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J Korean Soc Emerg Med > Volume 30(1); 2019 > Article
Journal of The Korean Society of Emergency Medicine 2019;30(1): 77-82.
응급실을 방문하는 요관결석 환자에서 현미경적 혈뇨와 수신증 정도의 임상적 의의
이재민1 , 진상찬1 , 최우익1 , 정원호2 , 김기호3 , 서영진3 , 이경섭3
1계명대학교 동산의료원 응급의학교실
2계명대학교 동산의료원 비뇨기과학교실
3동국대학교 의과대학 비뇨기과학교실
Clinical significance of microscopic hematuria and hydronephrosis in ureteral calculi patients visiting emergency department
Jaemin Lee1 , Sang-Chan Jin1 , Woo-Ik Choi1 , Wonho Jung2 , Ki Ho Kim3 , Young Jin Seo3 , Kyung Seop Lee3
1Department of Emergency Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
2Department of Urology, Keimyung University Dongsan Medical Center, Daegu, Korea
3Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
Correspondence  Sang-Chan Jin ,Tel: 053-250-8779, Fax: 053-250-7028, Email: jchan98@hanmail.net,
Received: July 11, 2018; Revised: August 23, 2018   Accepted: September 10, 2018.  Published online: February 28, 2019.
ABSTRACT
Objective:
This study examined the clinical significance of microscopic hematuria and grade of hydronephrosis in ureteral calculi patients visiting the emergency department (ED).
Method:
The EDs of two medical centers were reviewed retrospectively from August 1, 2012 to July 31, 2017. The total ureteral calculi patients were 2,069 and 1,593 patients were analyzed after exclusion. The normal range of microscopic hematuria in both medical centers was 0-5/high power field (HPF) of red blood cell in urinalysis. Therefore, microscopic hematuria more than 5/HPF was defined as positive. The size of the stone, grade of hydronephrosis (normal, mild, moderate, and severe) and location of ureteral calculi in the non-contrast abdomen and pelvis computed tomography (CT) was measured by one person at each medical center using same method. The patients with or without microscopic hematuria and grade of hydronephrosis were then compared.
Results:
The median size of the ureteral calculi patients without and with microscopic hematuria was 5.4 mm (range, 3.8- 9.0 mm) and 4.0 mm (range, 3.0-5.8 mm) (P<0.001). The patients grouped as normal to mild, and moderate to severe hydronephrosis, without microscopic hematuria was 191 (16.5%) and 91 (20.9%), respectively. On the other hand, microscopic hematuria was 966 (83.5%) and 345 (79.1%) (P=0.042). According to the location of ureteral calculi, with and without microscopic hematuria was 81.9% and 18.1% in the upper ureter, 82.9% and 17.1% in the mid ureter, and 82.6% and 17.4% in the lower ureter, respectively (P=0.935).
Conclusion:
The median size of the stone and grade of hydronephrosis were related to microscopic hematuria but the location of the ureteral calculi was not related. Therefore, in cases without microscopic hematuria in suspected ureteral calculi, clinicians should check the abdomen and pelvis CT for an accurate diagnosis and treatment of ureteral calculi.
Key words: Ureteral calculi; Hematuria; Hydronephrosis
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