The most common GU complaint in the emergency department for suspected nephrolithiasis is which symptom?

• A. Dysuria
• B. Hematuria
• C. Frequency
• D. Flank pain

Answer: (D)

Nephrolithiasis typically presents with renal colic, which is sudden, severe, cramping flank pain that often radiates toward the groin as the stone moves through the ureter. This intense, ongoing pain is the symptom that most commonly brings patients to the emergency department for suspected kidney stones. The pain is usually accompanied by restlessness, nausea or vomiting, and sometimes rapid heart rate.

Dysuria and frequency are more characteristic of bladder or urethral irritation or infection, and while hematuria can occur with stones, it is not the defining complaint for seeking urgent care. Hematuria may be present but the hallmark feature driving ED visits for suspected nephrolithiasis is the severe flank pain.