Management of acute renal colic in the UK: a questionnaire survey

Abstract

Background: There is great variation in the Accident and Emergency workload and location of Urology services in UK hospitals. This study investigated the relationship of the initial management of acute renal colic with the department workload plus local facilities including location of X-ray and urology services in UK Accident and Emergency (A&E) departments.

Comparison of the therapeutic effects of diclofenac sodium, prednisolone and an alpha blocker for the treatment of renal colic

“…[9] In this double-blind, randomized study, no statistically significant differences were found between the groups in terms of effectiveness or side effects. Lasoye et al [21] identified that the most common treatment agent for acute renal colic in the emergency departments and urology clinics in England is diclofenac sodium. Yilmaz et al divided 114 patients with acute renal colic into 3 groups and treated them with 3 different alpha-blocker therapies.…”

Urological Aspects of Management

“…Similarly, the choice of initial analgesia was found to vary significantly depending on the annual number of patients seen in an emergency department. Among emergency departments categorized as small, 21% utilized opiates as first-line medications compared to 2.9, 5.7, and 12.5% of medium, large, and very large departments, respectively (P = 0.011) [12]. The implementation of a standardized analgesic protocol comprised of a ketorolac and morphine combination resulted in a 49% reduction in time to pain relief among patients seen in the emergency department for renal colic, compared to a matched cohort receiving ad hoc care.…”

Acute Management of Renal Colic and Compliance with National Standards: Closure of the Audit Loop

“…Fifty-five percent of those with recurrent stones have a family history of urolithiasis [3] and having such a history increases the risk of stones by a factor of three [4]. Upon presentation to the A&E department, suspected acute renal colic patients must have a clinical examination and radiological investigations to confirm the diagnosis [5].…”

“…The best imaging study to confirm the diagnosis of a urinary stone in a patient with acute flank pain is unenhanced, helical CT of the abdomen and pelvis [6]. If CT is unavailable, plain abdominal radiography should be performed, since 75 to 90 percent of urinary calculi are radiopaque [5]. Although ultrasonography has high specificity (greater than90 percent), its sensitivity is much lower than that of CT, typically in the range of 11 to24 percent [5].…”

“…If CT is unavailable, plain abdominal radiography should be performed, since 75 to 90 percent of urinary calculi are radiopaque [5]. Although ultrasonography has high specificity (greater than90 percent), its sensitivity is much lower than that of CT, typically in the range of 11 to24 percent [5]. Thus, ultrasonography is not used routinely but is appropriate as the initial imaging test when colic occurs during pregnancy [7].…”