Acute Ureteral Colic and Fluid Intake

Edna, Tom-Harald; Hesselberg, Fredrik

doi:10.3109/00365598309180164

Cited by 17 publications

(7 citation statements)

References 12 publications

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“…The rate of increase of tension, rather than the absolute value, is the main determinant of pain. 3,7,11,12 Wall tension is greater in the renal pelvis than in the ureter because of the larger radius of the renal pelvis. Consequently, pain is often felt in the flank, even with distal ureteric calculi.…”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

“…Glomerular filtration rate (GFR) and urine flow decrease as ureteric pressure rises. 3 Eventually, both renal blood flow and ureteric pressure fall, and blood flow to the contralateral kidney is increased. 4…”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

“…No difference in the rapidity of pain relief or level of analgesia was observed. 3 On that basis, hydration beyond normal maintenance, and replacement of losses in the patient with vomiting, is not recommended.…”

Section: Intravenous Fluid Therapymentioning

confidence: 99%

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Renal colic: A diagnostic and therapeutic review

Hardcastle¹

1999

Emergency Medicine

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Renal colic is a common presenting problem in emergency departments where the focus of treatment is on prompt analgesia, limited supportive investigations and exclusion of other serious disorders. This review gives an overview of the pathophysiology of this condition and those aspects of its care that are specific to the emergency department. The role of narcotics and non‐steroidal anti‐inflammatory drugs in treatment is examined, and the available imaging techniques are described and evaluated. Alternative diagnoses and indications for hospital admission are discussed.

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Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

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Renal colic: A diagnostic and therapeutic review

Hardcastle¹

1999

Emergency Medicine

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“…There was also no difference in the spontaneous stone passage rate, with 17 of 30 in the fluid deprivation group passing their stone and similarly 18 of 30 in the high fluid administration group [56]. These findings are supported by a more recent randomized trial, which compared narcotic use and stone passage rates of patients administered minimal IV hydration (20 mL/h) to patients randomized to ''forced IV hydration'' (2 L over 2 h).…”

Section: Hydrationmentioning

confidence: 60%

Urological Aspects of Management

Miller

Stoller

2011

Clinic Rev Bone Miner Metab

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Renal colic describes the acute, severe, and paroxysmal pain caused by the obstruction, distension, and resultant increase in intraluminal pressure of the urinary tract. The treatment of renal colic is aimed at relief of symptoms, facilitating urinary drainage to preserve renal function and treat infection and ultimately removal or passage of the obstructing stone. The medical management of renal colic is directed at mitigating, through pharmacologic intervention, one or more of the complex processes contributing to the clinical sequelae of obstruction including pain, nausea, vomiting, and irritative voiding symptoms. Numerous medications and combinations of medications have been employed with varying degrees of clinical success. Urgent interventions are typically directed at bypassing ureteral obstruction in order to palliate the patient until such time as definitive treatment may be accomplished or facilitate drainage to further the treatment of urinary tract infection. Timing and mode of urgent intervention are dependent on clinical factors, clinician expertise, and preference and the availability of specialized equipment. Definitive management of ureteral stones is typically performed in an elective fashion and seeks to balance the risks of intervention with the clinical benefits of the various treatment modalities. Treatment approaches vary according to clinical indications, patient preference, clinician expertise, and the availability of facilities and equipment. This section covers current supporting evidence and rationale, indications and techniques for the medical management, urgent intervention, and definitive management of acute renal colic caused by ureteral stones.

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“…Fluid restriction was also prescribed in one-third of cases, despite the lack of validated eect on AARC [23,24]. Pain management in EDs remains a current practice problem, underlining the need to improve pain assessment in this context [25,26].…”

Section: Discussionmentioning

confidence: 99%