Nephritic colic presents with an episode of very intense, spasmodic pain that appears abruptly in the patient and increases in intensity. The pain starts in the lower back and radiates laterally to the abdomen, groin and genitals. It is not a constant type of pain, but fluctuates in intensity with peaks of great pain and periods of slight remissions.
Also, the duration of renal colic is variable, and can last from several hours to 2-3 days. It is usually accompanied by general involvement, sweating, nausea and/or vomiting and often fever. It can sometimes cause discomfort when urinating, as well as the need to urinate small amounts frequently, a feeling of not completely emptying the bladder and/or a stinging sensation during urination. During colic the urine is usually dark, concentrated and sometimes may contain blood.
Why does renal colic occur?
The causes of renal colic can vary. Although it can be caused by triggers (not drinking enough water or a family history of renal colic), the most common cause is the presence of kidney stones (calculi) in the ureter. These are formed by mineral salts in the form of crystals that are usually expelled with the urine. However, these stones or calculi are formed when there are high doses of these substances in the urine. When stones are present, the obstructed kidney holds the urine and the urinary tract dilates, causing pain. In addition to stones, any other element in the ureter, obstructing the kidney, can cause nephritic colic.
How to treat nephritic colic
The first thing to do when faced with renal colic is to achieve rapid and adequate pain control, facilitate the expulsion of the calculus or stone and prevent new episodes from occurring. The initial treatment to avoid pain will be spasmodic analgesics and anti-inflammatory drugs. If the pain is very intense, the Urology specialist will administer the medication intramuscularly or intravenously. To be more effective treatments are usually combined with drugs to prevent nausea and vomiting.
With regard to calculi or stones, it is very important to assess the size, location and shape, as well as the probability of spontaneous expulsion, the composition of the stone, the symptoms it causes in the patient and the presence or absence of urinary tract infection.
If the calculus does not exceed 5mm, it is usually expelled spontaneously in most cases of lithiasis. If they are not expelled (due to their large size), there is the option of breaking them into tiny pieces so that they can be expelled naturally with urine (ESWL). If this cannot be done or if it is a complicated colic, it will be removed surgically.
The most commonly used techniques to fragment or surgically remove kidney stones are:
- Extracorporeal shock wave lithotripsy (ESWL).
- Ureteroscopy
- Percutaneous surgery
- Laparoscopic surgery with high definition (HD) 3D technology