Why does renal colic occur?
The kidney produces urine continuously. If an obstacle suddenly arises in the way of its outflow, urine continues to flow into the pelvis, but cannot come out. The pressure inside the kidney increases sharply, its capsule, rich in nerve endings, stretches, and pain occurs.
- Ureteral stone is the most common cause, in the vast majority of cases
- Blood clot blocking the ureter
- Accumulation of salts and mucus
- Compression of the ureter by a tumor or scar
- Bend of the ureter with nephroptosis
- Swelling of the ureteral wall after endoscopic interventions
- Necrotic renal papilla in some diseases
How to recognize renal colic
- Sudden onset, often at night or after exercise, bumpy driving, drinking too much
- Very severe pain in the lower back or side on one side
- The pain radiates downwards - to the groin, external genitalia, inner thigh
- The person rushes about, cannot lie still and does not find a relief position
- Nausea and vomiting without relief
- Bloating, gas and stool retention
- Frequent, painful urination if the stone is in the lower third of the ureter
- Blood in urine
- Wave-like character: the pain intensifies and then weakens
What to do before the doctor arrives
- Вызвать скорую помощь или обратиться в clinicsу — почечную колику должен оценить врач
- Не пить большое количество воды и не принимать мочегонные: при перекрытом мочеточнике это увеличивает давление в почке и усиливает боль
- Не прикладывать грелку и не принимать горячую ванну, если есть температура или озноб — при гнойном воспалении тепло резко ухудшает состояние
- Не принимать обезболивающие бесконтрольно перед осмотром хирурга, если не исключена острая патология брюшной полости
- Запомнить время начала приступа, сторону боли, наличие температуры, крови в моче, рвоты
- Если моча всё же выделяется — собрать её и по возможности процедить: отошедший камень нужно сохранить для анализа
What does a doctor do
- Pain relief - non-steroidal anti-inflammatory drugs and antispasmodics; they not only relieve pain, but also reduce swelling of the ureteral wall
- Assessment of condition: temperature, pressure, urine volume, signs of infection
- CT scan of the urinary system without contrast - accurately determines the stone, its size, density and level
- Ultrasound of the kidneys is an accessible method that shows the expansion of the pelvis
- Urinalysis, blood test, creatinine
- Decision on tactics: observation with drug support, emergency drainage or stone removal
The key decision is whether there is an infection. Colic without fever with a small stone is often managed conservatively. Colic with fever requires immediate drainage of the kidney: a stent or nephrostomy is placed first, before any fragmentation.
How to treat the cause of colic
- Medical expectant management for small stones with condition monitoring
- Ureteral stenting - rapid restoration of urine outflow
- Percutaneous nephrostomy - drainage through a puncture in the lower back for purulent inflammation
- Contact laser or pneumatic stone crushing
- External shock wave lithotripsy
- Laparoscopic ureterolithotomy for large impacted stones
- Antibacterial therapy for associated infection
Why you can’t limit yourself to pain relief
The most common mistake is to take a painkiller, wait until the attack passes, and then calm down. The subsidence of the pain does not mean that the problem is solved.
- The stone may move, but remain in the ureter and continue to block the kidney without significant pain.
- The pain sometimes disappears because the kidney has stopped producing urine - this is a dangerous sign
- Prolonged stone formation leads to cicatricial stricture of the ureter and loss of kidney function
- The addition of an infection against the background of a block can quickly turn into urosepsis
Prevention of recurrent attacks
- Adequate fluid intake is the main and most accessible way
- Analysis of the composition of the passed stone and selection of a diet based on it
- Metabolic examination for recurrent stones
- Limiting salt and moderation in animal protein
- Timely treatment of urinary tract infections
- Ultrasound monitoring at least once a year for established urolithiasis
- Take special care during hot months and when working outdoors
Where to go for renal colic in Tashkent
During an attack, you need a clinic where you can get pain relief around the clock, perform a CT scan and, if necessary, urgently drain the kidney.
In Tashkent, assistance for renal colic and subsequent treatment of urolithiasis is provided at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If the attack has already passed, do not delay a visit to the urologist: an examination after colic allows you to understand whether the stone has passed and prevent a repeat attack. Clinic contacts are below on the page.
