Haematuria in the diagnosis of urinary calculi.

The aims of this study were to compare the sensitivity of urine dipstix (Combur 9 test) versus urine microscopy in detecting haematuria 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.