The aims of this study were to compare the sensitivity of urine dipstix (Combur 9 test) versus urine microscopy in detecting and to determine the proportion of patients with renal or ureteric colic due to urinary calculi who have haematuria.This is a prospective study of 122 patients presenting to an emergency department in a tertiary teaching hospital with symptoms suggestive of renal or ureteric colic. The same urine specimen tested using dipstix was sent for urine microscopic examination for haematuria, after which a plain radiograph of the kidneys, ureter and bladder was done. An early intravenous urogram was done (delay of an average of 4 days). Telephone interviews were done to determine whether any calculi had been passed. Urine dipstix detected haematuria in 95.4% [95% confidence intervals (CI) 87.1% to 100.0%] of patients with urinary calculi, whilst urine microscopy detected haematuria in 70.8% (95% CI 58.2% to 92.6%). This study showed that urine Combur 9 is more sensitive than urine microscopy in detecting haematuria. The combined use of urine Combur 9 and microscopy does not increase the sensitivity of detecting haematuria. In the absence of haematuria on urine Combur 9 for suspected ureteric colic, alternative diagnoses should be considered.
Patients with renal or ureteric colic are commonly seen at our Emergency Department. We routinely check their urine for haematuria using the Combur 9 test (Boehringer Mannheim, Germany) alone without doing urine microscopy unless the patient shows pyuria on the Combur 9 test.
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