Ureteric colic: value of initial investigations and the outcome

During a one-year period (from April 1992 to April 1993), 294 patients with the complaint of ureteric colic seen at the Emergency Department of Tan Tock Seng Hospital were investigated with a plain X-ray of the kidney, ureter and bladder (KUB), urinary analysis (urine FEME) and subsequently intravenous urogram (IVU) at the outpatient clinic. The results showed that majority (73%) of the patients were male. Sixty percent of the cohort were in the age group 30-50 years. After evaluation, it was found that only 114 (39%) of the patients with ureteric colic had abnormal IVU. Among these patients, 99 were diagnosed to have calculus disease, 12 with urothelial tumours, 1 with renal cyst and 2 had no pathology detected. Nevertheless most (72%) of the patients did not require intervention. In addition, it was noted that if the KUB or urine FEME was positive, the chances that a urological pathology was present were 72% and 91% respectively. However, if both of them were negative, the chance that a pathology would not be present was 93%. This suggests that patient selection is very essential to avoid unnecessary investigations.