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Nontraumatic Renal Emergencies

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Urological Emergencies In Clinical Practice
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Abstract

Sudden onset of severe pain in the flank is most often due to the passage of a stone formed in the kidney, down through the ureter. The pain is characteristically of very sudden onset, is colicky in nature (waves of increasing severity are followed by a reduction in severity, but it seldom goes away completely), and it radiates to the groin as the stone passes into the lower ureter. The pain may change in location, from the flank to the groin, but the location of the pain does not provide a good indication of the position of the stone, except in those cases where the patient has pain or discomfort in the penis and a strong desire to void, which suggest that the stone may have moved into the intramural part of the ureter. The patient cannot get comfortable and may roll around in agony. Indeed, the majority of women we have seen with radiologically confirmed ureteric stones and who have also had children describe the pain of a ureteric stone as being worse than the pain of labor.

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References

  • Agrawal M, Gupta M, Gupta A, et al. Prospective randomized trial comparing efficacy of alfuzosin and tamsulosin in management of lower ureteral stones. Urology. 2009;73:706–9.

    Article  PubMed  Google Scholar 

  • Aswathaman K, Gopalakrishnan G, Gnanaraj L, et al. Emphysematous pyelonephritis: outcome of conservative management. Urology. 2008;71:1007–9.

    Article  PubMed  Google Scholar 

  • Bove P, Kaplan D, Dalrymple N, et al. Re-examining the value of hematuria testing in patients with acute flank pain. J Urol. 1999;162:685–7.

    Article  PubMed  CAS  Google Scholar 

  • Caro JJ, Trindale E, McGregor M. The risks of death and severe non-fatal reactions with high vs. low osmolality contrast media. AJR. 1991;156:825–32.

    Article  PubMed  CAS  Google Scholar 

  • Dellabella M. Efficacy of tamsulosin in the medical management of juxtavesicalureteral stones. J Urol. 2003;170:2202–5.

    Article  Google Scholar 

  • Grabe M, Bjerklund-Johansen TE, Botto H, Wullt B, Çek M, Naber KG, Pickard RS, Tenke P, Wagenlehner F. The European Association of urology guidelines on urological infections. Arnhem: European Association of Urology; 2012. p. 16.

    Google Scholar 

  • Holm-Nielsen A, Jorgensen T, Mogensen P, Fogh J. The prognostic value of probe renography in ureteric stone obstruction. Br J Urol. 1981;53:504–7.

    Article  PubMed  CAS  Google Scholar 

  • Hussain Z. Use of glyceryl trinitrate patches in patients with ureteral stones: a randomized, double-blind, placebo-controlled study. Urology. 2001;58:521–5.

    Article  PubMed  CAS  Google Scholar 

  • Khadra MH, Pickard RS, Charlton M, et al. A prospective analysis of 1,930 patients with hematuria to evaluate current diagnostic practice. J Urol. 2000;163:524–7.

    Article  PubMed  CAS  Google Scholar 

  • Kobayashi T, Nishizawa K, Mitsumori K, Ogura K. Impact of date of onset on the absence of hematuria in patients with acute renal colic. J Urol. 2003;1770:1093–6.

    Article  Google Scholar 

  • Laerum E, Ommundsen OE, Granseth J, et al. Intramuscular diclofenac versus intravenous indomethacin in the treatment of acute renal colic. Eur Urol. 1996;30:358–62.

    PubMed  CAS  Google Scholar 

  • Leslie SW. An assessment of the clinical efficacy of intranasal desmopressin spray in the treatment of renal colic. BJU Int. 2001;87:322–5.

    Google Scholar 

  • Louca G, Liberopoulos K, Fidas A, et al. MR urography in the diagnosis of urinary tract obstruction. Eur Urol. 1999;35:14.

    Article  Google Scholar 

  • Luchs JS, Katz DS, Lane DS, et al. Utility of hematuria testing in patients with suspected renal colic: correlation with unenhanced helical CT results. Urology. 2002;59:839.

    Article  PubMed  Google Scholar 

  • O’Malley ME, Soto JA, Yucel EK, Hussain S. MR urography: evaluation of a three-dimensional fast spin-echo technique in patients with hydronephrosis. AJR. 1997;168:387–92.

    Article  PubMed  Google Scholar 

  • Parsons JK, Hergan LA, Sakamoto K, et al. Efficacy of alpha blockers for the treatment of ureteral stones. J Urol. 2007;177:983–7.

    Article  PubMed  CAS  Google Scholar 

  • Pearle MS. Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol. 1998;160:1260.

    Article  PubMed  CAS  Google Scholar 

  • Preminger GM. 2007 Guideline for the management of ureteral calculi Joint EAU/AUA Nephrolithiasis Guideline Panel. J Urol. 2007;178:2418–34.

    Article  PubMed  Google Scholar 

  • Rubin RH, Shapiro ED, Andriole VT, Davis RJ, Stamm WE. Evaluation of new anti-infective drugs for the treatment of urinary tract infection. Infectious Diseases Society of America and the Food and Drug Administration. Clin Infect Dis. 1992;15 Suppl 1:S216–7.

    Article  PubMed  Google Scholar 

  • Smith RC, Verga M, McCarthy S, Rosenfield AT. Diagnosis of acute flank pain: value of unenhanced helical CT. AJR. 1996;166:97–101.

    Article  PubMed  CAS  Google Scholar 

  • Springhart WP, Marguet CG, Sur RL, et al. Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial. J Endourol. 2006;20:713–6.

    Article  PubMed  Google Scholar 

  • Thomson JM, Glocer J, Abbott C, et al. Computed tomography versus intravenous urography in diagnosis of acute flank pain from urolithiasis: a randomized study comparing imaging costs and radiation dose. Australas Radiol. 2001;45:291–7.

    Article  PubMed  CAS  Google Scholar 

  • Thorley JD, Jones SR, Sanford JP. Perinephric abscess. Medicine. 1974;58:441.

    Article  Google Scholar 

  • Yilmaz E, Batislam E, Basar MM, et al. The comparison and efficacy of 3 different alpha 1 adrenergic blockers for distal ureteric stones. J Urol. 2005;173:2010.

    Article  PubMed  CAS  Google Scholar 

  • Zehri AA, Ather MH, Abbas F, Biyabani SR. Preliminary study of efficacy of doxazosin as a medical expulsive therapy of distal ureteric stones in a randomized clinical trial. Urology. 2010;75:1285–8.

    Article  PubMed  Google Scholar 

  • Zhangqun Y, Huan Y, Hong L, et al. A multicentre, prospective, randomized trial: comparative efficacy of tamsulosin and nifedipine in medical expulsive therapy for distal ureteric stones with renal colic. Br J Urol Int. 2010;108:276–9.

    Google Scholar 

  • Zhu Y. Alpha blockers to assist stone clearance after extra-corporeal shock wave lithotripsy: a meta-analysis. BJU Int. 2009;106:256–61.

    Article  PubMed  Google Scholar 

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Correspondence to John Reynard DM, FRCS (Urol) .

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© 2013 Springer-Verlag London

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Reynard, J. (2013). Nontraumatic Renal Emergencies. In: Hashim, H., Reynard, J., Cowan, N., Wood, D., Armenakas, N. (eds) Urological Emergencies In Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-4471-2720-8_3

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  • DOI: https://doi.org/10.1007/978-1-4471-2720-8_3

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  • Online ISBN: 978-1-4471-2720-8

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