• Silvio R Tasso, Christopher P Shields, Carl R Rosenberg, Diane M Sixsmith Md, and Dorothy S Pang.
• From New York Hospital Medical Center of Queens, Flushing, NY, Department of Emergency Medicine (SRT, CPS, CRR, DMS, DSP)Cornell University Medical College, New York, NY, Department of Medicine, Division of Emergency Medicine (SRT, CPS, CRR, DMS. DSP).
• Acad Emerg Med. 1997 Aug 1; 4 (8): 780-784.

ObjectiveTo determine whether IV pyelography (IVP) is required routinely for all patients presenting to the ED with ureteral colic.MethodsA randomized prospective study was conducted with 2 patient groups-a routine IVP group, in which all patients underwent IVP, and a selective IVP group, in which patients were treated, observed, and released without undergoing IVP unless they experienced continued symptoms. The study was performed in a large university-affiliated, community hospital ED. Participants were patients aged 18-65 years with signs and symptoms consistent with ureteral colic.ResultsAmong the 40 patients enrolled in the routine IVP group, 26 had positive studies, 8 of which necessitated hospitalization. Among the 41 patients randomized to the selective IVP group, there were only 19 IVPs performed, of which 6 were positive and 4 necessitated hospitalization. Compared with the routine IVP group, there were 54% fewer FVPs performed and a 51 % lower admission rate in the selective IVP group. Despite the fact that fewer IVPs were performed in the selective IVP group, clinical outcomes in the 2 groups were similar, without significant complication in either group.ConclusionsIVPs do not need to be routinely performed for all patients presenting to the ED with ureteral colic. The decision to perform an IVP may be dictated by symptoms that persist after initial evaluation and treatment.© 1997 Society for Academic Emergency Medicine.

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