Understanding Urinalysis

Clues for the Obstetrician-Gynecologist

Sarah Coad; Boris Friedman; Roxana Geoffrion

Disclosures

Expert Rev of Obstet Gynecol. 2012;7(3):269-279. 

In This Article

Expert Commentary

Urinalysis is a simple, accessible office test used to diagnose a great variety of common yet serious diseases. Although it has been used for several centuries for diagnostic purposes, it has only recently been used in predicting morbidity and mortality. Dipstick proteinuria, for example, has been shown to predict morbidity and mortality from organ systems remote from the urinary tract, such as cardiovascular and respiratory systems. A variety of more accurate and more definitive tests such as fasting blood glucose determination have largely replaced urinalysis. On the other hand, urinalysis is still the gold standard initial test for urinary tract ailments such as infection and cancer. In most cases, further testing is needed; however, in certain diseases such as UTI, empiric treatment can be initiated just on the basis of the urinalysis findings, thus avoiding further patient discomfort and anxiety. In obstetrics and gynecology, while urinalysis is widely used as an initial screen for preeclampsia, there is clearly a paucity of data on ranges of normal values in pregnancy and in gynecologic diseases. Pelvic organ prolapse, pelvic infections and pelvic tumors with mass effect on the bladder are just some of the conditions that are likely to influence urinalysis findings. Urinalysis changes in these settings are unknown. As we become more innovative, treating urinary incontinence and pelvic organ prolapse with synthetic materials, we also need to be alert to the possibility of urinary tract injury or erosion, and initiate prompt referral for patient evaluation if hematuria, frequent bladder infections or stone formation occur. More research is needed to delineate the role of urinalysis in the diagnosis and follow-up of common conditions encountered by the obstetrician–gynecologist.

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