kidney stones ? and the ER

[mommy2boys]

I had a friend who, turned out to have a kidney stone, went to the ER. The doctor felt that she had a stone and ordered all the tests. WHile they were waiting for the CT scan results the doctor ordered at lady partsl exam. Why would a doctor order a pelvic exam when he already said that he it could be a stone?

I have passed a ton of stones and never had to have a lady partsl exam. I'm just trying to figure out why her trip was different. Or is it because I have a history of stones and am currently seeing a urologist for them. She asked me if I ever had to have a lady partsl exam w/ a stone and if this was normal. The only thing that I could think of was that she may have complained of other symptoms and the doctor wanted to do a full check.

Thanks.

[suzanne4, RN]

If this was the first time that she ever had a kidney stone, how did anyone know for sure that she had one until all exams came back? Most times that a female patient comes to the ER complaining of any pain below the waist, a pelvic exam in included, unless it has already been documented about the kidney stones.

[Altra, BSN, RN]

If this was the first time that she ever had a kidney stone, how did anyone know for sure that she had one until all exams came back? Most times that a female patient comes to the ER complaining of any pain below the waist, a pelvic exam in included, unless it has already been documented about the kidney stones.

Agree. Was your friend's primary symptom flank/back pain? Otherwise unexplained back pain in women should be evaluated gynecologically. Also, in an ER setting, it would be to no one's benefit to proceed with one test or means of evaluation at a time. Providers need to check out the 3-4 most likely causes of your symptoms and cover all the bases.

[luvmy2angels]

I am a chronic sufferer of kidney stones and no one ever did a lady partsl exam on me, even before I had stones in my medical history. It does make sense though, after reading the posts above me that they may do one to rule out any gyno problems. Hope all works out okay, kidney stones are NO fun!! I have had to have surgery twice in the past 6 months!! Best wishes to your friend!

[VivaLasViejas, ASN, RN]

I am a chronic sufferer of kidney stones and no one ever did a lady partsl exam on me, even before I had stones in my medical history. It does make sense though, after reading the posts above me that they may do one to rule out any gyno problems. Hope all works out okay, kidney stones are NO fun!! I have had to have surgery twice in the past 6 months!! Best wishes to your friend!

You, too? Actually, it's been two laser lithotripsies in the past 9 months for me, but I keep forming these stupid things and each time they grow bigger and faster. You have my sympathies!!

BTW: I've had kidney stones about half a dozen times now, and I've NEVER had a pelvic during the workup process. It makes sense, though, especially in a younger woman, to do a full GYN exam to r/o problems in that region. (I was 42 when I had my first stone episode; maybe that's why they didn't do one.......oh, darn. )

[caroladybelle, BSN, RN]

I have a known history of ulcerative colitis and yet if I present with abdominal pain, they give me a pelvic, to r/o that source of possible pain.

[matchstickxx]

The second time I went to the ER for kidney stones, the doc insisted on a pelvic and wanted to rule out an ectopic pregnancy. My daughter was a baby and I was still breastfeeding. I hadn't had a period in over a year. Even though I denied even the slightest chance of being pregnant, he still insisted on a pelvic exam. Of course the exam ruled out an ectopic and I did indeed have a kidney stone....which I had been telling him since I arrived in the ER.

[Altra, BSN, RN]

The second time I went to the ER for kidney stones, the doc insisted on a pelvic and wanted to rule out an ectopic pregnancy. My daughter was a baby and I was still breastfeeding. I hadn't had a period in over a year. Even though I denied even the slightest chance of being pregnant, he still insisted on a pelvic exam. Of course the exam ruled out an ectopic and I did indeed have a kidney stone....which I had been telling him since I arrived in the ER.

Amenorrhea in a pre- or perimenopausal woman does not necessarily preclude pregnancy - even if you have been without menstrual periods for some period of time for whatever reason, such as breastfeeding (which does not serve as contraception), who is to say that you haven't recently ovulated?

[caroladybelle, BSN, RN]

Amenorrhea in a pre- or perimenopausal woman does not necessarily preclude pregnancy - even if you have been without menstrual periods for some period of time for whatever reason, such as breastfeeding (which does not serve as contraception), who is to say that you haven't recently ovulated?

In my case, I hadn't had sex in so long, it would have had to have been from phone sex, or an almost imaculate conception. Yet I still get the "required" pregnancy test, and pelvic.

[Katnip, RN]

Because if emergency personnel had a nickle for every time they hear "I can't possibly be pregnant" while they're catching the baby.

Too many people say they can't be pregnant and are. It's nothing personal, just that ER folks really don't have a reliable way of who is reliable to believe and who is not.

[caroladybelle, BSN, RN]

Well, since I refused my insurance to pay for the unnecessary pregnancy test, it really isn't a problem. The financial office gets ticked when I force them to take it off the bill, but my insurance should not be required to pay for the test.

[Katnip, RN]

Oh, I don't blame you a bit. It's just that there is so much liablity that any woman of childbearing age who may need a CT or x-ray gets the pregnancy test no matter how sure she's not pregnant. Too many women are sure and turn out they are.

Of course if they absolutely refuse, they have to sign a waver stating we will not be responsible for any damage to a fetus that may be there.