ABSTRACT
It is very important to obtain an exact history of the symptoms of renal and urinary tract disease because the kidney, ureter and bladder are not readily accessible for physical examination. When asked to show you the site of renal pain, the patient usually spreads a hand around his waist with fingers covering the renal angle and thumb above the anterior superior iliac spine. In most cases, the pain starts in the loin and then radiates downwards, around the waist, obliquely across the abdomen just above the inguinal ligament, and to the base of the penis, the testes or the labia. Blood may be noticed during or after micturition. Modest bleeding may not affect the colour of the urine, or may make it look darker than usual. With heavy bleeding, the urine may be bright red. Old blood or clot in the bladder is usually very dark.
