Abstract: PD02-05
Sources of Funding: None

Introduction

Conflicting reports exist regarding the prevalence of asymptomatic microscopic hematuria (AMH) in women with prolapse, with rates as high as 20% having been reported. Thus, we sought to evaluate the prevalence of AMH in women presenting with pelvic floor disorders and the relationship of prolapse stage with AMH.

Methods

The charts of women evaluated in a Female Pelvic Medicine and Reconstructive Surgery clinic between January 2015 and July 2016 were retrospectively reviewed. The prevalence of AMH (defined as ≥3 red blood cells per high power field on microscopy on one urinalysis) for women presenting with symptomatic pelvic organ prolapse was recorded. As a comparison cohort, the rate of AMH was determined as well for women evaluated for urinary incontinence (UI) without symptomatic pelvic organ prolapse. Prolapse stage was evaluated by Pelvic Organ Prolapse Quantification system. Patient features were evaluated for association with the presence of AMH using Pearson chi-square and Wilcoxon rank-sum tests.

Results

Overall, 455 of the 498 patients evaluated (91%) had a urinalysis with microscopy. The prevalence of AMH was 3.3% (15/455), and was not significantly different between women presenting for prolapse (9/264, 3.4%) versus UI (6/191, 3.1%; p=0.87). Likewise, the presence of stage ≥2 anterior prolapse was not associated with an increased rate of AMH (p=0.91). Increased rates of AMH were associated with voided versus catheterized specimens (15.2% vs 2.4%; p=0.003). Hematuria evaluation identified two cases of urothelial bladder cancer (one low-grade non-invasive, one muscle-invasive), one urethral mesh erosion, and one asymptomatic kidney stone, while the remaining evaluations were negative.

Conclusions

We found a prevalence of AMH in women with pelvic organ prolapse lower than previously reported and consistent with prior population screening studies, as well as with patients presenting for UI. As such, AMH noted among women with pelvic organ prolapse should not be ascribed solely to the presence of prolapse.

Funding

None