Abstract
Colic describes any severe spastic pain originating from distention or obstruction of a hollow organ. In particular, renal colic refers to sharp paroxysmal pain originating from spasm in or distention of the renal capsule or ureter or pain resulting from ureteral obstruction. It is perceived as intermittent sharp pain generally originating from the flank and occasionally radiating to the lower abdomen, groin, scrotum, or vulva and has variably been estimated to affect between 1 and 10% of the population at some time in their lives (1–3).
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Holdgate A, Chan T. How accurate are emergency clinicians at interpreting noncontrast computed tomography for suspected renal colic? Acad Emerg Med 2003; 10: 315–319.
Shokeir AA. Renal colic: pathophysiology, diagnosis and treatment. Eur Urol 2001; 39: 241–249.
Hiatt RA, Dales LG, Friedman GD, et al. Frequency of urolithiasis in a prepaid medical care program. Am J Epidemiol 1982; 115: 255–265.
Dalrymple NC, Verga M, Anderson KR, et al. The value of unenhanced helical computerized tomography in the management of acute flank pain. J Urol 1998; 159: 735–740.
Bove P, Kaplan D, Dalrymple N, et al. Reexamining the value of hematuria testing in patients with acute flank pain. J Urol 1999; 162: 685–687.
Luchs JS, Katz DS, Lane MJ, et al. Utility of hematuria testing in patients with suspected renal colic: correlation with unenhanced helical CT results. Urology 2002; 59: 839–842.
Clark AJ. Norman RW. “Mirror pain” as an unusual presentation of renal colic. Urology 1998; 51: 116–118.
Power RE, Winter DC, Kelly CJ. A near fatal case of renal colic. J Urol 2001; 165: 1987.
Korzets Z, Plotkin E, Bernheini J, et al. The clinical spectrum of acute renal infarction. Isr Med Assoc J 2002; 4: 781–784.
Talner L, Vaughan M. Nonobstructive renal causes of flank pain: findings on noncontrast helical CT (CT KUB). Abdom Imaging 2003; 28: 210–216.
Gluckman GR, Stoller M. Munchausen’s syndrome: manifestation as renal colic. Urology 1993; 42: 347–350.
Chew BH, Pace KT, Honey RJ. Munchausen syndrome presenting as gross hematuria in two women. Urology 2002; 59: 601.
Li SF, Ender K. Toothpick injury mimicking renal colic: case report and systematic review. J Emerg Med 2002; 23: 35–38.
Efstathiou SP, Pefanis AV, Tsioulos DI, et al. Acute pyelonephritis in adults: prediction of mortality and failure of treatment. Arch Intern Med 2003; 163: 1206–1212.
Meng MV, Mario LA, McAninch JW. Current treatment and outcomes of perinephric abscesses. J Urol 2002; 168: 1337–1340.
Auge BK, Munver R, Kourambas J, et al. Endoscopic management of symptomatic caliceal diverticula: a retrospective comparison of percutaneous nephrolithotripsy and ureteroscopy. J Endourol 2002; 16: 557–563.
Wulfsohn MA. Pyelocaliceal diverticula. J Urol 1980; 123: 1–8.
Wogan JM. Pyelocalyceal diverticulum: an unusual cause of acute renal colic. J Emerg Med 2002; 23: 19–21.
Mulgi A, Williams JW, Nettleman M. Renal colic. Utility of the plain abdominal roentgenogram. Arch Intern Med 1991; 151: 1589–1592.
Yilmaz S, Sindel T, Arslan G, et al. Renal colic: comparison of spiral CT, US and IVU in the detection of ureteral calculi. Eur Radiol 1998; 8: 212–217.
Roth CS, Bowyer BA, Berquist TH. Utility of the plain abdominal radiograph for diagnosing ureteral calculi. Ann Emerg Med 1985; 14: 311–315.
Levine JA, Neitlich J, Verga M, et al. Ureteral calculi in patients with flank pain: correlation of plain radiography with unenhanced helical CT. Radiology 1997; 204: 27–31.
Assi Z, Platt JF, Francis IR, et al. Sensitivity of CT scout radiography and abdominal radiography for revealing ureteral calculi on helical CT: implications for radiologic follow-up. AJR Am J Roentgenol 2000; 175: 333–337.
Gorelik U, Ulish Y, Yagil Y. The use of standard imaging techniques and their diagnostic value in the work up of renal colic in the setting of intractable flank pain. Urology 1996; 47: 637–642.
Haddad MC, Sharif HS, Shahed MS, et al. Renal colic: diagnosis and outcome. Radiology 1992; 184: 83–88.
Pfister SA, Deckart A, Laschke S, et al. Unenhanced helical computed tomography vs intravenous urography in patients with acute flank pain: accuracy and economic impact in a randomized prospective trial. Eur Radiol 2003; 13(11): 2513–2520.
Smith RC, Rosenfield AT, Choe K A, et al. Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography. Radiology 1995; 194: 789–794.
Smith RC, Verga M, McCarthy S, et al. Diagnosis of acute flank pain: value of unenhanced helical CT. AIR Am J Roentgenol 1996; 166: 97–101.
Shokcir AA, Abdulmaaboud M. Prospective comparison of nonenhanced helical computerized tomography and Doppler ultrasonography for the diagnosis of renal colic. J Urol 2001; 165: 1082–1084.
Ahmad NA, Ather MH, Rees J. Unenhanced helical computed tomography in the evaluation of acute Hank pain. Int J Urol 2003; 10: 287–292.
Boulay I, Holtz P, Foley WD, et al. Ureteral calculi: diagnostic efficacy of helical CT and implications for treatment of patients. AJR Am J Roentgenol 1999; 172: 1485–1490.
Fielding JR. Fox LA, Heller H, et al. Spiral CT in the evaluation of flank pain: overall accuracy and feature analysis. J Comput Assist Tomogr 1997; 21: 635–638.
Kobayashi T, Nishizawa K, Watanabe J, et al. Clinical characteristics of ureteral calculi detected by nonenhanced computerized tomography after unclear results of plain radiography and ultra sonography. J Urol 2003; 170: 799–802.
Blake SP, McNicholas MM, Raptopoulos V. Nonopaque crystal deposition causing ureteric obstruction in patients with HIV undergoing indinavir therapy. AJR Am J Roentgenol 1998; 171: 717–720.
Boridy IC, Kawashima A, Goldman SM, et al. Acute ureterolithiasis: nonenhanced helical CT findings of perinephric edema for prediction of degree of ureteral obstruction. Radiology 1999; 213: 663–667.
German I, Lantsberg S, Crystal P, et al. Non contrast computerized tomography and dynamic renal scintigraphy in the evaluation of patients with renal colic: are both necessary? Eur Urol 2002; 42: 188–191.
Dalrymple NC, Casford B, Raiken DP, et al. Pearls and pitfalls in the diagnosis of ureterolithiasis with unenhanced helical CT. Radiographics 2000; 20: 439 447.
Bell TV, Fenlon HM, Davison BD, et al. Unenhanced helical CT criteria to differentiate distal ureteral calculi from pelvic phleboliths. Radiology 1998; 207: 363–367.
Kawashima A, Sandier CM, Boridy IC, et al. Unenhanced helical CT of ureterolithiasis: value of the tissue rim sign. AJR Am J Roentgenol 1997; 168: 997–1000.
Heneghan JP, Dalrymple NC, Verga M, et al. Soft-tissue “rim” sign in the diagnosis of ureteral calculi with use of unenhanced helical CT. Radiology 1997; 202: 709–711.
Older RA, Jenkins AD. Stone disease. Urol Clin North Am 2000; 27: 215–229.
Al-Chaer ED, Traub RJ. Biological basis of visceral pain: recent developments. Pain 2002; 96: 221–225.
Moody TE, Vaughn ED Jr, Gillenwater JY. Relationship between renal blood flow and ureteral pressure during 18 hours of total unilateral urethral occlusion. Implications for changing sites of increased renal resistance. Invest Urol 1975; 13: 246–251.
Cadnapaphornchai P, Aisenbrey G, McDonald KM, et al. Prostaglandin-mediated hyperemia and renin-mediated hypertension during acute ureteral obstruction. Prostaglandins 1978; 16: 965–971.
Holmlund D, Sjodin JG. Treatment of ureteral colic with intravenous indomethacin. J Urol 1978; 120: 676–677.
Holmlund DE, Sjodin JG. Indomethacin in the treatment of ureteral colic. Surg Forum 1978; 29: 639–641.
Lundstam S, Sengupta CH, Timbal Y, et al. Diclofenac sodium in renal colic. Practitioner 1984; 228: 704–705.
Marsala F, Cavrini P, Bufalino L, et al. Treatment of acute pain of ureteral and biliary colic with naproxen sodium administered by the parenteral route. Int J Clin Pharmacol Res 1986; 6: 495–500.
Labrecque M, Dostaler LP, Rousselle R, et al. Efficacy of nonsteroidal anti-inflammatory drugs in the treatment of acute renal colic. A meta-analysis. Arch Intern Med 1994; 154: 1381–1387.
Ginifer C, Kelly AM. Administration of rectal indomethacin does not reduce the requirement for intravenous narcotic analgesia in acute renal colic. Eur J Emerg Med 1996; 3: 92–94.
Sedor JR, Davidson EW, Dunn MJ. Effects of nonsteroidal anti-inflammatory drugs in healthy subjects. Am J Med 1986; 81: 58–70.
Gambaro G, Perazella MA. Adverse renal effects of anti-inflammatory agents: evaluation of selective and nonselective cyclooxygenase inhibitors. J Intern Med 2003; 253: 643–652.
Perlmutter A, Miller L, Trimble LA, et al. Toradol, an NS AID used for renal colic, decreases renal perfusion and ureteral pressure in a canine model of unilateral ureteral obstruction. J Urol 1993; 149: 926–930.
Brater DC. Effects of nonsteroidal anti-inflammatory drugs on renal function: focus on cyclooxygenase-2-selective inhibition. Am J Med 1999; 107(6A): 65S–70S.
Shokeir AA, Abdulmaaboud M, Farage Y, et al. Resistive index in renal colic: the effect of nonsteroidal anti-inflammatory drugs. BJU Int 1999; 84: 249 251.
Kinn AC, Larsson SA, Nelson E, et al. Diclofenac treatment prolongs renal transit time in acute ureteral obstruction: a renographic study. Eur Urol 2000; 37: 334–338.
Oosterlinck W, Philp NH, Charig C, et al. A double-blind single dose comparison of intramuscular ketorolac tromethamine and pethidine in the treatment of renal colic. J din Pharmacol 1990; 30: 336–341.
Lcnnon GM, Bourke J, Ryan PC, et al. Pharmacological options for the treatment of acute ureteric colic. An in vitro experimental study. Br J Urol 1993; 71: 401–407.
Larsen LS, Miller A, Allegra JR. The use of intravenous ketorolac for the treatment of renal colic in the emergency department. Am J Emerg Med 1993; 11: 197–199.
Larkin GL, Peacock WFT, Pearl SM, et al. Efficacy of ketorolac tromethamine vs meperidine in the ED treatment of acute renal colic. Am J Emerg Med 1999; 17: 6–10.
Cordell WH, Wright SW, Wolfson AB, et al. Comparison of intravenous ketorolac, meperidine, and both (balanced analgesia) for renal colic. Ann Emerg Med 1996; 28: 151–158.
Stein A, Ben Dov D, Finkel B, et al. Single-dose intramuscular ketorolac vs diclofenac for pain management in renal colic. Am J Emerg Med 1996; 14: 385–387.
Cohen E, Hafner R, Rotenberg Z, et al. Comparison of ketorolac and diclofenac in the treatment of renal colic. Eur J din Pharmacol 1998; 54: 455–458.
Edwards JE, Meseguer F, Faura C, et al. Single dose dipyrone for acute renal colic pain. Cochrane Database Syst Rev 2002; CD003867.
Al-Waili NS, Saloom KY. Intramuscular piroxicam vs intramuscular diclofenac sodium in the treatment of acute renal colic: double-blind study. Eur J Med Res 1999; 4: 23–26.
Supervia A, Pedro-Botet J, Nogues X, et al. Piroxicam fast-dissolving dosage form vs diclofenac sodium in the treatment of acute renal colic: a double-blind controlled trial. Br J Urol 1998; 81: 27–30.
Nakada SY, Jerde TJ, Bjorling DE, et al. Selective cyclooxygenase-2 inhibitors reduce ureteral contraction in vitro: a better alternative for renal colic? J Urol 2000; 163: 607–612.
Kekec Z, Yilmaz U, Sozuer E. The effectiveness of tenoxicam vs isosorbide dinitrate plus tenoxicam in the treatment of acute renal colic. BJU Int 2000; 85: 783–785.
Grenabo L, Aurell M, Delin K, et al. Antidiuretic hormone levels and the effect of indomethacin on ureteral colic. J Urol 1983; 129: 941–943.
Kimoto Y, Constantinou CE. Effects of [l-desamino-8-d-arginine]vasopressin and papaverine on rabbit renal pelvis. Eur J Pharmacol 1990; 175: 359–362.
Moro U, De Stefani S, Crisci A, et al. Evaluation of the effects of desmopressin in acute ureteral obstruction. Urol Int 1999; 62: 8–11.
Kjaer A. Vasopressin as a neuroendocrine regulator of anterior pituitary hormone secretion. Ada Endocrinol (Copenh) 1993; 129: 489–496.
Lopes T, Dias JS, Marcelino J, et al. An assessment of the clinical efficacy of intranasal desmopressin spray in the treatment of renal colic. BJU Int 2001; 87: 322–325.
el-Sherif AE, Salem M, Yahia H, et al. Treatment of renal colic by desmopressin intranasal spray and diclofenac sodium. J Urol 1995; 153: 1395–1398.
Constantinides C, Kapralos V, Manousakas T, et al. Management of renal colic with intranasal desmopressin spray. Ada Urol Belg 1998; 66: 1–3.
Romics I, Molnar DL, Timberg G, et al. The effect of drotaverine hydrochloride in acute colicky pain caused by renal and ureteric stones. BJU Int 2003; 92: 92–96.
Eray O, Cete Y, Oktay C, et al. Intravenous single-dose tramadol vs meperidine for pain relief in renal colic. Eur J Anaesthesiol 2002; 19: 368–370.
Cordell WH, Larson TA, Lingeman JE, et al. Indomethacin suppositories vs intravenously titrated morphine for the treatment of ureteral colic. Ann Emerg Med 1994; 23: 262–269.
Thompson JF, Pike JM, Chumas PD, et al. Rectal diclofenac compared with pethidine injection in acute renal colic. BMJ 1989; 299: 1140–1141.
Iguchi M, Katoh Y, Koike H, et al. Randomized trial of trigger point injection for renal colic. Int J Urol 2002; 9: 475–479.
Kober A, Dobrovits M, Djavan B, et al. Local active warming: an effective treatment for pain, anxiety and nausea caused by renal colic. J Urol 2003; 170: 741–744.
Lee YH, Lee WC, Chen MT. et al. Acupuncture in the treatment of renal colic. J Urol 1992; 147: 16–18.
Segura JW, Preminger GM, Assimos DG, et al. Ureteral Stones Clinical Guidelines Panel sum mary report on the management of ureteral calculi. The American Urological Association. J Urol 1997; 158: 1915–1921.
Miller OF, Kane CJ. Time to stone passage for observed ureteral calculi: a guide for patient education. J Urol 1999; 162: 688–690.
Bortolotti M, Trisolino G, Barbara L. Nifedipine in biliary and renal colic. JAM A 1987; 258: 3516.
Caravati EM, Runge JW, Bossart PJ, et al. Nifedipine for the relief of renal colic: a double-blind, placebo-controlled clinical trial. Ann Emerg Med 1989; 18: 352–354.
Borghi L, Meschi T, Amato F, et al. Nifedipine and methylprednisolone in facilitating ureteral stone passage: a randomized, double-blind, placebo-controlled study. J Urol 1994; 152: 1095–1098.
Cooper JT, Stack GM, Cooper TP. Intensive medical management of ureteral calculi. Urology 2000; 56: 575–578.
Stief CG, Uckert S, Truss MC, et al. A possible role for nitric oxide in the regulation of human ureteral smooth muscle tone in vitro. Urol Res 1996; 24: 333–337.
Ng CK, Yip SK, Sim LS, et al. Outcome of percutaneous nephrostomy for the management of pyonephrosis. Asian J Surg 2002; 25: 215–219.
Pearle MS, Pierce HL, Miller GL, et al. Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 1998; 160: 1260–1264.
Docimo SG. Dewolf WC. High failure rate of indwelling ureteral stents in patients with extrinsic obstruction: experience at two institutions. J Urol 1989; 142: 277–279.
Yossepowitch O, Lifshitz DA, Dekel Y, et al. Predicting the success of retrograde stenting for managing ureteral obstruction. J Urol 2001; 166: 1746–1749.
Lennon GM, Thornhill JA, Grainger R, et al. Double pigtail ureteric stent vs percutaneous nephrostomy: effects on stone transit and ureteric motility. Eur Urol 1997; 31: 24–29.
Leventhal EK, Rozanski TA, Grain TW, et al. Indwelling ureteral stents as definitive therapy for distal ureteral calculi. J Urol 1995; 153: 34–36.
Satoh S, Okuma A. Fujita Y, et al. Spontaneous rupture of the renal pelvis during pregnancy: a case report and review of the literature. Am J Perinatol 2002; 19: 189–195.
Coe FL, Parks JH, Lindheimer MD. Nephrolithiasis during pregnancy. N Engl J Med 1978; 298: 324–326.
Horowitz E, Schmidt JD. Renal calculi in pregnancy. Cin Obstet Gynecol 1985; 28: 324–338.
Biyani CS, Joyce AD. Urolithiasis in pregnancy. I: pathophysiology, fetal considerations and diagnosis. BJU Int 2002; 89: 811–818.
Stothers L, Lee LM. Renal colic in pregnancy. J Urol 1992; 148: 1383–1387.
Drago JR. Rohner TJ Jr, Chez RA. Management of urinary calculi in pregnancy. Urology 1982; 20: 578–581.
Biyani CS, Joyce AD. Urolithiasis in pregnancy. II: management. BJU Int 2002; 89: 819–823.
Meares EM Jr. Urologic surgery during pregnancy. Clin Obstet Gynecol 1978; 21: 907–920.
Lifshitz DA, Lingeman JE. Ureteroscopy as a first-line intervention for ureteral calculi in pregnancy. J Endourol 2002; 16: 19–22.
Watterson JD, Girvan AR, Beiko DT, et al. Ureteroscopy and holmium: YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy. Urology 2002; 60: 383–387.
Shokeir AA, Mutabagani H. Rigid ureteroscopy in pregnant women. Br J Urol 1998; 81: 678–681.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
Purohit, R.S., Stoller, M.L. (2005). Renal Colic Resulting From Renal Calculus Disease. In: Wessells, H., McAninch, J.W. (eds) Urological Emergencies. Current Clinical Urology. Humana Press. https://doi.org/10.1385/1-59259-886-2:241
Download citation
DOI: https://doi.org/10.1385/1-59259-886-2:241
Publisher Name: Humana Press
Print ISBN: 978-1-58829-256-8
Online ISBN: 978-1-59259-886-1
eBook Packages: MedicineMedicine (R0)