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J Endourol. 2011 Dec;25(12):1909-13. doi: 10.1089/end.2011.0265. Epub 2011 Sep 1.

Urolithiasis location and size and the association with microhematuria and stone-related symptoms.

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Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.



To conduct a study to assess the association between calculus location and size and the incidence of both microhematuria and symptoms of urolithiasis in a urology office environment.


After Institutional Review Board approval, a prospective study was conducted with data from 100 consecutive patients who presented to our office with documented urolithiasis. The location (caliceal, pelvic, or ureteral) and size (<or ≥ 8 mm) of each calculus was determined from available diagnostic radiographs. The incidence of microhematuria was ascertained via a urine dipstick and microscopic examination. The presence of any symptoms associated with urolithiasis, including pain, subjective fever or chills, or urinary urgency, was recorded.


A total of 111 stones were found in the study population resulting in a 45.9% incidence of microhematuria. In patients with renal pelvic and ureteral stones, 67.6% demonstrated microhematuria vs 36.4% with caliceal stones, P=0.0035. For stones ≥ 8 mm, 62.5% were positive for microhematuria vs 29.1% of stones <8 mm, P=0.0006. Ureteral or renal pelvic stones caused the most symptoms (70.6%) compared with caliceal stones (16.9%), P=0.0001. In those patients who reported pain associated with urolithiasis, 65.6% had concomitant microhematuria vs 36.8% in those without pain, P=0.0097.


Urinary calculus location and size are associated with the incidence of microhematuria and stone-related symptoms. Pain related to urolithiasis may be a positive predictor for the presence of microhematuria.

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