Background: Renal colic not only leads to significant morbidity, but also imposes a financial burden on society in that it decreases productivity and increases healthcare costs. Methods: A review of medical literature regarding reno - urethral colic was performed using MEDLINE and on-line publications, like European Association of Urology (EAU) Guidelines. Clinical presentation of Renal colic, mechanisms of urethral peristalsis and pathophysiology of Renal colic were studied. An overview of available medical treatments was presented.Findings: The classic presentation of acute Renal colic is sudden onset of severe pain in flank, primarily caused by acute urethral obstruction. The pain associated with urethral obstruction is caused by a rise in intra luminal pressure which produces an increase in urethral smooth muscle tension. The diagnosis is often made on clinical symptoms. The objectives of therapy at this stage are to eliminate pain, preserve Renal function and eliminate the obstruction. Many drugs have been used in the treatment of Renal colic, such as NSAIDs, opioid analgesics, and even loco-regional anesthesia and acupuncture. Nonetheless, the safest and most effective treatment has not yet been clearly defined.Conclusion: An accurate understanding of the pathophysiology of reno- urethral colic allows the physician to tailor the best treatment for each patient. Although many drugs have been suggested for treating Renal colic, it seems that the first line medications should be NSAIDs, mostly in oral form. Fluid intake is encouraged and chemical analysis of stone should be performed whenever possible.

Pelvis rupture secondary to Renal colic is an exceptionally rare but severe complication of nephrolithiasis. This case report describes a 32-year-old male who presented with intense flank pain, gross hematuria, and urinary obstruction. A computed tomography (CT) scan revealed a 3-mm calculus at the ureterovesical junction causing hydronephrosis and, notably, a rupture of the Renal pelvis with urine extravasation into the retroperitoneal space. Immediate intervention included ureteroscopic lithotripsy, stent placement, and antibiotic therapy, leading to symptom resolution and improved Renal function. This report highlights the diagnostic challenges associated with pelvis rupture, which often mimics typical Renal colic symptoms, and emphasizes the critical role of contrast-enhanced CT in detection. Prompt management is essential to prevent complications such as sepsis and long-term Renal damage. The case underscores the importance of recognizing this rare entity to optimize patient outcomes and guide future clinical approaches to similar presentations.

Objective: Urolithiasis is responsible for the majority of urological emergencies. Although computed tomography (CT) scan can identify urinary obstruction caused by stones, there is a growing concern about exposure to radiation made by this method. Renal scintigraphy can provide valuable insights regarding the functional status of kidneys and can significantly reduce exposure to radiation. The goal of present study was to assess Renal function through Renal scintigraphy in patients with acute Renal colic and it explores the association between Renal scintigraphy performance and ultrasound in terms of detecting hydronephrosis. Methods: For this study, 20 patients with acute Renal colic were chosen. Each patient underwent Renal ultrasonography and subsequently received Renal scintigraphy with Technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA). Cohen's Kappa coefficient and Cramer's V correlation were employed to demonstrate the extent of agreement between ultrasound and Renal scintigraphy. Results: 12 (60%) patients were male. Glomerular filtration rate (GFR) values were correlated with Cockcroft-Gault equation and the Gates method (P=0.002, r=0.642). There was a good agreement and a statistically significant relationship between ultrasound and Renal scintigraphy in terms of detecting obstructive uropathy in both kidneys. Conclusion: To conclude, GFR values were correlated between Cockcroft-Gault equation and the Gates method in patients with acute Renal colic. There was a good agreement and statistically significant relationship between ultrasound and obstructive renography results in both kidneys. However, we found no association between perfusion phase of Renal scintigraphy and ultrasonography in terms of hydronephrosis detection.

Background and purpose: Many emergency referrals are due to Renal colic which is more frequently caused by nephrolithiasis. Imaging techniques have a key role in diagnosis and treatment of this disease. There are some limitations associated with these techniques, so this study aimed at comparing the diagnostic value of CTU and MRU for the diagnosis of the obstructions of urinary tract.Materials and methods: This study was conducted in 30 patients with Renal colic and heamaturia attending Imam khomaeini Hospital, Sari. The selected subjects were patients with suspicions of obstruction of the urinary tract whom diagnosis were not confirmed through ultrasonography.Results: The sample consisted of 30 patients (24 male and 6 female) with a mean age of 46.8. The sensitivity of MRU and CTU without contrast agent were 50% and 90%, respectively and the specificity of both methods was 100%. The findings also showed that MRU and CT scan without contrast agent had relatively good agreement (66.7%, Kappa=0.33) for the accurate diagnosis of Renal colic and 100% agreement rate (Kappa=1) for the diagnosis of urinary tract obstruction and Renal hydronephrosis.Conclusion: Our results showed that the MRU is a suitable alternative and efficient method for CTU in the Renal colic cases. Because in this method the exposure to X-Ray is less which could be more appropriate during pregnancy and in uremic patients.

A 71-year-old male came to the emergency room complaining of weakness, nausea and pain in the left flank and groin irradiating into his left hemiscrotum. Clinical examination revealed arterial hypotensis and tachycardia. Because of the patient’ s history of urolithiasis in the past, left Renal colic was suspected and non-enhanced computed tomography (CT) was requested. The CT scan confirmed nephrolithiasis, but the crucial finding was an aneurysm of the abdominal aorta measuring 95 mm in diameter. Furthermore, the dorsal wall of the aorta was in direct contact with the spine, creating a “ draped aorta sign” (Figure 1a)...

Purpose: To evaluate the intracutaneous injection of sterile water in the treatment of Renal colic. Patients and Methods: One hundred patients with Renal colic were randomly divided irito two groups of 50 patients and underwent the treatment. In the first (study) group 0.5 ml of sterile water and in the control group, 0.5 ml of normal saline was intradermally injected. The severity of pain was assessed by visual analogue scale (VAS) system before and 30 and 90 minutes after the injection. Patients in whom the presence of stone was not proved were excluded from the study. Results: Before the treatment mean pain severity in the study group was 9.86:tOA and in the control group was 9.96:t0.19, so that the difference was not statistically significant (p=0.12). Thirty and 90 minutes after the injection, the means were 0.76:t2.3 and 1.02:t2.63 in study group and 5.94:t4 and 6.7:t4.19 in control group, respectively. The results in 30 and 90 minutes between the two groups were statistically significant (p=O.OOOand p=O.OOO,respectively). Pain in all patients in the study group was relieved; however, only %34 of the patients in the control group reported a decrease in pain. There was no complication among the patients of both groups and only a severe and transient pain during injection was reported by the patients. Conclusion: This study along with many other existing studies indicates the efficacy of intradermal injection of sterile water for the treatment of severe pain syndromes such as Renal colic. The advantages of this method are its efficacy, availability, cost benefits, and easy application. We recommend the use of this approach for the treatment of Renal colic.

Introduction: This study was conducted to compare the level of knowledge of medical interns who have gone through the urology course during their externship with interns who have not gone through the urology course during their externship.Methods: In this cross-sectional study that was conducted in the year 2021 at the Isfahan University of Medical Sciences, Isfahan, Iran, 97 medical interns entered in September 2014, 38 of whom underwent a neurosurgery course and 59 underwent a urology course and the level of public awareness about Renal colic It was studied in them.Results: The total evaluation score in the neurosurgery group was 71.79±13.93 and the urology group was 85.83±7.19, and the students who completed the urology course were significantly higher than the average (P-value<0.001). The average percentage of correct answers to questions in the field of ​​differential diagnosis was 25.39±4.55, the field of ​​use of painkillers was 78±19.77, and the field of ​​emergency intervention was 83.3%±18.41 in all students. The average percentage of correct answers to the differential diagnosis questions in the neurosurgery and urology groups was 22.5±5.15 and 27.25±2.9, respectively, and the difference between the two groups was significant (P-value<0.001).Conclusion: The findings of the present study show that the medical students who completed the urology course during the externship have a higher level of knowledge about Renal colic than the students who completed the neurosurgery course.