{"id":4095,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/loinpain\/"},"modified":"2026-02-27T10:54:30","modified_gmt":"2026-02-27T10:54:30","slug":"loinpain","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/urology\/loinpain\/","title":{"rendered":"Loin Pain"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<div data-wp-interactive=\"core\/file\" class=\"wp-block-file\"><object data-wp-bind--hidden=\"!state.hasPdfPreview\" hidden class=\"wp-block-file__embed\" data=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Loin-Pain-Feb-2026-flowchart.pdf\" type=\"application\/pdf\" style=\"width:100%;height:1120px\" aria-label=\"Embed of Loin Pain Feb 2026 flowchart.\"><\/object><a id=\"wp-block-file--media-f0cf26a0-22b3-4019-a1b7-6bb697cfffec\" href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Loin-Pain-Feb-2026-flowchart.pdf\">Loin Pain Feb 2026 flowchart<\/a><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Loin-Pain-Feb-2026-flowchart.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-f0cf26a0-22b3-4019-a1b7-6bb697cfffec\">Download<\/a><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>H.S &amp; D.M<\/strong> &#8211; <strong><strong>Updated Dec 2025<\/strong><\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>Who to refer:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Pyelonephritis and ill \u2013 via Flow Centre<\/li>\n\n\n\n<li>Pyelonephritis &amp; under follow up for stone disease \u2013 on call Urology<\/li>\n\n\n\n<li>Renal colic and uncontrolled pain \u2013 on call Urology if known stones and under follow up with Urology or via Flow Centre<\/li>\n\n\n\n<li>Renal mass on scan \u2013 urgent suspicion of cancer to Urology<\/li>\n\n\n\n<li>Ureteric calculi or hydronephrosis on scan \u2013 refer urgently to Urology<\/li>\n\n\n\n<li>Renal calculi \u2013 refer routine to Urology<\/li>\n\n\n\n<li>New loin pain not requiring admission in a patient with known history of stones should be referred back to the Scottish Lithotriptor Centre urgently (SCI Gateway referral to urology), who will arrange imaging tailored to the patient (CT KUB is not routinely necessary for these patients, who are at risk of a significant cumulative radiation dose as a result of repeated stone episodes).<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who not to refer:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Normal investigations and no red flags<\/li>\n\n\n\n<li>Or where other pathways more suitable e.g. haematuria<\/li>\n\n\n\n<li>Where admission not indicated \u2013 initial referral to radiology, depending on presentation.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>How to refer:<\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Through SCI Gateway &gt; Western General Hospital &gt; Urology.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BLADDER-FLUID-BALANCE-DIARY-DEC-25.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BLADDER-FLUID-BALANCE-DIARY-DEC-25.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Urology &#8211; Bladder diary <\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Urology-IPSS-Score-International-PROSTATE-Symptom-Score-DEC-25.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Urology-IPSS-Score-International-PROSTATE-Symptom-Score-DEC-25.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Urology &#8211; IPSS International Prostate Symptom Score &#8211; NHS Lothian<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/services.nhslothian.scot\/scottishlithotriptorcentre\/\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Lithotriptor Centre \u2013 NHS Lothian | Our Services<\/a><\/li>\n<\/ul>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>H.S &amp; D.M &ndash; Updated Dec 2025<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4500,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[671],"class_list":["post-4095","page","type-page","status-publish","hentry","category-loinpain"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/urology\/loinpain\/\" rel=\"tag\">Loin Pain<\/a>","rttpg_excerpt":"H.S &amp; D.M &ndash; Updated Dec 2025","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4095","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4095"}],"version-history":[{"count":26,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4095\/revisions"}],"predecessor-version":[{"id":27050,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4095\/revisions\/27050"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4500"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4095"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4095"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}