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Renal colic

What is colic?

Renal colic is an episode of very intense lumbar pain, spasm-like, accompanied by general malaise, sweating, nausea and/or vomiting. Not all patients present the same symptoms; some patients report pain in the groin area. Colic usually occurs due to obstruction of the kidney by a stone (lithiasis) found in the ureter or kidney. If this stone is located in the lower ureter, near the bladder, urinary discomfort (when urinating) may occur. If the picture of renal colic is accompanied by fever, it is very likely that there is a urinary tract infection.

What are its causes?

Renal colic is triggered by the presence of urinary lithiasis, i.e. the presence of stones (calculi) in the ureter and/or kidney. When the lithiasis does not allow the urine to follow its natural course, the kidney and urinary tract dilate, causing urine obstruction, which triggers very intense lumbar pain. Not only urinary stones cause renal colic. Anything that occupies the ureter and obstructs the kidney can cause colic. For example, some tumors that grow inside the ureter or outside the ureter, in another organ and compress the urinary system.

Symptoms

  • Severe pain in the lumbar region radiating to the genitalia
  • Pain when urinating
  • Bleeding in the urine (hematuria )
  • Nausea and vomiting
  • Urgent urge to urinate
  • Fever and chills in cases associated with a urinary tract infection.
  • Genital pain

Treatments

Medication: usually, the first treatment is pharmacological, using drugs such as Diclofenac, Ketorolac and indomethacin.

Extracorporeal lithotripsy: it is an outpatient treatment, good extracorporeal lithotripsy equipment does not require anesthesia for the patient to tolerate the treatment. The extracorporeal lithotripsy seeks as a result the fragmentation of the urinary lithiasis, through the application of shock waves generated externally by the lithotripter. The impact of this energy on the calculus causes it to disintegrate and then the lithiasis fragments are eliminated through the urine.

Minimally invasive surgery: when kidney stones, due to their location, could not be treated with extracorporeal lithotripsy or due to the size of the stone (it is very large), a surgery called “Percutaneous nephrolithotripsy (PCNL)” is performed. This surgical procedure consists of extracting the kidney stones through a one centimeter incision in the back, through which the kidney is accessed and all the lithiasis are extracted. The patient must remain hospitalized after this surgery.

Endoscopic lithotripsy: this method is used to remove stones located in the bladder or ureters. Using anesthesia, it is an outpatient procedure that involves inserting a thin tube with a camera (ureteroscope) through the urethra, which allows the stone to be seen and pulverized with the HOLMIUM Laser. The patient is discharged home approximately 5 hours after the ureteroscopy is performed.