Kidney and urinary symptoms can come from infection, stones, obstruction, bladder conditions, prostate problems and other causes. A urine test, blood test, ultrasound, CT or specialist review may be useful, but the safest choice depends on your symptoms and urgency.
I advise patients not to choose an imaging test in isolation when urinary symptoms are new or changing. The clinician first needs to understand pain, fever, urine changes, bladder emptying, past infections and any medical risks.
A scan can answer focused questions about the kidneys and urinary tract. It cannot replace urgent assessment for severe pain, fever, retention or heavy bleeding.
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Victoria Medical Clinical Team
GMC-registered physicians and specialist consultants
Match the test to the clinical question
A clinician chooses tests based on the likely cause and the severity of symptoms.
| Pattern | Possible first steps |
|---|---|
| Burning, frequency or urgency | Urine testing and GP assessment |
| Flank pain or suspected obstruction | Clinical review with appropriate imaging |
| Visible blood in urine | Prompt GP or urology assessment |
| Slow flow or incomplete emptying | GP or urology review with targeted urine and bladder assessment |
| Severe illness or inability to pass urine | Urgent medical assessment |
When ultrasound can be useful
A kidney and urinary tract ultrasound may assess selected structural questions, such as the appearance of the kidneys, urinary tract dilatation, bladder appearance or residual urine. It does not identify every cause of symptoms and may not be the right urgent test.
Red flags that need urgent help
Seek urgent medical advice for severe pain, fever or shaking chills with urinary symptoms, an inability to pass urine, repeated vomiting, confusion, heavy visible bleeding in urine or rapid deterioration.
A routine ultrasound appointment is not an emergency pathway. If you cannot pass urine or feel acutely unwell, seek urgent medical care.
Frequently Asked Questions
References
- [1]Wang D et al. Point-of-care ultrasonography for diagnosis of hydronephrosis: systematic review and meta-analysis. Journal of the American Society of Nephrology.
- [2]NICE. Suspected cancer: recognition and referral, haematuria recommendations.
- [3]NHS. Urinary tract infection information and when to seek urgent help.