Rectal tenesmus as a frequent symptom in renal colic: a retrospective study of 4758 patients from Emergency Department

Abstract

Background: To investigate the frequency of rectal tenesmus in urolithiasis patients presented with renal colic, and describe the clinical characteristics of these patients. Methods: A retrospective study across three large hospitals in Guangzhou was conducted, and all Emergency Department (ED) visits with renal colic during 2016 were included. Finally a total of 4758 patients were enrolled, and we collected then analyzed their medical histories, including general information, characteristics of renal colic, accompanying symptoms, as well as the signs, the typical examination results and the therapeutic effects. Results: The frequency of tenesmus in the patients with renal colic was 72.5%, higher than urinary irritation symptoms (23.4%) and the upper gastrointestinal symptoms (54.9%). Patients with tenesmus tended to suffer from renal colic during morning time (0:00-12:00) and at sleep or rest status. Higher likelihood of stones located in lower ureter (p<0.001) were found in this cohort of patients. Conclusions: Rectal tenesmus is a common accompanying symptom in patients presented with renal colic. This manifestation is related to certain characteristics of the patients and the stones. Future studies will be conducted to explore the feasibility of using rectal tenesmus in differential diagnosis for renal colic and other acute abdominal pain in ED. Trial registration The study was approved by the Institute Research Ethics Committee at the Sun Yat-sen University. The approval number is 2016 No. 59 of Sun Yat-sen Memorial Hospital. The study was retrospectively registered at http://www.chictr.org.cn/index.aspx (registration number: ChiCTR-RRC-17012373) in 15 August 2017.