The influence of emergency urography and haematuria on the diagnosis of ureteric colic.

The literature concerning the investigation of ureteric colic is reviewed. I have compared previous papers with the results of a prospective study of 50 patients who underwent emergency urography and testing for haematuria. Haematuria was present in 88% of all patients and in 97% of those with proven ureteric colic. The high haematuria figure is thought to be due to patient selection. Thirty-four patients (68%) had abnormal urographic findings consistent with ureteric colic. Seven of these patients (20%) had no plain film abnormality and the contrast films therefore confirmed the diagnosis. Haematuria is a useful indication of ureteric colic. However, since ureteric obstruction occurs without haematuria, and a normal urogram may be associated with haematuria, emergency urography is essential to confirm ureteric colic. This should be performed soon after the onset of pain if maximal information is to be obtained, thereby avoiding unnecessary investigation.