Initial evaluation of patients with renal colic: Should all patients receive non-contrast computed tomography?

Abstract

Aim: Although spiral computed tomography (SCT) is the gold standard and the most sensitive diagnostic method for ureterolithiasis, urinary system ultrasonography (USG) is more preferred because it is cheap, widespread, non-invasive, and radiation-free. The purpose of this study was to evaluate the rate of renal colic in patients with ureteral stones and without hydronephrosis at first admission to the outpatient clinics and the data of stone related factors affecting it. Materials and Methods: The files of patients who admitted to the emergency and urology departments of our hospital with renal colic who had ureteral stones which were detected by SCT were evaluated retrospectively. Results: A total of 346 patients with renal colic who admitted to our hospital were evaluated. No statistically significant relation was found between age and gender and the degree of hydronephrosis. The stone size was found to be statistically related to the degree of hydronephrosis, valid for both axial size and coronal craniocaudal lengths. There was a difference between stone localizations in terms of being hydronephrosis, and, in particular, it was found that less hydronephrosis occurs in distal ureter stones compared to other regions. Discussion: Some of the ureteral stones may cause renal colic without hydronephrosis, and the diagnosis of ureteral stone may be missed in patients if evaluated only by urinary system USG. Therefore, the evaluation of these patients with SCT should be recommended.