Pelvic examination: an iatrogenic cause of microscopic hematuria in women?

Introduction and hypothesis Microscopic hematuria (MH) in women is a common incidental finding that can trigger morbid and costly investigation. Identifying non-pathologic etiologies of MH may help limit unnecessary investigation. Our study aimed to determine whether pelvic examination (PE) increases the prevalence of MH in women. Methods Between May 2018 and October 2018, 157 women > 18 years of age and presenting to the Obstetrics and Gynecology private clinics at a tertiary care center were approached and asked to provide two urine samples: one before PE and one after. Samples were then analyzed to asses for the presence of MH. The McNemar test was used to evaluate whether the conversion from no MH to MH could be attributed to PE rather than to chance. An associated p < 0.05 was determined to be significant. Chi-square test was used to determine whether this conversion is influenced by age and menopausal status. Results Thirteen women (8.3%) had MH before PE. Of 144 participants with no initial MH, 22 (15.3%) had MH after PE. PE was significantly correlated with the conversion from no MH to MH ( p = 0.002). The conversion from no MH to MH following PE was not correlated with age ( p = 0.451) or menopausal status ( p = 0.411). Conclusions PE performed within an hour before urinalysis was found to be a risk factor for MH in women.