Ultrasound in urological emergency: results of self audit and implications for training

The efficacy of ultrasound examination by the trainee urologists in the management of urological emergencies admitted in a district general hospital was studied. Fifty patients (100 kidney units) had renal ultrasound performed by urological trainees on acute admission. The results were compared with subsequent definitive radiological investigations. On analysis of 100 renal units there were 7 discordant results, 2 false negatives and 5 false positives achieving 97% specificity (95% confidence interval 93% to 100%) and 84% sensitivity (95% confidence interval 71% to 97%). Adopting 50-patient analysis there was 89% specificity (95% confidence interval 74% to 100%) and 84% sensitivity (95% confidence interval 71% to 97%). These intervals indicate the levels of success to be expected in future studies. The study shows that urological trainees can use ultrasound with high levels of accuracy improving patient management.