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Significance and diagnostic accuracy of renal calculi found by ultrasonography in patients with asymptomatic microscopic hematuria
Author(s) -
Marumo Ken,
Horiguchi Yutaka,
Nakagawa Ken,
Oya Mototsugu,
Ohigashi Takashi,
Asakura Hirotaka,
Nakashima Jun,
Murai Masaru
Publication year - 2002
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1046/j.1442-2042.2002.00489_1.x
Subject(s) - medicine , asymptomatic , microscopic hematuria , extracorporeal shockwave lithotripsy , extracorporeal shock wave lithotripsy , radiology , urinary system , kidney , abdominal ultrasonography , natural history , lithotripsy , ultrasonography , surgery , proteinuria
Background : The purpose of the present study was to evaluate the clinical significance and the accuracy of the diagnosis of renal calculi incidentally found by ultrasonography (US). Methods : A total of 906 subjects (639 men and 267 women) aged 18–78 years were referred for asymptomatic microscopic hematuria. Of these, 743 patients who underwent US were studied. Results : Hyperechogenic spots in the central echo complex suggesting renal calculi were noted in 195 patients (21.5%). The occurrence of hyperechogenic spots was higher in patients with 20 or more urinary red blood cells per high‐power field (χ 2 = 4.896, P = 0.0269) and in men than in women (χ 2 = 7.101, P = 0.0077), but it was lowest in patients who were 29 years old or younger. Of these 195 patients, who were followed up for 1–161 months (average: 33.5 months), 24 patients (12.3%) needed urological management. Extracorporeal shockwave lithotripsy was carried out in eight patients, transureteral lithotripsy was carried out in three patients, spontaneous passage occurred in 11 patients and medication for hyperuricemia was initiated in two patients (1%). Among the patients in whom hyperechogenic spots were found in the kidney by US but calculi were not visible on abdominal plain radiographs, 39 patients underwent computed tomography. Of them, 31 patients were confirmed to have renal calculi. Conclusion : The obtained results suggest that US is an effective and reliable means of detecting renal calculi in patients with asymptomatic microscopic hematuria, and in facilitating prompt urological intervention or predicting the natural course of renal calculi.