Emergency room follow-up trends in urolithiasis: single-center report

Over 1 million emergency room visits are made annually for renal colic and urinary stone disease in the United States. This study seeks to determine patterns of follow-up for patients diagnosed with ureterolithiasis in a single emergency department.

A retrospective review identified 556 patients diagnosed with ureterolithiasis in the emergency department at the University of Wisconsin Hospital over a 2-year period.

Of these patients, 130 met inclusion criteria including first-time stone formers and no prior urological visit within the past 5 years. Fourteen patients seen in the emergency room at their initial visit received immediate urological consultation. Of the remaining 116 patients discharged by the emergency room, 71 (61%) patients followed up with a urologist, 27 (23%) patients followed up with a primary care physician, 10 (9%) patients returned to the emergency department for their initial follow-up, and 8 (7%) patients had no further follow-up. Of the 44 patients with ureteral calculi 5 mm or greater, 38 (86%) patients either received urological consultation in the emergency department or followed up with a urologist as an outpatient (P < .05).

This study demonstrates that most patients seen in the emergency department at our institution for ureterolithiasis with > 4 mm ureteral stones follow up with a urologist on an outpatient basis. Alternatively, based on the overall subset of patients identified, it is conceivable that a significant percentage of patients never see a urologist.