trimesters) and major adverse outcomes of pregnancy

2016

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Background:The aim of this study was to investigate the relationship between idiopathic microscopic hematuria (in the first and second trimesters) and major adverse outcomes of pregnancy.Materials and Methods:Urinalysis was done for 700 pregnant women before 24 weeks of pregnancy. Those who had 3–5 red blood cells per milliliter in urinalysis were considered positive urinalysis. Then, all individuals were examined for blood pressure and other alarm signs of pregnancy complications in each visit. All mothers were followed for the incidence of preeclampsia, preterm delivery, and pregnancy outcome until the end of pregnancy.Results:The results of this study showed that no significant difference in terms of incident of pregnancy complications between the pregnant women with and without hematuria and the only abortions and neonatal deaths differed between the two groups.Conclusion:These results suggest that further studies are needed to determine whether idiopathic microscopic hematuria can be a predictive value for pregnancy complications or not.

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The prevalence of microscopic hematuria in a cohort of women with pelvic organ prolapse

Cited by 18 publications

References 16 publications

Microhematuria in Postmenopausal Women: Adherence to Guidelines in a Tertiary Care Setting

Microhematuria in Postmenopausal Women: Adherence to Guidelines in a Tertiary Care Setting

Age May Be the Only Variable Effecting Microhematuria Prevalance in Pelvic Organ Prolapse

Investigation of the relationship between idiopathic microscopic hematuria (in the first and second trimesters) and major adverse outcomes of pregnancy

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