Affiliation:
1. Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
2. Department of Urology, State University of New York, Upstate Medical University, Syracuse, NY, USA
Abstract
Objectives: To examine gender-related differences in the presentation, management, and outcomes of patients admitted to the emergency department ED with ureteral stones. Methods: Retrospective analysis of all patients admitted to the ED at our institution, found to have a ureteral stone on CT. Clinical, laboratory, imaging parameters, and outcomes were collected. Results: 778 patients were admitted with ureteral stones between January 2018 and December 2020. 78% ( n = 609) were males and 22% ( n = 169) were females. The mean ages were 49.4 (SD 14.4) and 51.6 (SD 15.7) in males and females, respectively ( p = 0.08). Female patients presented with a higher body temperature ( p = 0.01), pulse rate ( p < 0.0001), nausea and vomiting ( p < 0.0001), elevated serum C-reactive protein (CRP) ( p = 0.002) compared to males. The prevalence of elevated serum creatinine was higher in males ( p < 0.0001). Alpha-blockers were recommended on discharge in 54.8% (334) of males, compared to only 29.6% (50) of females ( p < 0.0001). Spontaneous stone expulsion was significantly higher in males compared to females ( p = 0.01). Conclusions: Our results demonstrate that gender does effect presentation and outcome of patients presenting with renal colic. Females were found to have elevated infectious parameters, more nausea and vomiting and a higher incidence of positive urine cultures. Males admitted to the ED were found to have significantly higher serum creatinine levels. Medical expulsive therapy (MET) with alpha-blockers was prescribed significantly less in female patients, which may have resulted in a lower spontaneous stone expulsion rate.