Ureteric Colic

Introduction

Ureteric colic is defined as a medical condition characterized by the presence of a urinary stone, leading to a severe urinary system pain.

An excruciating pain that can strike without a warning, ureteric colic or renal colic is caused by dilation, stretching and spasm of the ureter.

The peak age of onset of this disorder is 35 to 45 years and a family history of stones doubles the risk of the disorder.

Risk Factors

Here we list a few of the main predisposing factors to renal stones:

· Excessive calcium in the urine

· Excessive oxalate in the urine

· Excessive excretion of uric acid

· Deficiency of citrate in the urine

· Cystinuria

Key Symptoms

The pain in this condition, comes in waves and is intense, beginning in the small of the back and usually spreading to the lower abdomen, external genitals and inner thigh.

Other key symptoms include:

· Nausea

· Vomiting

· Abdominal distension

· Chills

· Fever

· Blood in the urine

· Abnormal urine color

· High blood pressure, increased recently (within 2 weeks)

· Urinary tract infection

· Foul smelling urine

· Mental status changes

Causes of Ureteric Colic

Ureteric colic is primarily caused by the passage of solid material along the ureter, most commonly a stone that has originated in the kidney, although an injury or other conditions could also cause the disorder.

The disorder may result in permanent damage to the kidney and may be a cause of hypertension. It usually does not cause kidney failure because the second kidney continues to function.

Diagnostic Tools

To identify the condition of ureteric colic, the following tests are generally conducted:

· Urinalysis, which might reveal blood in the urine

· Urine culture, in order to reveal a urinary tract infection

· CBC, to look for leukocytosis as a sign of infection

· Basic metabolic panel, to asses kidney function

Treatment Options

The treatment of ureteric colic focuses on eliminating or minimizing the obstruction. The main options are:

· Antibiotics, if there is a urinary tract infection

· Stents or drains, placed in the ureter or in the renal pelvis

· Surgery to repair the underlying cause

· Nephrectomy .i.e. removal of the kidney and nephrotomy .i.e. incision into the kidney is necessary if the kidney functions poorly or is severely infected

Self Care

The following self-care measures have been found to be useful:

· If you are prone to kidney stones, drink plenty of water (6 to 8 glasses per day)

· Diet low in sodium and oxalate and high in citrate significantly reduces risk of calcium-based kidney stone formation

· Seek medical intervention if kidney stones persist or recur to identify the cause and to prevent formation of new stones