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Query: UMLS:C0152169 (renal colic)
 811 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sonography is well established as a screening tool to evaluate the kidney for the presence of renal obstruction. The role of sonography in the evaluation of acute obstruction is less clear, however. Despite recent reports emphasizing the ability of gray-scale sonography and kidney/urinary/bladder films to screen for acute colic, experience indicates that the sonographic diagnosis of acute renal stone disease may be unreliable. Multiple studies have demonstrated the many potential pitfalls of the sonographic examination for acute obstruction. False-negative studies may result if the kidney is evaluated before hydronephrosis occurs. Conversely, nonobstructive pyelocaliectasis and parapelvic cysts may result in false-positive studies. Because of these sonographic limitations, many imaging practices exclusively have utilized excretory urography for the evaluation of patients with symptoms of renal colic.
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PMID:Role of the resistive index in the evaluation of acute renal obstruction. 783 74

We have conducted a double-blind, randomized, placebo-controlled trial with oral diclofenac to study the prophylactic effect on renal colic recurrence and spontaneous stone expulsion rate. Forty-one patients were given 50 mg oral diclofenac 3 times a day for 7 days after being discharged for a colic episode from Oslo Emergency Hospital (< 24 h stay) and 39 patients were given matching placebo tablets. The number of new renal colic episodes per accumulated patient treatment days was 64/287 in the diclofenac group and 119/273 in the placebo group (p < 0.01). This difference was greatest during the first 4 treatment days. A similar trend was found for pain intensity (0-10 cm VAS) with the greatest difference on day 1 (4.3 vs. 2.8, p = 0.05). Side effects, mainly gastrointestinal, were reported for 14% of the treatment days in both treatment groups. Stone expulsion rate was almost identical (28 vs. 29 days), regardless of stone size. Readmission rate to Oslo Emergency Hospital/other hospitals were 10 and 67% (p < 0.001). In conclusion, oral treatment with diclofenac was effective as short-term prophylaxis of new colic episodes, especially during the first 4 days, and reduces the number of hospital readmissions significantly. The stone passage rate appears not to be affected.
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PMID:Oral diclofenac in the prophylactic treatment of recurrent renal colic. A double-blind comparison with placebo. 852 32

Renal colic arises in acute ureteral obstruction and indicates a sharp rise in intrapelvic pressure (up to 150 mm Hg). The diagnosis of renal colic is made basing on direct and indirect measurements of intrapelvic pressure. Ultrasound in renal colic detects dilatation of the calices and pelvis on the colic side, ureterolith can be also revealed by ultrasound. The authors used extracorporeal lithotripsy for fragmentation of the stone and colic relief in 68 patients. The colic stopped in all the cases. This method is extremely valuable in cases when spasmolytic and analgetic drugs, other conservative modalities fail.
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PMID:[Extracorporeal lithotripsy in the treatment of renal colic]. 892 26

We have conducted a double-blind randomised placebo controlled trial with oral diclofenac to study the prophylactic effect on recurrence of renal colic and rate of spontaneous stone expulsion. 41 patients were given 50 mg oral diclofenac three times a day for seven days after being discharged for a colic episode from Oslo Emergency Hospital and 39 patients were given matching placebo tablets. The number of new ureteral colic episodes per accumulated patient treatment days was 64/287 in the diclofenac group and 119/273 in the placebo group (p < 0.01). The difference was greatest during the first four days of treatment. A similar trend was found for pain intensity, with the greatest difference on day one. There was no difference in reported type or frequency of side effects in the two treatment groups. Stone expulsion rate was almost identical. The effect of the treatment was not affected by fluid intake. Re-admission rates to Oslo Emergency Hospital or other hospitals were 10 and 67% (p < 0.001).
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PMID:[Diclofenac in the short-term prevention of recurrent colic from ureteral calculi. A placebo controlled double-blind study]. 897

According to various authors the frequency of inflammatory complications associated with the use of IUDs ranges from 2% to 8%. Gynecological surgery on account of purulent, inflammatory disease of the adnexa uteri associated with IUD use (4-7%), damaging the urinary bladder and the ureters, is not uncommon. At the urological clinic of Stavropol, Russia, a total of 64 women who were in the 18-64 year age range, had urological complications, and had worn IUDs for 6 months to 14 years were observed. 34 of them presented with acute pyelonephritis attacks, 29 of them with renal colic and acute pyelonephritis, and 26 with renal calculi. In 22 women the acute pyelonephritis attacks were treated with antibiotics and uro-antiseptics. 19 of the 29 women who had renal colic and acute pyelonephritis underwent catheterization and drainage of the renal pelvis, and all of them passed fine kidney stones after the removal of their catheters. Urethral catheterization and drainage of the renal pelvis were performed in 31 patients in order to arrest renal colic and acute pyelonephritic attacks. The catheters stayed in for 2-3 days. For all these women removal of the IUD was recommended. 1 patient underwent ureterolithotomy. 8 patients rejected the removal of the IUD and had recurrent renal colics and acute pyelonephritis attacks. Removal of the IUD arrested pyelonephritis and lithogenesis in the kidneys. In 1 case of IUD removal injury to the uterine cervix and urinary bladder occurred, resulting in a vesicovaginal fistula. The report concludes with the case of a 44-year old patient who had worn a plastic IUD for 14 years.
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PMID:[The urological complications of contraception using intrauterine coils]. 941 10

The objective of this study was to determine whether helical computed tomography (CT) performed without oral or intravenous contrast agents is accurate in the evaluation of patients with suspected acute renal colic. One hundred consecutive patients with suspected renal colic or ureteral colic were referred by our institution's emergency department for unenhanced helical CT scans. We reviewed the original radiographic report for each patient and recorded the size and location of ureteral calculi and other concurrent urinary tract calculi, if any. We also recorded the presence or absence of hydronephrosis, hydroureter, perinephric edema, and periureteral edema. A total of 49 patients had ureteral calculi, 17 patients had only renal calculi, and 34 patients had no stones. Forty-nine patients had ureteral calculi, and 40 (82%) of these 49 patients had associated CT signs including hydroureter and periureteral edema. Calculi were present in the proximal ureter in 11 patients, the midureter in seven patients, and the distal ureter including ureterovesical junction in 31 patients. Calculi were seen elsewhere in the urinary tract and renal pelvis in 44 patients. Other diagnostic tests and stone passage were used to confirm the CT diagnosis of ureteral stones. The sensitivity and specificity of helical CT in evaluating ureteral calculi were 100% and 94%, respectively. Sixteen extraurinary lesions were detected in 34 patients who had no urinary calculi. Most extraurinary lesions (81%) were deemed the cause of acute flank pain. The room time for CT averaged 26 min, compared to 69 min for intravenous urography (IVU). The charge for CT was $600 compared to $400 for IVU in our institution. Unenhanced helical CT was fast and accurate in determining the cause of colic and proved to be highly accurate for emergency situations.
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PMID:Can noncontrast helical computed tomography replace intravenous urography for evaluation of patients with acute urinary tract colic? 1019 91

The article presents the analysis of using percutaneous paracentetic nephrostomy (PPN) in diagnosis and treatment of 31 children aged from 11 months to 15 years with renal colic. Decompression of the kidney arrested the colic and inflammation progression, allowed to study renal function, to determine causes of acute supravesical occlusion. Seven patients with associated pelvic and ureter stones as a cause of acute occlusion with obstruction in the peripelvic ureter site have undergone one-stage reconstructive operations with stone removal. In diagnosis of isolated pelvic stones (4 children) nephrolithoextraction through nephrostomy canal was performed. Pilot experience with PPN in renal colic has demonstrated good results and allowed to expect good perspectives of introduction of minor invasive methods in urgent practice of pediatric urology.
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PMID:[Percutaneous paracentric nephrostomy in acute occlusion of upper urinary tracts in children]. 1118 12

Kidney stones are common in industrialised nations: up to 15% of white men and 6% of all women will develop one stone, with recurrence in about half these people. Risk factors for formation of stones include urinary promoters (calcium, urate, cystine, and sodium) and urinary inhibitors (magnesium, citrate, and nephrocalcin). Acute renal colic can be precipitated by dehydration and reduced urine output, increased protein intake, heavy physical exercise, and various medicines. Such colic manifests as severe loin pain and can be accompanied by frequent urination, dysuria, oliguria, and haematuria. Documentation of stone characteristics is extremely important: type, size, location, and underlying metabolic abnormalities. Such details can be obtained with a combination of biochemical investigations, microscopic examination of urine under polarised light, and an intravenous pyelogram. Ultrasonography and plain abdominal radiographs are also useful, especially for patients unable to tolerate an intravenous pyelogram. Acute therapy includes complete pain relief, rehydration, and encouragement of diuresis. Long-term management encompasses education of patients with regard to diet and fluid intake, control of calciuria, citrate replacement, and treatment of any underlying urinary-tract infection or metabolic abnormality. Stones smaller than 5 mm normally pass spontaneously, whereas larger stones, as big as 2 cm, are best treated with extracorporeal shock-wave lithotripsy. All physicians should have a clear understanding of the pathogenesis and clinical management (acute treatment and prevention of recurrence) of renal stone disease.
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PMID:Recurrent renal stone disease-advances in pathogenesis and clinical management. 1180 20

In this paper we describe a case in which acute renal colic was associated with elimination of multiple hyphal masses of Aspergillus flavus. Also, we reviewed the literature on similar cases and we found a similar pattern characterized by a marked male predominance, association with at least one underlying medical condition that predisposes to fungal infection, the presence of local symptoms resembling acute ureteral colic, and the absence of systemic manifestations. Moreover, our data suggest that Aspergillus balls must be suspected when a diabetic and intravenous drug user presents with acute renal colic and that non-obstructive renal aspergillosis may be initially treated with itraconazole.
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PMID:Isolated renoureteric aspergilloma due to Aspergillus flavus: case report and review of the literature. 1153 27

The equivalent sensitivity of non-contrast computed tomography (NCCT) and intravenous urography (IVU) in the diagnosis of suspected ureteric colic has been established. Approximately 50% of patients with suspected ureteric colic do not have a nephro-urological cause for pain. Because many such patients require further imaging studies, NCCT may obviate the need for these studies and, in so doing, be more cost effective and involve less overall radiation exposure. The present study compares the total imaging cost and radiation dose of NCCT versus IVU in the diagnosis of acute flank pain. Two hundred and twenty-four patients (157 men; mean age 45 years; age range 19-79 years) with suspected renal colic were randomized either to NCCT or IVU. The number of additional diagnostic imaging studies, cost (IVU A$136; CTU A$173), radiation exposure and imaging times were compared. Of 119 (53%) patients with renal obstruction, 105 had no nephro-urological causes of pain. For 21 (20%) of these patients an alternative diagnosis was made at the initial imaging, 10 of which were significant. Of 118 IVU patients, 28 (24%) required 32 additional imaging tests to reach a diagnosis, whereas seven of 106 (6%) NCCT patients required seven additional imaging studies. The average total diagnostic imaging cost for the NCCT group was A$181.94 and A$175.46 for the IVU group (P < 0.43). Mean radiation dose to diagnosis was 5.00 mSv (NCCT) versus 3.50 mSv (IVU) (P < 0.001). Mean imaging time was 30 min (NCCT) versus 75 min (IVU) (P < 0.001). Diagnostic imaging costs were remarkably similar. Although NCCT involves a higher radiation dose than IVU, its advantages of faster diagnosis, the avoidance of additional diagnostic imaging tests and its ability to diagnose other causes makes it the study of choice for acute flank pain at Christchurch Hospital.
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PMID:Computed tomography versus intravenous urography in diagnosis of acute flank pain from urolithiasis: a randomized study comparing imaging costs and radiation dose. 1153 51


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