Loin Pain Haematuria Syndrome - A Narrative Review of Pain Management Strategies

Grech, Andrew Kristian

doi:10.3344/kjp.2016.29.2.78

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…Many patients suffering from LPHS have become addicted to narcotics [4,7]. In an attempt to avoid this, other management strategies have been attempted to reduce pain and hematuria symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Other research studies suggest that LPHS may be caused by coagulopathies, hypersensitivity reactions, or renal vasospasm [4][5]. Intratubular crystal formation has been identified in roughly half of the patients diagnosed with primary LPHS; leading researchers believe the microcrystal deposition can be linked to the underlying cause of LPHS [6][7].…”

Section: Introductionmentioning

confidence: 99%

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A Case Report of the Ongoing Management and Comorbidities of Loin Pain Hematuria Syndrome with an Unusual Presentation

Meier¹,

Grove²,

Gromley³

et al. 2022

Cureus

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Loin pain hematuria syndrome (LPHS) is a rare chronic pain disorder that is poorly understood. LPHS presents as unilateral or bilateral flank pain with hematuria of unknown cause. The lack of knowledge surrounding pathogenesis and effective treatment has resulted in missed diagnoses as well as narcotic addiction in some patients. In this case, we describe the presentation and management of a 30-year-old female with a history of anxiety, depression, chronic pelvic bleeding, and pain recently diagnosed with LPHS after a total hysterectomy. She presented with ongoing pelvic pain symptoms with recent tachycardia, recurrent urinary tract infections, and nephrolithiasis. Loin pain hematuria presents as a particularly rare and difficult diagnosis to manage with multiple, sometimes unpredictable, comorbidities. This case serves as an example of a unique presentation with additional uncommon symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case Report of the Ongoing Management and Comorbidities of Loin Pain Hematuria Syndrome with an Unusual Presentation

Meier¹,

Grove²,

Gromley³

et al. 2022

Cureus

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“…A recent narrative review on pain management strategies in LPHS indicates that catheter-based renal denervation seems to be a promising approach for the treatment of LPHS patients. 3 Surgical renal denervation has traditionally been a potential last line pain management strategy in LPHS cases refractory to noninvasive modalities. Surgical denervation via laparoscopic intervention performed in 9 patients over 10 years revealed favorable data with a curative intervention rate of 44% (median follow-up of 70.5 months).…”

Section: Systematic Reviews/observational Studiesmentioning

confidence: 99%

“…The disease imposes a significant health and economic impact in terms of loss of productivity and quality of life in a young population as they are shuffled between numerous health care providers. 3 Multiple visits to the emergency rooms add to the significant burden of investigations and consultations. The debilitating pain leads to increased absenteeism; fragments of interpersonal relationships increase the risk of mood disorders and severely interrupt the quality of life.…”

Section: Problem To Be Addressedmentioning

confidence: 99%

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Feasibility Study of a Randomized Controlled Trial Investigating Renal Denervation as a Possible Treatment Option in Patients With Loin Pain Hematuria Syndrome

Prasad

Jafari

Kour

et al. 2020

Can J Kidney Health Dis

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Background: Loin Pain Hematuria Syndrome (LPHS) is a poorly understood clinical condition characterized by severe pain localized to the kidney but in the absence of identifiable urinary tract disease. There is no consensus on optimal treatment strategies for LPHS. Case reports and series have shown renal denervation via catheter-based radiofrequency ablation to be an effective therapeutic option for the treatment of LPHS. To determine whether catheter-based renal denervation is a meaningful addition to the treatment options in these often-difficult-to-treat LPHS patients, a randomized clinical trial is needed. Prior to conducting a definitive trial that focuses on patient outcomes, ensuring the feasibility of undertaking such a trial is required. As such, we will conduct a single-center randomized control feasibility trial designed to determine viability and provide framework and direction for a larger trial. Objective: The objective of the study is to determine whether conducting a randomized trial of renal denervation versus sham procedure is feasible in terms of recruitment and eligibility, and adequacy of follow-up in LPHS patients. Design: Single-center double-blinded, parallel-group, partial crossover, sham-controlled, randomized feasibility trial of 10 LPHS patients. Setting: Regina General Hospital in Regina, Saskatchewan, Canada. Patients: Ten LPHS patients who require opioid therapy. Measurements: The main feasibility outcome measures include proportion of target patients who undergo the procedure (treatment or sham) within 6 months; proportion of randomized participants (treatment or control) who entirely complete the follow-up measures at 6 weeks, 3 and 6 months; proportion of the participants who were randomized to control group, cross over after 6 months and opt-in renal denervation treatment; proportion of the crossover participants who complete the follow-up measures at 6 weeks, 3 and 6 months. Pain will be assessed using Brief Pain Inventory Score, McGill Pain Questionnaire, and a pain diary. Mood, disability, and quality of life will be measured by Center for Epidemiologic Studies Depression Scale, Oswestry Disability Index, EuroQol-5D, and Short Form Health Survey Questionnaire, respectively. Methods: Eligible participants will be randomized into either renal denervation (treatment group) or a sham treatment (control group). Data (pain, quality of life, mood, disability) will be collected from both groups at baseline, 6 weeks, 3 and 6 months after the intervention. After the initial 6-month follow-up is over, the participants who received the sham procedure will cross over into the treatment group and will be followed for an additional 6 months in the same manner as the treatment group. Descriptive statistics will be used to report outcomes for all patients. Limitations: Single-center study, small sample size. Conclusions: The lessons learnt from this trial will lay the framework and direction for conducting a multisite randomized controlled trial involving a larger cohort of patients. Trial registration: ClinicalTrials.gov (NCT04332731).

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Renal Denervation and Kidney Pain Syndromes

Lugo-Gavidia,

Kiuchi,

Carnagarin

et al. 2023

Renal Denervation

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Loin Pain Haematuria Syndrome - A Narrative Review of Pain Management Strategies

Cited by 5 publications

References 33 publications

A Case Report of the Ongoing Management and Comorbidities of Loin Pain Hematuria Syndrome with an Unusual Presentation

A Case Report of the Ongoing Management and Comorbidities of Loin Pain Hematuria Syndrome with an Unusual Presentation

Feasibility Study of a Randomized Controlled Trial Investigating Renal Denervation as a Possible Treatment Option in Patients With Loin Pain Hematuria Syndrome

Renal Denervation and Kidney Pain Syndromes

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