Magnitude and outcome of urologic emergencies: prospective cohort study

Urological emergencies, which range from acute urinary retention to life-threatening malignancies, represent a significant source of morbidity and mortality. Despite their prevalence in routine clinical practice, the spectrum and overall burden of these conditions in developing countries remain poorly characterized.

A prospective cohort study was conducted at a tertiary hospital between August 2024 and February 2025, among all adult patients with urologic emergencies who visited the emergency department during the study period. Data collected by 2 research assistants from patient interviews by structured questionnaire, medical record reviews, and patients followed until discharge or transfer out from the emergency department.

About 162 patients were included in the study, and urologic emergencies account for 12.2% (176/1446) of all surgical emergencies. The most common presentation of urologic emergency patients was flank pain, at 100 (61.7%), followed by urinary retention, at 23 (14.2%), and hematuria, at 12 (7.4%). Trauma related to the Genitourinary system, which is seen in 14(8.6%), is among the reasons for emergency visits during the study period. Urolithiasis accounts for 51.7% (77/149), followed by Benign prostatic hyperplasia (BPH), cervical cancer, and urethral stricture as the commonest underlying causes for non-traumatic causes. Emergency surgical intervention was done for (n = 151, 93%) of the patients, with the most common procedure performed for non-traumatic urologic emergencies being Ureteric stenting for 46 (30.5%), Percutaneous nephrostomy for 27(17.9%), transurethral catheterization for 23(15.2%), and stone extraction for (n = 19 12.5%). Patients who came within 1 month or less duration of symptoms have approximately 4.3 times higher odds of improved outcome when compared with those with duration of symptoms of >1month (AOR: 4,34; 95% CI: 1.45-12.99). Additionally, having increased abnormal creatinine at presentation has inversely affected improved outcome by an odds ratio of 0.1(95% CI: 0.01-0.82).

Urological emergencies account for a significant proportion of all emergency surgery presentations. Renal colic with or without obstructive uropathy is the leading cause of surgical emergency admissions in this geographic area. Delayed presentation of over 1 month and abnormal creatinine level at presentation negatively affect the outcome of patients.