Nephrolithiasis: surgical treatment and metabolic evaluation
J Kellogg Parsons, E James Wright in The Brady Urology Manual, 2019
Renal colic: Classically described as flank pain, often acute in onset, radiating to the ispilateral abdomenDistal ureteral stones may be associated with ipsilateral groin, testicular (in men – can mimic torsion or epididymitis), and vulvar (in women) painUsually waxes and wanes; continuous pain may indicate pyelonephritisIn contrast to patients with peritonitis, patients with renal colic will frequently move about to find a more comfortable position.
Renal Disease; Fluid and Electrolyte Disorders
John S. Axford, Chris A. O'Callaghan in Medicine for Finals and Beyond, 2023
Acute ureteric obstruction causes renal colic with acute and intense flank pain, often radiating to the groin, and sometimes nausea, vomiting, abdominal discomfort, dysuria, renal tenderness and haematuria. On examination, there may be renal tenderness on palpation if there is urinary tract obstruction. Bladder stones can halt urine flow suddenly, with penile or perineal pain that may be relieved by lying down. There are three main sites where stones lodge in the ureter: Pelviureteric junction: Pain refers to the loin and back.Pelvic brim: Pain refers to the testis or labium majus.Entry site of the ureter into the bladder: Pain refers to the tip of the penis or perineum.
Single best answer (SBA)
Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon in Radiology for Undergraduate Finals and Foundation Years, 2018
CT is now the investigation of choice for patients with suspected renal colic. Usually an unenhanced examination is sufficient. In cases where there is some doubt as to whether a calcific density lies inside or outside a ureter, a second delayed phase after the administration of contrast medium to outline the ureter may be employed. Ultrasound is useful for assessment of hydronephrosis or for investigation of other causes of haematuria but is less sensitive than CT at detection of calculi particularly within the ureter. KUB still plays a role in the follow up of radio-opaque calculi. MRI is not indicated. The advent of CT has meant that the IVU is now employed far less frequently when CT is available; its role now is limited to specialised situations such as the investigation of post-operative complications.
Emergency vs elective ureteroscopy for a single ureteric stone
Published in Arab Journal of Urology, 2021
Abdullatif Al-Terki, Majd Alkabbani, Talal A. Alenezi, Tariq F. Al-Shaiji, Shabir Al-Mousawi, Ahmed R. El-Nahas
The retrospective design is the main limitation of the present study, as some data were not available such as operative time. We tried to do a fair comparison by excluding elective cases with an already present ureteric stent because all emergency cases had no stents. However, there was still some inevitable selection bias, as the stones were significantly smaller in the EM Group. This led to more use of baskets in the EM Group and more use of laser lithotripsy the EL Group. Also, the EM Group had more hydronephrosis than the EL Group, which resulted in the insertion of more ureteric stents (92% vs 72%). Another significant difference was observed in serum creatinine levels, as it was significantly higher in the EM Group (1.5 vs 0.9 mg/dL). This is expected, as acute renal colic can be associated with nausea and vomiting that may cause dehydration. We performed emergency URS in these patients because Abdel-Kader [20] reported the safety of emergency URS in patients with calcular anuria and high serum creatinine at a mean level of 3.5 mg/dL.
Resistant hypertension after renal infarction in a man with fibromuscular dysplasia
Published in Blood Pressure, 2021
Nikolina Bukal, Dražen Perkov, Luka Penezić, Bojan Jelaković, Živka Dika
Several aspects of this presentation are intriguing, but some at the same time at start were misleading. First, renal colic is a frequent complaint evaluated at EDs, but renal infarction is its rare cause with an incidence of about 0.004–0.007% [5–7]. In a French single-centre retrospective angiographic study of 186 cases of renal infarction, 81.8% were caused by renal artery lesion predominantly atherosclerosis disease (34.4%) followed by dissecting haematoma (23.2%) and fibromuscular dysplasia (19.2%) [3]. According to the US and European/International fibromuscular dysplasia (FEIRI) registry, renal artery dissection and renal infarction were more common presentation of FMD in men than women [2,8]. At the time of renal colic, our patient had normal BP and normal laboratory data, except mildly decreased eGFR.
US-guided laser treatment of parathyroid adenomas
Published in International Journal of Hyperthermia, 2020
Liat Appelbaum, Shraga Nahum Goldberg, Tiziana Ierace, Giovanni Mauri, Luigi Solbiati
The changes in serum PTH and calcium levels before ablation and at each follow-up period are summarized in Table 2. Serum PTH and calcium levels were significantly lower at 1, 12 and 24 months compared to before treatment (p < 0.01 for all comparisons), with stable reductions seen when comparing 12 to 24 m (p > 0.50). In 11/12 (91.7%) patients, PTH and calcium levels returned to normal, and 99mTc sestamibi scintigraphy confirmed success of the ablation (Figures 1 and 2). These, together with disappearance of nodule-related symptoms including ostealgia (in all five cases where present), and vomiting (three patients) by 6 months post-ablation revealed the effectiveness of ablation. Likewise, none of the five patients with repeated bouts of renal colic reported further episodes over the 2-year follow-up.
Related Knowledge Centers
- Abdominal Pain
- Hydronephrosis
- Reflex
- Smooth Muscle
- Urine
- Peristalsis
- Ureter
- Urinary System
- Kidney Stone Disease
- Spasm