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

Ayse Filiz Gokmen Karasu,Ilknur Adanir,Senad Kalkan,Serdar Aydin,Gulsah Ilhan,Seda Ates

doi:10.21613/gorm.2017.748

Abstract

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.

Highlights

Microhematuria is defined as the presence of three or more red blood cells per high- power field on a single urine sample with concurrent negative urine culture [1,2,3,4]
After logistic regression analysis; age was the only factor left in association with hematuria
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

Summary

Introduction

Microhematuria is defined as the presence of three or more red blood cells per high- power field (hpf) on a single urine sample with concurrent negative urine culture [1,2,3,4]. Dipstick testing may result in false positive results as a reaction to alkaline urine, presence of semen, myoglobinuria or contamination with chemical agents used to clean the vulva. Direct observation and counting of red blood cells under a microscope is the gold standard for ascertainment of hematuria. Proper collection of urine can exclude most of the plausible causes; such as avoiding analysis following recent vaginal douching, coitus, exercise, pelvic examination or during menstruation. Increased prevalence of microscopic hematuria among POP (pelvic organ prolapse) patients has been disputed [5,6]. Bladder involvement manifests as urinary symptoms which may accompany or precede POP symptoms [7]

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