Extra Burden on Urology Outdoor Due to Non Urology Flank Pain

2021 ◽  
Vol 15 (12) ◽  
pp. 3519-3521
Author(s):  
Liaqat Ali ◽  
Shahzad Ali ◽  
Naresh Kumar Valecha ◽  
Arif Ali ◽  
Saeed Ahmed Khan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Wide Spectrum ◽  
Medical Center ◽  
Flank Pain ◽  
Ultrasound Finding ◽  
Descriptive Case Study ◽  
Urinary Tract Symptoms ◽  
Musculoskeletal Problems ◽  
Urological Emergency

Background: Flank pain is one of common urological emergency. It can be result of various causes. Most commonly results from one of three causes: urinary tract infection (UTI), kidney stones, and musculoskeletal problems like a muscle strain or pinched nerve. Objective: Determine frequency of none urological flank pain burden in urology outdoors. Methods: This was prospective descriptive case study conducted at department of urology and transplantation at Jinnah Postgraduate Medical Center Karachi from September 2020 to December 2020. All patients with flank pain, who visited in urology outdoor, were included in study. All patients had detailed history and physical examination. Urinalysis and ultrasound abdomen were done in all patients. CT KUB was also done in patients who had abnormal ultrasound finding of kidney ureter and bladder. Results: Total 100 patients were included in this study, 41 (41%) male while 59 (59%) patients were females. 45 patients had right sided pain, 34 had left sided while remaining 21 patients had bilateral flank pain and six patients had also lower urinary tract symptoms along with pain. 13 patients had positive renal punch on examination, 23 patients had positive straight leg rising sign and rest of the 64 patients’ examination was unremarkable. 55 patients had urology related pathology on ultrasound, in 9 patients had non urological pathology and rest 36 patients it was unremarkable. CT KUB was done in all 55 patients who had positive findings on ultrasound showing pathology in kidney and ureter in which 47 patients CT scan had confirmed the diagnosis while in 8 patients it was in remarkable. Conclusion: flank pain is not always secondary to renal origin. It has wide spectrum of alternative significant causes also. Keywords: Flank pain, none urological, CT KUB

scholarly journals The diagnosis and management of a patient with acute pyelonephritis

2020 ◽  
Vol 29 (3) ◽  
pp. 144-150
Author(s):  
Carly Hudson ◽  
Gerri Mortimore
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Acute Pyelonephritis ◽  
Lower Urinary Tract ◽  
Hospital Admissions ◽  
Upper Urinary Tract ◽  
Flank Pain ◽  
Tract Infections ◽  
Lower Urinary

Lower urinary tract infections account for more than 224 000 hospital admissions each year and nearly all of these have the pathophysiological possibility to develop into pyelonephritis, known clinically as an upper urinary tract infection. Acute pyelonephritis is characterised by inflammation of the renal parenchyma caused by bacteriuria ascending from the bladder, up the ureters to the kidneys. Effective history taking, combined with refined physical examination skills, are the two most powerful tools to differentiate upper and lower urinary tract infections as well as assisting the practitioner to exclude other differential diagnoses. Utilisation of these skills by the practitioner, together with the recognised presenting symptom triad of flank pain, fever and nausea in this case study, enabled the diagnosis of acute pyelonephritis to be given.

scholarly journals P0277PATIENTS WITH PYELONEPHRITIS PRESENTING ONLY WITH LOWER URINARY TRACT SYMPTOMS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Fazal Rehman ◽  
Farrukh Umair
Keyword(s):  
Socioeconomic Status ◽  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Upper Urinary Tract ◽  
Flank Pain ◽  
Care Hospital ◽  
Delayed Presentation ◽  
Western Population ◽  
Urinary Tract Symptoms

Abstract Background and Aims The rate of acute pyelonephritis (APN) is assessed at almost 9– 11 cases for every 10,000 tenants. Its prevalence is more in developing countries and among those having low socioeconomic status. The demographics of the population in our region is different from the western population with multiple factors such as delayed presentation to hospital, varying socioeconomic status, malnutrition and lack of knowledge about basic treatment leads to increased morbidity and mortality as compared to western population. To the best our knowledge this will be the first study of its kind to describe the frequency of pyelonephritis without upper urinary tract symptoms in hospital setting. AIM To determine the frequency of pyelonephritis in patients presenting only with low urinary tract symptoms, at a tertiary care hospital, Karachi. Method Study is conducted at a tertiary care hospital charts and files were reviewed from 01-11-2018 to 28-02-2019 for all the patients having diagnosis of APN from medical record files. Results In our study total five hundred and twenty-one (n=521) patients were included (n=492 (94%) of the participants were suffering from pyelonephritis. Approximately, 22.8% of the patients showed absence of both flank pain and costo-vertebral tenderness but were diagnosed with pyelonephritis on the basis of CT/MRI as presented. While 27% of the patients reported both upper urinary tract symptoms and were also positive on CT-MRI. It is also witnessed that 24% and 16% of the patients either reported flank pain or costo-vertebral tenderness respectively. Insignificant association between gender, age, comorbid with pyelonephritis. While, the total leucocytes count was significantly related with CT/MRI. Conclusion Our study showed significant number of patients having pyelonephritis in the absence of any upper tract symptoms. Ignoring the diagnosis as serious can lead to under treatment, possibility of higher rate of re-admissions or poor selection of initial antibiotics. Whereas, other side of the spectrum haunts with higher investigation cost of imaging and broad spectrum use of antibiotic for every patient presenting with just urinary tract infection in Emergency department. A balance should be devised to equilibrate the balance between two extremes.

scholarly journals A Rare Location of Metastasis from Prostate Cancer: Hydronephrosis Associated with Ureteral Metastasis

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sebastian Schneider ◽  
Dieter Popp ◽  
Stefan Denzinger ◽  
Wolfgang Otto
Keyword(s):  
Prostate Cancer ◽  
Urinary Tract ◽  
Prostate Carcinoma ◽  
Lower Urinary Tract ◽  
Flank Pain ◽  
Diagnostic Investigation ◽  
Antihormonal Treatment ◽  
Urinary Tract Symptoms ◽  
Rare Location ◽  
Lower Urinary

Prostate carcinoma is a very rare origin of metastatic disease in the ureter. We report a case of a 74-year-old man who presented in November 2008 initially with flank pain and lower urinary tract symptoms. Diagnostic investigation revealed a skeletal metastasizing prostate carcinoma, and the cause for the flank pain was a hydronephrosis due to ureteral metastasis diagnosed by biopsy. Antihormonal treatment led to disappearance of the hydronephrosis; however, further progress finally ended in acute liver failure with patient's death in July 2010.

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