Manifestaciones urinarias de la apendicitis aguda

Abstract

OBJECTIVES: To identify the most frequent urinary tract symptoms of acute appendicitis. To determine the findings in urine analysis. To establish statistically the relationships between age, sex, duration of abdominal pain, appendix position and the evolution stage with the findings on clinical history and urine analysis. METHODS: We studied 500 consecutive patients undergoing surgery for acute appendicitis registering all data specified in the objectives. The chi-square test was used to establish statistical relationships. RESULTS: One third of the patients showed some urinary symptoms; right flank pain and dysuria were the most frequent symptoms. Urinary sediment showed pyuria > 10 cells per high-power field in 1/7 patients, and more than 3 red blood cells per high-power field in 1/6. 1/7 patients presented proteinuria; and 1/77 presented casts. Urinary symptoms, proteinuria, and urinary casts appeared more frequently in patients older than 59 years; pyuria in the group between 15-19 years; and microhematuria in females. Pelvic and retrocecal appendix positions were associated with a higher incidence of voiding symptoms. Duration of abdominal pain and evolution stage did not have any statistical relationship with either symptoms or urine analysis findings. CONCLUSIONS: Urinary tract symptoms are frequent in acute appendicitis; their presence should not exclude the diagnosis of this disease. Urine analysis is not useful to rule out the existence of acute appendicitis.