Hematuria: Is it useful in predicting renal or ureteral stones in patient presenting to emergency department with flank pain?

Autor: Alnazari M; Department of Urology, College of Medicine, Taibah University, Madinah, Saudi Arabia., Bakhsh A; Department of Urology, College of Medicine, Taibah University, Madinah, Saudi Arabia., Shaqroon HA; Department of Urology, College of Medicine, Taibah University, Madinah, Saudi Arabia., Rajih ES; Department of Urology, College of Medicine, Taibah University, Madinah, Saudi Arabia., Al-Nakshabandi NA; Department of Radiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia., Rabah DM; The Cancer Research Chair, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.; Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Jazyk: angličtina
Zdroj: Urology annals [Urol Ann] 2024 Jan-Mar; Vol. 16 (1), pp. 71-74. Date of Electronic Publication: 2023 Nov 15.
DOI: 10.4103/ua.ua_66_23
Abstrakt: Objectives: The objective of the study was to evaluate hematuria as a diagnostic test for renal and ureteral stones compared with a noncontrast-enhanced computed tomography (CT) scan (gold standard test) in emergency room patients with acute flank pain.
Patients and Methods: In total, 604 patients treated in our emergency department from 2006 to 2011, with a history of flank pain and suspected urolithiasis were included in a retrospective review. All patients were evaluated with a noncontrast-enhanced CT scan and urine analysis. Using the noncontrast CT scan as the gold standard for the evaluation of the presence, number, size, and site (renal or ureteral [upper, middle, and lower]) of the stones, we calculated the sensitivity, specificity, and positive and negative predictive values of hematuria for diagnosing both renal and ureteral stones.
Results: Urolithiasis was diagnosed in 388 patients (64%) and 216 patients (36%) had no stones on a noncontrast-enhanced CT scan. The sensitivity, specificity, positive predictive value, and negative predictive value for microhematuria were 77%, 33%, 67%, and 45%, respectively. Microhematuria was more common in patients with ureteral stones only (139 patients) and had a sensitivity of 85% compared to patients with renal stones only (32 patients), with a sensitivity of 55% ( P < 0.001). There were no significant differences in the specificity or positive or negative predictive values.
Conclusion: Although microhematuria is more sensitive to ureteral stones, the absence of microhematuria does not exclude the possibility of urolithiasis and a noncontrast-enhanced CT scan should be the gold standard diagnostic tool.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2023 Urology Annals.)
Databáze: MEDLINE
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