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Rabinowitz DE, Buford K, Wood AM, et al. Incidence of Significant Findings of Microhematuria Workup in Women-What Guidelines Work Best?. Urology. 2020;151:19-23doi: 10.1016/j.urology.2020.06.046.
Rabinowitz, D. E., Buford, K., Wood, A. M., Marziliano, A., Perez-Orozco, A., Diefenbach, M. A., Han, J., Hall, S. J., & Polland, A. (2021). Incidence of Significant Findings of Microhematuria Workup in Women-What Guidelines Work Best?. Urology, 15119-23. https://doi.org/10.1016/j.urology.2020.06.046
Rabinowitz, Daniel E, et al. "Incidence of Significant Findings of Microhematuria Workup in Women-What Guidelines Work Best?." Urology vol. 151 (2021): 19-23. doi: https://doi.org/10.1016/j.urology.2020.06.046
Rabinowitz DE, Buford K, Wood AM, Marziliano A, Perez-Orozco A, Diefenbach MA, Han J, Hall SJ, Polland A. Incidence of Significant Findings of Microhematuria Workup in Women-What Guidelines Work Best?. Urology. 2021 May;151:19-23. doi: 10.1016/j.urology.2020.06.046. Epub 2020 Jul 09. PMID: 32653567.
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Urology. 2021 May;151:19-23. doi: 10.1016/j.urology.2020.06.046. Epub 2020 Jul 09.

Incidence of Significant Findings of Microhematuria Workup in Women-What Guidelines Work Best?.

Urology

Daniel E Rabinowitz, Karis Buford, Andrew M Wood, Allison Marziliano, Andre Perez-Orozco, Michael A Diefenbach, Justin Han, Simon J Hall, Allison Polland

Affiliations

  1. Northwell Health Arthur Smith Institue for Urology: 450 Lakeville Rd Ste M41, New Hyde Park NY, 11042; Maimonides Medical Center: 4802 10th Ave, Brooklyn, NY 11219. Electronic address: [email protected].
  2. Northwell Health Arthur Smith Institue for Urology: 450 Lakeville Rd Ste M41, New Hyde Park NY, 11042; Maimonides Medical Center: 4802 10th Ave, Brooklyn, NY 11219.
  3. Northwell Health Arthur Smith Institue for Urology: 450 Lakeville Rd Ste M41, New Hyde Park NY, 11042.

PMID: 32653567 DOI: 10.1016/j.urology.2020.06.046

Abstract

OBJECTIVE: To apply the American Urogynecological Society (AUGS)/American College of Obstetricians and Gynecologists (ACOG) recommendations of foregoing workup in patients under 50 years of age with less than 25 red cells per high-powered field, to a cohort of asymptomatic microscopic hematuria (AMH) patients, and assess diagnostic accuracy, sensitivity, specificity, positive, and negative predictive value compared to the American Urologic Association (AUA) guidelines.

METHODS: Retrospective review of female patients who underwent AMH evaluation from 2012 to 2015. The number of patients who would have avoided workup following the AUGS/ACOG recommendations was determined. Sensitivity, specificity, positive- and negative-predictive value and accuracy of the AUGS/ACOG recommendations compared to AUA guidelines were determined.

RESULTS: Six hundred twenty women underwent AMH workup with 265 women undergoing full workup as per the AUA guidelines. Applying the AUGS/ACOG recommendations to this cohort would not have resulted in missed malignant diagnoses. Two tumors were found, both in patients who had undergone complete workup, and for whom AUGS/ACOG recommends workup. Following the AUGS/ACOG recommendations would have avoided workup in 126/620 of all women and 44/265 women who underwent the full AUA workup. In looking at findings of malignancy, the AUGS/ACOG workup had a sensitivity of 100% and a negative predictive value of 100% as compared to the AUA guidelines.

CONCLUSION: AUA guidelines may over screen female low risk AMH patients. Extensive workup in a low risk group of female patients does not result in increased cancer diagnoses. Perhaps a more nuanced approach could result in fewer workups without compromising cancer detection.

Copyright © 2020 Elsevier Inc. All rights reserved.

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