Renal colic Severe pain from retention of urine in the kidney

Renal colic arises when an urinary stone travels from the kidney to the bladder along the ureter and causes obstruction of the normal flow of urine.

The accumulation of urine inside the kidney leads to its dilation, which causes pain.

Renal colic is characterized by the sudden appearance of severe pain, usually located in the lower back. It is a pain that does not relieve with any position and can radiate to the inguinal region. It may be accompanied by nausea and vomiting.

In the acute phase, and until medical assistance is obtained, it is advisable to ingest a minimum amount of fluids, in order to avoid the production of urine, and to perform moist heat or a hot bath for pain relief.

Correct and timely assessment of patients with renal colic is essential, in order to safely distinguish those who benefit from medical therapy from those who need elective or urgent / emergent surgical intervention.

For better characterization, tests may be carried out, which may include laboratory tests, ultrasound of the kidney and ultrasound of the bladder, radiography of the urinary tract or abdominal and pelvic computed tomography.

In the simplest cases, smaller stones may be eliminated through the urine, being the   elimination monitored and eventually facilitated with medication.

When renal colic is complicated by infection or impaired kidney function, rapid resolution of the obstruction may be urgent in order to avoid complications that can be serious or fatal.

If the stones are bulky and / or persist in the ureter, active removal is required. There are several forms of treatment to do this:

- Chemiodissolution, which consists of dissolving calculi with drugs;

- LEOC (Extracorporeal Shock Wave Lithotrice), which consists of the emission of multiple shock waves focused on the calculi, promoting their fragmentation;

- RIRS (retrograde intrarenal surgery) or Ureterolithextraction, whixh is an endoscopic surgery that consists of the introduction, through the urinary tract, of small-caliber devices - semi-rigid or flexible ureterorenoscopes - in order to fragment the calculi with LASER energy;

- Percutaneous surgery, which consists of the removal or direct fragmentation of more bulky kidney stones through a direct access to the kidney with a small incision in the lumbar region;

- Classic or laparoscopic surgery, in rare and very selected cases.