Microhematuria in Postmenopausal XXXX : Adherence to Guidelines in a Tertiary Care Setting.

@entity1 @entity150 @entity811 @entity293 @entity703
PURPOSE: In 2012 the AUA (American Urological Association) released a revision of the asymptomatic microscopic @entity811 guidelines. Our study objectives were to assess adherence to these guidelines and describe the prevalence of urinary tract malignancy in postmenopausal @entity1 at our institution. MATERIALS AND METHODS: This is a cross-sectional analysis of @entity1 older than 55 years evaluated at the Division of Urogynecology or Urology from August 2012 to August 2014 for a diagnosis of asymptomatic microscopic @entity811 . @entity1 who underwent evaluation for 3 or more red blood cells per high power field on microscopic urinalysis were considered to have true asymptomatic microscopic @entity811 . Those evaluated after a dipstick test with blood who had fewer than 3 red blood cells per high power field on urinalysis or no urinalysis were considered positive dipstick. Demographics, laboratory values, imaging results and cystoscopy findings were extracted from electronic medical records. RESULTS: Our study population included 237 @entity1 with a mean    SD age of 67.1     8.3 years. In our overall population 169 of 237 @entity1 (71.3%) had true asymptomatic microscopic @entity811 , 48 (20.3%) had a positive dipstick test and 20 (8.4%) underwent evaluation in the setting of @entity293 . We detected 3 urinary tract malignancies (1.4%). One @entity703 was identified in a 56-year-old current smoker with a urine dipstick result of 1+ blood. @entity150 was detected in a 58-year old smoker with 6 red blood cells per high power field on urinalysis and in a 64-year-old nonsmoker with 42 red blood cells per high power field on urinalysis. CONCLUSIONS: In postmenopausal @entity1 evaluated for asymptomatic microscopic @entity811 the overall prevalence of urinary tract malignancy was low at 1.4%. Of our population 28.7% underwent evaluation without meeting guideline criteria for asymptomatic microscopic @entity811 . This demonstrates an opportunity to improve adherence to existing guidelines to provide high quality care and avoid unnecessary expensive testing.
