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Renal colic: new concepts related to pathophysiology, diagnosis and treatment
1Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. ahmedshokeir@hotmail.com
Purpose Of Review:
To give new insights into the pathophysiology, diagnosis and treatment of acute renal colic caused by a stone disease.
Recent Findings:
Traditional intravenous pyelography is no longer the primary method of investigation in patients with renal colic. If the patient has a history of previous attacks of renal colic and stone disease the recommended diagnostic approach is to start with plain abdominal radiography and ultrasonography together with Doppler ultrasonography. Noncontrast computerized tomography is reserved for unsolved problems. If the patient has no history of stone disease or has atypical clinical presentation it is better to start with noncontrast computerized tomography. Intravenous pyelography is indispensable if an endoscopic or open intervention is required. Magnetic resonance imaging is a promising method of investigation, particularly in pregnant women. Effective pain relief is achieved by the use of opioids, nonsteroidal antiinflammatory drugs or desmopressin.
Summary:
The diagnostic approach to renal colic has recently been changed due to the introduction of new, noninvasive radiologic procedures such as Doppler ultrasonography, noncontrast computerized tomography and magnetic resonance imaging.