abstract410 - RISK FACTORS FOR MICROSCOPIC HEMATURIA IN WOMEN REFERRED TO UROGYNECOLOGY
RISK FACTORS FOR MICROSCOPICHEMATURIA IN WOMEN REFERRED TO UROGYNECOLOGY
R. ROLSTON1, V.VELASCO 2, C. HORTON 1, A. GOEBEL 3,C. E. DANCZ 3, B. OZEL 3;
1FemalePelvic Medicine & Reconstructive Surgery, LAC+USC Med. Ctr., LosAngeles, CA, 2Obstetrics & Gynecology, LAC+USC Med.Ctr., Los Angeles, CA, 3LAC+USC Med. Ctr., Los Angeles,CA.
Introduction: The AmericanUrological Association recommends obtaining a urine analysis, andurine culture if indicated, for the initial work up of urinaryincontinence in women. The primary reason for this is to evaluate forother etiologies of incontinence such as pyuria andhematuria.
Objective: Our aim was to determine the rate andpredictors of microscopic hematuria among women with pelvic floordysfunction referred to the urogynecology clinic.
Methods:A retrospective chart review was performed on all new urogynecologyclinic visits at a single institution from June 1, 2015 to July 1,2016. Patient characteristics including age, parity, height, weight,symptoms of stress incontinence, urgency incontinence, fecalincontinence or prolapse, presence of diabetes mellitus (DM), priorhysterectomy, tobacco use, prolapse stage, urinalysis and presence ofmicroscopic hematuria prior to initial urogynecology clinicappointment were recorded. Microscopic hematuria was defined as 3 ormore RBCs per hpf on microscopy. Statistical analysis was performedwith Student's t-test and Fisher's exact test to compare patientswith microscopic hematuria and those without microscopichematuria.
Results: A total of 349 charts were reviewed.217 (62.2%) women had a documented urine analysis performed prior toreferral to the urogynecology clinic. Of those 217 women, 142 (65.4%)had a urinalysis performed with microscopy and 82 (57.7%) hadmicroscopic hematuria. Of the 75 women who had urinalysis withoutmicroscopy, 6 (8%) had trace or more blood on urinalysis. Of the 82women with microscopic hematuria, 20 (24.3%) had negative blood onurine dipstick. Between the group of women with a microscopichematuria and those without, there was no difference in age (p=0.36),parity (p=0.15), body mass index (p=0.95), history of priorhysterectomy (p=0.82), current tobacco use (p=1.00), DM (p=0.47), orprolapse stage greater than or equal to 2 (p=0.18). There was also nodifference in symptoms of stress incontinence (p=0.34), urgencyincontinence (p=0.12), fecal incontinence (p=0.60) or prolapse(p=0.59) between the two groups. Women with microscopic hematuriawere significantly more likely to have > 10 WBCs per hpf (23.2%vs. 5%, OR=5.7, p=0.004); but were no more likely to have a positiveurine culture (p=0.36).
Conclusions: A large portion ofurinalyses were performed without microscopy, limiting usefulness inevaluating for microscopic hematuria. Of the women who had urinemicroscopy, over 50% of women had evidence of microscopic hematuria;almost one fourth of these women had negative blood on urinedipstick. When performing urinalysis in the evaluation of women withurinary symptoms, urine microscopy for RBCs should be performed atleast once even if the urine dipstick is negative.