Evaluation Of Urological Emergency Cases Admitted To Emergency Department

Abstract

Aim: Especially in recent years, with the increase in the number of patients admitted to the emergency services the number of urological emergencies is increasing. Some of these require immediate attention. There are not enough studies on urological emergencies in our country. In this study, we aimed to investigate the demographic data of patients over the age of 18 who presented to the emergency department with non-traumatic urological emergency complaints. Materials and Methods: This study was designed based on a 6-month prospective, cross-sectional study. After obtaining the approval of the ethics committee, patients over the age of 18 with urological emergency complaints were examined between 06.11.2019 and 06.05.2020. Results: The ratio of urological emergencies to all patients was found to be 1.5%. 56.76% (n: 231) of the patients were male and 43.24% (n = 176) were female. In the study was found 44.7% of the patients to be urinary tract infection, 31.45% renal colic, 8.8% hematuria, 6.88% acute urinary retention. In our study, urology consultation was requested for 19% of urological emergency patients. Emergency intervention was applied to 21.13% of all urological emergency cases. Emergency operation was required for 1.47% of the patients. 10.81% of the patients required hospitalization. Conclusion: As a result, urological emergencies are common. Among these cases, there may be diseases that require urgent intervention or surgery. It is very important for the patients the emergency physicians who evaluate the patient first to make a careful and meticulous evaluation and to make a urology consultation if necessary.

Keywords

• Renal colic
• Urinary tract infection
• Urological emergency
• Renal kolik
• İdrar yolu enfeksiyonu
• Ürolojik acil

Acil Servise Başvuran Ürolojik Acil Olgularin Değerlendirilmesi

Öz

Amaç: Özellikle son yıllarda acil servislere başvuran hasta sayısının da artmasıyla ürolojik acil olguların da sayısı gün geçtikçe artmaktadır. Bunlardan bazıları acil müdahale gerektirir. Ülkemizde yeteri kadar ürolojik aciller ile ilgili çalışma yoktur. Bu çalışmada acil servise travma dışı ürolojik acil şikâyetlerle başvuran 18 yaş üstü hastaların demografik verilerini incelemeyi planladık. Gereç ve Yöntem: Çalışma 6 aylık prospektif, kesitsel araştırmaya dayanarak tasarlandı. Etik kurul onayı alındıktan sonra bir üniversite hastanesi acil servisine 06. 11.2019 ile 05. 06. 2020 tarihleri arasında başvuran ürolojik acil şikayetleri olan 18 yaş üzeri hastalar incelendi. Bulgular: Ürolojik acil hastaların tüm hastalara oranı %1,5 olarak saptandı. Hastaların %56,76 (n: 231)’sı erkek, %43,24(n=176)’ü kadın olarak saptandı. Çalışmada hastaların %44,7’si idrar yolu enfeksiyonu, %31,45’si renal kolik, %8,8’i hematüri, %6,88’i akut üriner retansiyon, olarak saptanmıştır. Çalışmamızda ürolojik acil hastaların %19’una üroloji konsültasyonu istenmiştir. Tüm ürolojik acil olguların %21,13’ine acil girişim uygulanmıştır. Hastaların %1,47’sine acil operasyon gerekmiştir. Hastaların %10,81’ine servis yatışı gerekmiştir. Sonuç: Sonuç olarak, ürolojik acil olgulara sık rastlanmaktadır. Bu olgular arasında acil girişim veya operasyon gerektiren hastalıklar olabilir. Hastayı ilk değerlendiren acil servis hekimlerinin dikkatli ve titiz bir değerlendirme yapması, gerekirse üroloji konsültasyonu istemesi oldukça önemlidir.

Anahtar Kelimeler

• Renal kolik
• İdrar yolu enfeksiyonu
• Ürolojik acil

References

1. 1- Akıncı H. Karabük Devlet Hastanesi'ne Başvuran Ürolojik Acil Olguların Analizi. Uludağ Tıp Derg. 2009; 35(1): 17-20.
2. 2- Kafkaslı A, Selimoğlu A, Boz MY, Yazıcı Ö, Akif T, Hamarat MB, et al. Ürolojik acil olguların analizi: Tek merkezli çalışma. Yeni Üroloji Dergisi.9(3):10-3.
3. 3- Foxman B. The epidemiology of urinary tract infection. Nat Rev Urol. 2010 Dec;7(12):653-60. doi: 10.1038/nrurol.2010.190. PMID: 21139641.
4. 4- Cowan NC. CT urography for hematuria. Nat Rev Urol. 2012 Mar 13;9(4):218-26. doi: 10.1038/nrurol.2012.32. PMID: 22410682.
5. 5- Kamel, A., Mahmoud, M., Zaky, K., Alsayed, M., Alsharkawey, A. (2020). Role of CT For Evaluation of Hematuria. SVU-International Journal of Medical Sciences, 3(2), 79-86. doi: 10.21608/svuijm.2020.111987
6. 6- Vedula R, Iyengar AA. Approach to Diagnosis and Management of Hematuria. Indian J Pediatr. 2020 Aug;87(8):618-624. doi: 10.1007/s12098-020-03184-4. Epub 2020 Feb 6. PMID: 32026313.
7. 7- Fontanarosa PB, Roush WR. Acute urinary retention. Emerg Med Clin North Am. 1988 Aug;6(3):419-37. PMID: 3292220.
8. 8- Thomas K, Chow K, Kirby RS. Acute urinary retention: a review of the aetiology and management. Prostate Cancer Prostatic Dis. 2004;7(1):32-7. doi: 10.1038/sj.pcan.4500700. PMID: 14999235.

9. 9- Pamukçu Günaydın G, Doğan NÖ, Çevik Y, Korkmaz H, Savrun A, Çıkrıkçı G. Evaluation of Patients with Renal Colic that Present to an Emergency Department During the Month of Ramadan. Eurasian J Emerg Med 2013;12:24-26.
10. 10- Shokeir AA. Renal colic: new concepts related to pathophysiology, diagnosis and treatment. Curr Opin Urol. 2002 Jul;12(4):263-9. doi: 10.1097/00042307-200207000-00001. PMID: 12072644.
11. 11- Bağcıoğlu M, Kayış A. Fournier Gangreni. Türkiye Klinikleri Üroloji-Özel Konular. 2017;10(4):321-8.
12. 12- Voelzke BB, Hagedorn JC. Presentation and Diagnosis of Fournier Gangrene. Urology. 2018 Apr;114:8-13. doi: 10.1016/j.urology.2017.10.031. Epub 2017 Nov 13. PMID: 29146218.
13. 13- Sharp VJ, Kieran K, Arlen AM. Testicular torsion: diagnosis, evaluation, and management. American family physician. 2013;88(12):835-40.
14. 14- Broderick GA, Kadioglu A, Bivalacqua TJ, Ghanem H, Nehra A, Shamloul R. Priapism: pathogenesis, epidemiology, and management. J Sex Med. 2010 Jan;7(1 Pt 2):476-500. doi: 10.1111/j.1743-6109.2009.01625.x. PMID: 20092449.
15. 15- Van der Horst C, Stuebinger H, Seif C, Melchior D, Martínez-Portillo FJ, Juenemann KP. Priapism - etiology, pathophysiology and management. Int Braz J Urol. 2003 Sep-Oct;29(5):391-400. doi: 10.1590/s1677-55382003000500002. PMID: 15745583.
16. 16- Güner E, Özdal ÖL, Akdemir AO. Testis ve Epididim Enfeksiyonları. Türkiye Klinikleri Üroloji-Özel Konular. 2018;11(2):118-27.
17. 17- Pelit S, Bulut ME, Bayraktar B. Üretrit semptomları olan erkek hastalarda Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum ve Mycoplasma hominis sıklığının araştırılması. Bakırköy Tıp Derg. 2017;13(1):10-3.
18. 18- Shah HH, Uppal NN. Acute kidney injury. Handbook of Medicine in Psychiatry. 2020:313.
19. 19- Talreja S, Banerjee I, Teli R, Agarwal N, Vyas N, Priyadarshi S, et al. A spectrum of urological emergency reported at a tertiary care teaching hospital: an experience. Journal of clinical and diagnostic research: JCDR. 2015;9(11):PC12.
20. 20- Traore M, Yameogo C, Kabore M, Ouedraogo S. Epidemiology of Urological Emergencies at the Regional University Hospital Center of Ouahigouya, Burkina Faso. Open Journal of Urology. 2020;10(06):177.
21. 21- Bah I, Diallo T, Bah O, Amougou B, Bah M, Guirassy S. The profile urological emergencies at the Conakry university teaching hospital, Guinea. Progres en Urologie: Journal de L'association Francaise D'urologie et de la Societe Francaise D'urologie. 2010;20(3):214-8.
22. 22- Ndiaye M, Sow O, Sarr A, Ndiath A, Ondo C, Sine B, et al. Urological Emergency in a University Hospital Setting: Epidemiological, Diagnostic and Therapeutic Aspects, International Journal of Clinical Urology. 2020;4(2):51-4. doi: 10.11648/j.ijcu.20200402.13
23. 23- Topaktaş R, Altın S, Aydın C, Akkoç A, Yılmaz Y. Retrospective evaluation of urological admissions to emergency service of a training and research hospital. Turkish journal of urology. 2014;40(4):216.
24. 24- Girgin R, Erdem K. Epidemiologic Analysis of Urological Cases Admitted to an Emergency Department of a Tertiary Care Center. Journal of Urological Surgery. 2020;7(3):227.
25. 25- Moore CL, Carpenter CR, Heilbrun ME, Klauer K, Krambeck AC, Moreno C, et al. Imaging in suspected renal colic: systematic review of the literature and multispecialty consensus. Journal of the American College of Radiology. 2019;16(9):1132-43.
26. 26- Fall B, Diao B, Fall P, Diallo Y, Sow Y, Ondongo A, et al. Urological emergencies at the Dakar university teaching hospital: epidemiological, clinical and therapeutic features. Progres en Urologie: Journal de L'association Francaise D'urologie et de la Societe Francaise D'urologie. 2008;18(10):650-3.
27. 27- Motterle G, Morlacco A, Iafrate M, Bianco M, Federa G, Xhafka O, et al. The impact of COVID-19 pandemic on urological emergencies: a single-center experience. World Journal of Urology. 2020:1.
28. 28- Madanelo M, Ferreira C, Nunes‐Carneiro D, Pinto A, Rocha MA, Correia J, et al. The impact of the coronavirus disease 2019 pandemic on the utilisation of emergency urological services. BJU international. 2020;126(2):256-8.