In an older study, Tom-Harald Edna, PhD, and colleagues studied 60 patients with ureteral colic, randomizing them to receive either no fluid or 3 L of IV fluid over 6 hours.
A Cochrane analysis in 2012 concluded that there was no reliable evidence to support the use of high-volume fluid therapy in the treatment of acute ureteral colic. (3)
A new option in the treatment of ureteral colic
? Urologe A 2007;46:1219-23.
in their letter to the editor commented that urolithiasis causes elevation of IL-6 through two distinct mechanisms: (a) a mechanical one as stones cause direct damage to the endothelium and (b) in response to smooth contraction during renal or ureteral colic
The authors included all randomized trials or controlled clinical trials of medical therafor adults with acute ureteral colic
Ultrasonography by emergency physicians in patients with suspected ureteral colic. J Emerg Med 1998; 16:865-870.
Suspected ureteral colic: Plain Film and Sonography vs unenhanced helical CT A prospective study in 66 patients.
Furthermore, all patients were instructed to drink a minimum of 2 L of water daily and were asked to keep a diary on ureteral colic, stone expulsion and the side effects of medical therapy.
Ureteral colic occurred in 23.5% of patients in Group 1, but in only 5.3% of patients in Group 2 (p = 0.041).
Severe flank pain and microhematuria are usually reliable signs of ureteral colic
. The patient in this case taught us to consider another important diagnosis: renal infarction due to an embolism.
On the other hand watchfull waiting approach can be used with good spontaneous expulsion of stones, even this approach has complications like recurrent ureteral colic
, infection of urinary tract, hydronephrosis with its ill effects on renal function.
Although there is a growing interest in URS, there is little data available on the use of emergency URS to treat ureteral colic
caused by ureteral stones.