Relationship between microscopic haematuria and hydronephrosis in urolithiasis

Area of Science:

• Urology
• Nephrology
• Emergency Medicine

Background:

• Ureteral stones often present with microscopic haematuria.
• The absence of microscopic haematuria can complicate diagnosis and treatment planning.

Purpose of the Study:

• To investigate the relationship between hydronephrosis degree and microscopic haematuria in patients with ureteral stones.
• To identify factors associated with hydronephrosis in emergency department presentations of ureteral stones.

Main Methods:

• Retrospective analysis of 476 patients with ureteral stones diagnosed via non-contrast CT abdomen/pelvis and urinalysis.
• Review of radiology reports for stone size, location, and hydronephrosis degree.
• Comparison of patients with and without microscopic haematuria regarding hydronephrosis severity.

Main Results:

• Patients without microscopic haematuria had larger median stone size (5.5 mm vs. 4.1 mm).
• Stone size, pyuria, and absence of microscopic haematuria were significant risk factors for moderate to severe hydronephrosis.
• Absence of microscopic haematuria (OR: 1.31, P = .017) was linked to increased risk of hydronephrosis.

Conclusions:

• Imaging studies are crucial for diagnosing and treating emergency cases of ureteral stones when microscopic haematuria is absent.
• Patients lacking microscopic haematuria may have larger stones and more severe hydronephrosis, necessitating further investigation.