Page 2 - Renal Colic
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Renal colic





        alpha-blocker (e.g. tamsolusin / Flomax  or silodosin/    Most cases will require a general anaesthetic (you
                                             TM
        Rapaflo ) to help the muscle of the ureter relax and      are “put to sleep”) or spinal anaesthetic (a needle
               TM
        facilitate stone passage.                                 in the back “freezes” you below the waist and you
                                                                  remain conscious). Some cases can be performed
        The majority of kidney stones cannot be dissolved.        comfortably with sedation alone. Once visualized
        However, one form (uric acid stone) may occasionally      through the scope, the stone can then be removed
        disintegrate when the urine is made less acid with        by trapping it in a wire “basket” and carefully pulling it
        medication (alkalinization). It is important to try to    out. Various instruments including lasers are available
        collect any stone passed so that it can be analyzed       to fragment larger stones and allow their passage
        to determine its chemical make-up. This will allow your   or removal. Upon completion of the procedure,
        physician to advise measures to reduce the risk of        a thin plastic tube (ureteric stent) may be placed
        further stone formation.                                  temporarily in the ureter to prevent blockage while
                                                                  any swelling resolves. Overnight hospitalization may
        When pain is difficult to control or the stone            be recommended.
        becomes lodged and fails to pass, your physician
        will recommend additional treatment. A fever              Percutaneous nephrolithotomy
        (greater than 38.5°C) or chills suggests the possibility
        of infection and indicates the need for more urgent
        treatment. There are a number of ways to treat a          Percutaneous nephrolithotomy (PCNL) is a surgical
        stone causing renal colic. The type of treatment          procedure in which kidney stones are removed using
        recommended will depend on a number of factors,           a scope passed through a small skin incision made in
        including your general health, as well as the type, size   the flank or the back into the kidney containing the
        and location of your stone.                               stone(s). The procedure is usually recommended for
                                                                  patients with kidney stones which are too large or
                                                                  numerous for shock wave lithotripsy or ureteroscopy.
        Shock wave lithotripsy                                    This procedure is carried out in a hospital or surgical
                                                                  centre with appropriate anaesthetic and hospital
        Shock wave lithotripsy (SWL) (“stone blasting”) is a      admission for a few days.
        non-surgical treatment in which high energy shock
        waves are used to pulverize a stone into smaller
        fragments which may pass more easily and with less        Follow-up
        pain.
                                                                  Patients who experience renal colic need follow-up
        A special machine (which may not be available at          with their family physician or urologist until the stone
        your local hospital) is used to generate shock waves.     passes.
        X-rays or ultrasound are used to focus the shock          Call your doctor or go directly to a hospital
        waves precisely on the stone. The shock waves pass        emergency room if you have:
        harmlessly through body tissues until they hit the hard
        stone causing it to break up. The fragments can then      •  Severe and persistent pain not relieved by
        flush out more easily in the urine. SWL may not be          your prescription painkiller
        appropriate for larger stones or for those that are       •  Chills or fever above 38.5°C or 101°F
        difficult to locate on x-ray.                             •  Persistent nausea and vomiting
                                                                  Please arrange a follow-up appointment with
        Ureteroscopy                                              Dr. ____________________in ______days / weeks.

        Ureteroscopy is a procedure in which a narrow             o  An X-ray should be obtained immediately
        telescope is passed through the urethra (urinary tube)      prior to your follow-up appointment.
        and bladder, into the ureter up to the stone. This        If you have any questions or concerns regarding
        surgical procedure requires some form of anaesthesia.     kidney stone formation, you should not hesitate to
                                                                  discuss them with your family doctor or urologist.

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        practitioner. The Canadian Urological Association disclaims all liability and legal responsibility howsoever caused, including negligence, for the   cua.org
        information contained in or referenced by this brochure.                                                      38E-RNCE-01-14
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