Suboptimal guideline adherence for hematuria after menopause

(HealthDay)—The prevalence of urinary tract malignancy is low among postmenopausal women evaluated for asymptomatic microscopic hematuria, according to a study published in the April issue of The Journal of Urology.

Megan S. Bradley, M.D., from the Duke University Medical Center in Durham, N.C., and colleagues conducted a cross-sectional analysis of 237 women older than 55 years assessed from August 2012 to August 2014 for a diagnosis of asymptomatic microscopic hematuria. Women who underwent assessment for three or more red blood cells per high power field on microscopic urinalysis were considered to have true asymptomatic microscopic hematuria; positive dipstick was considered for those assessed after a dipstick test with blood who had fewer than three red blood cells per high power field on urinalysis or no urinalysis.

The researchers found that 71.3 percent of the women had true asymptomatic microscopic hematuria; 20.3 percent had positive dipstick test; and 8.4 percent underwent assessment in the setting of urinary tract infection. Three urinary tract malignancies were identified (1.4 percent); one patient had a urine dipstick result of 1+ blood; one had six and one had 42 red blood cells per high power field on urinalysis.

"Of our population, 28.7 percent underwent evaluation without meeting guideline criteria for asymptomatic microscopic hematuria," the authors write. "This demonstrates an opportunity to improve adherence to existing guidelines to provide high quality care and avoid unnecessary expensive testing."

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