Do patients with stage 2-4 pelvic organ prolapse have to undergo costly and burdensome diagnostic procedures for asymptomatic microhematuria

Objective: To compare the frequency of asymptomatic microhematuria (AMH) in patients with stage 2-4 and stage 0-1 pelvic organ prolapse (POP).

Methods: The hospital database was searched for women diagnosed with pelvic floor disorders and all medical records were reviewed retrospectively for the presence of AMH. An additional search was conducted for women with other benign gynecological conditions such as myoma uteri, endometrial hyperplasia or adnexal masses without evidence of pelvic organ prolapse (control group). The control group was created using 1:1 matching for age and menopausal status. The frequency of AMH in these patients were compared. The degree of hematuria was categorized as reported by the laboratory as 3 to 25 ( low grade hematuria), 26 to 50 (intermediate grade hematuria) and 51 or more (high grade hematuria) red blood cell/high powered field.

Results: AMH is statistically significant more often seen in study group than in control group (p:0.016). In the prolapse group 20 women (13.7%) had AMH compared with 9 (6.2%) in the control group. All of 29 patients with AMH had low grade hematuria defined as < 25 red blood cell/high powered field. Patients were followed up for 22 ± 7 (12 to 33) months. No bladder cancer and no cancer of the upper urinary tract has been detected in these 29 patients with AMH during follow-up.

Conclusions: Women with stage 2-4 POP are more likely to be diagnosed with AMH than those with stage 0-1 prolapse.