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

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Abstract

Introduction and hypothesis

In 2012, the American Urological Association (AUA) revised its guidelines for microscopic hematuria (MH). We hypothesize that the prevalence of MH is greater in women with pelvic organ prolapse than in the general population.

Methods

All patients presenting to an outpatient urogynecological center with prolapse between January 2008 and December 2011 were reviewed. Exclusion criteria included: pregnancy, presence of gross hematuria, menses, or urological pathology. MH was defined as ≥3 red blood cells per high power field on one urinalysis specimen with a negative urine culture, and the prevalence of MH was calculated. Statistical analysis was performed.

Results

One thousand and forty women with pelvic organ prolapse were included in the analysis. Mean age was 64.1 years (range 20 to 96) and mean parity was 2.7 (range 0 to 12). Two hundred and nine out of 1,040 met the criteria for MH. No cases of urological malignancy were diagnosed in patients who underwent further workup. One hundred and ninety-seven patients with MH (93.4 %) had cystoceles on examination.

Conclusions

This is the largest study to investigate MH in women with prolapse based on the new guidelines. The prevalence of MH was 20.1 % in our study population. Cystoscopy, renal function testing, and CT urography are now recommended after one positive urinalysis, regardless of gender or the presence of prolapse. Owing to the low incidence of urological malignancy detected as well as the increased prevalence of MH found in women with prolapse, specific guidelines for the management of MH in this population are needed.

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Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, North Shore—Long Island Jewish Health System, 865 Northern Boulevard Suite 202, Great Neck, Manhasset, NY, 11021, USA

    Nirmala Pillalamarri, Dara Shalom, Lawrence Lind & Harvey Winkler

  2. Obstetrics and Gynecology, North Shore—Long Island Jewish Health System, Manhasset, NY, USA

    Sharlene Sanidad

  3. North Shore—Long Island Jewish Health System, Feinstein Institute for Medical Research, Biostatistics, Manhasset, NY, USA

    Meredith Akerman

Authors
  1. Nirmala Pillalamarri
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  2. Dara Shalom
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  3. Sharlene Sanidad
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  4. Meredith Akerman
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  5. Lawrence Lind
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  6. Harvey Winkler
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Correspondence to Nirmala Pillalamarri.

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Pillalamarri, N., Shalom, D., Sanidad, S. et al. The prevalence of microscopic hematuria in a cohort of women with pelvic organ prolapse. Int Urogynecol J 26, 85–90 (2015). https://doi.org/10.1007/s00192-014-2450-6

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  • DOI: https://doi.org/10.1007/s00192-014-2450-6

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