Skip to main content

Advertisement

SpringerLink
Log in

Pelvic examination: an iatrogenic cause of microscopic hematuria in women?

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Microscopic hematuria (MH) in women is a common incidental finding that can trigger morbid and costly investigation. Identifying non-pathologic etiologies of MH may help limit unnecessary investigation. Our study aimed to determine whether pelvic examination (PE) increases the prevalence of MH in women.

Methods

Between May 2018 and October 2018, 157 women > 18 years of age and presenting to the Obstetrics and Gynecology private clinics at a tertiary care center were approached and asked to provide two urine samples: one before PE and one after. Samples were then analyzed to asses for the presence of MH. The McNemar test was used to evaluate whether the conversion from no MH to MH could be attributed to PE rather than to chance. An associated p < 0.05 was determined to be significant. Chi-square test was used to determine whether this conversion is influenced by age and menopausal status.

Results

Thirteen women (8.3%) had MH before PE. Of 144 participants with no initial MH, 22 (15.3%) had MH after PE. PE was significantly correlated with the conversion from no MH to MH (p = 0.002). The conversion from no MH to MH following PE was not correlated with age (p = 0.451) or menopausal status (p = 0.411).

Conclusions

PE performed within an hour before urinalysis was found to be a risk factor for MH in women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

MH:

Microscopic hematuria

PE:

Pelvic examination

RBCs/HPF:

Red blood cells per high-powered field

References

  1. Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ, et al. Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol. 2012;188(6 Suppl):2473–81.

    Article  Google Scholar 

  2. Halpern JA, Chughtai B, Ghomrawi H. Cost-effectiveness of common diagnostic approaches for evaluation of asymptomatic microscopic hematuria. JAMA Intern Med. 2017;177(6):800–7.

    Article  Google Scholar 

  3. Linder BJ, Bass EJ, Mostafid H, Boorjian SA. Guideline of guidelines: asymptomatic microscopic haematuria. BJU Int. 2018;121(2):176–83.

    Article  Google Scholar 

  4. Wollin T, Laroche B, Psooy K. Canadian guidelines for the management of asymptomatic microscopic hematuria in adults. Can Urol Assoc J. 2009;3(1):77–80.

    Article  Google Scholar 

  5. No CO. 703 summary: asymptomatic microscopic hematuria in women. Obstet Gynecol. 2017;129(6):1153–4.

    Article  Google Scholar 

  6. Tiemstra JD, Chico PD, Pela E. Genitourinary infections after a routine pelvic exam. J Am Board Fam Med. 2011;24(3):296–303.

    Article  Google Scholar 

  7. Tiemstra JD, Pela E. Urinary symptoms after a routine pelvic exam. J Am Board Fam Med. 2011;24(3):290–5.

    Article  Google Scholar 

  8. Tiemstra JD, Sinacore JM. The association of urinary tract infection with a recent pelvic examination in women. Arch Fam Med. 1996;5(6):357–60.

    Article  CAS  Google Scholar 

  9. Medicine ECoL. European urinalysis guidelines. Scand J Clin Lab Investig Suppl. 2000;231:1–86.

    Google Scholar 

  10. Harris NM, Yardley I, Basketter V, Holmes SA. Is sexual intercourse a significant cause of haematuria? BJU Int. 2002;89(4):344–6.

    Article  CAS  Google Scholar 

  11. Hosseini SR, Mohseni MG, Atharikia D. Role of sexual intercourse in hematuria and proteinuria in males and females. Urol Int. 2008;81(3):271–4.

    Article  CAS  Google Scholar 

  12. Bellinghieri G, Savica V, Santoro D. Renal alterations during exercise. J Ren Nutr. 2008;18(1):158–64.

    Article  Google Scholar 

  13. Siegel AJ, Hennekens CH, Solomon HS, Van Boeckel B. Exercise-related hematuria. Findings in a group of marathon runners. JAMA. 1979;241(4):391–2.

    Article  CAS  Google Scholar 

  14. Jones GR, Newhouse IJ, Jakobi JM, LaVoie NL, Thayer R. The incidence of hematuria in middle distance track running. Can J Appl Physiol. 2001;26(4):336–49.

    Article  CAS  Google Scholar 

  15. Messing EM, Young TB, Hunt VB, Emoto SE, Wehbie JM. The significance of asymptomatic microhematuria in men 50 or more years old: findings of a home screening study using urinary dipsticks. J Urol. 1987;137(5):919–22.

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Rima Hajjar and Talar Telvizian contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El-Solh, Beirut, Beirut, 1107 2020, Lebanon

    Rima Hajjar & Tony Bazi

  2. Department of Internal Medicine, American University of Beirut, Beirut, Lebanon

    Talar Telvizian

  3. Faculty of Medicine, University of Balamand, Beirut, Lebanon

    Fady Constantinos

  4. Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon

    Omar Baba

Authors
  1. Rima Hajjar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Talar Telvizian
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fady Constantinos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Omar Baba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tony Bazi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tony Bazi.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hajjar, R., Telvizian, T., Constantinos, F. et al. Pelvic examination: an iatrogenic cause of microscopic hematuria in women?. Int Urogynecol J 31, 947–950 (2020). https://doi.org/10.1007/s00192-019-04031-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-019-04031-7

Keywords

Search

Navigation