PURPOSE: The objective of this study were to evaluate the location of ureteral stones and the diameter of the ureter in patients with renal colic. MATERIALS AND METHODS: We retrospectively reviewed the records of 95 consecutive patients who presented to the emergency department with renal colic in whom urinary stones were diagnosed by computed tomography between January 2009 and August 2009. The size and location of the stones were investigated. The length and diameter of unaffected ureters were also measured. RESULTS: The mean size of the stones was 4.87+/-3.49 mm (range, 0.9-22 mm). Stones were located at ureterovesical junction (UVJ) in 44 cases (46.3%), proximal ureter in 29 (30.5%), distal ureter in 16 (16.8%), ureteropelvic junction (UPJ) in 5 (5.2%), and the ureter crossing external iliac vessel (UEIV) in 1 case (1%). The mean length of the ureter was 226.8+/-20.8 mm (range, 175-286 mm). The mean diameter of the ureter was 3.40+/-0.61 mm (range, 1.9-5.3 mm). The mean diameter of the UEIV was 3.28+/-0.59 mm (range, 2.2-5.3 mm). CONCLUSIONS: The UPJ and UEIV were not common sites of ureteral stones. The smaller the stones, the closer to the UVJ that the stones were located. Spontaneous passage of the stones was most frequently observed for stones in the UVJ. The UEIV was not significantly narrower than the other parts of the ureter.
Colic ; Emergencies ; Glycosaminoglycans ; Humans ; Renal Colic ; Retrospective Studies ; Ureter ; Ureteral Calculi ; Urinary Calculi

PURPOSE: The aim of this study was to evaluate the effect of tamsulosin on expulsion of ureteral stones after extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: Seventy-six patients(39 with upper ureteral stones and 37 with lower ureteral stones) treated with ESWL for stones <10mm were randomly divided into two groups. Tamsulosin(0.2mg orally once daily) was administered to group 1; group 2 received no medications. All patients were evaluated with respect to the number of episodes of ureteral colic, the expulsion rates of stones after ESWL, and the mean number of sessions of ESWL until complete expulsion of stones. RESULTS: The complete expulsion rates of upper and lower ureteral stones did not differ significantly between groups 1 and 2 during each session of ESWL; however, the mean session of ESWL was lower in group 1 than in group 2. For upper ureteral stones, 1.8 sessions were necessary per patient in group 1, while 2.3 sessions were required for the patients in group 2(p=0.039). For lower ureteral stones, 2.0 sessions were necessary per patient in group 1, while 2.9 sessions were required for the patients in group 2(p=0.032). There were significant decreases in the number of episodes of pain in group 1 with lower ureteral stones(p=0.014). There were no side effects associated with tamsulosin. CONCLUSIONS: The use of tamsulosin in the treatment of upper and lower ureteral stones after ESWL can decrease the mean number of sessions of ESWL and the number of episodes of pain, but cannot improve the expulsion rate. Further research regarding the cost-effectiveness of tamsulosin after ESWL is needed.
Calculi ; Humans ; Lithotripsy ; Renal Colic ; Shock ; Sulfonamides ; Ureter

PURPOSE: This study was performed to evaluate the success rate, failure causes, complications, safety and effectiveness of extracorporeal shock wave lithotripsy(SWL) with domestic SDS-5000 lithotriptor for the treatment of urinary calculi. MATERIALS AND METHODS: SWL monotherapy using the Domestic SDS-5000 lithotripter was performed in 195 urinary stones from 173 patients between 9 years and 74 years old from March 1998 to February 1999. Distribution of stones, location and size of stones, session, success rate, causes of failure and complications of SWL were reviewed. RESULTS: Of 195 cases, 88(45.1%) had renal, and 107(54.9%) ureteral stones. Of these cases 44.6% had stones smaller than 0.9cm, 33.3% from 1 to 1.9cm, 15.9% from 2 to 2.9cm, and 4% larger than 3cm. The overall success rate of complete SWL was 91.3% with 90.1% in 5-9mm, 96.9% in 10-19mm, 90.3% in 20-29mm and 62.5% over 30mm stone size. There were no significant complications. The cases of transient gross hematuria were developed in 11.3%, renal colic in 8.7%, steinstrasse in 2.0% and fever in 1.0%. These complications were controlled with conservative treatment or repeated session of shock wave lithotripsy, Double - J stent insertion. CONCLUSIONS: SWL with Domestic SDS-5000 lithotriptor is considered to be a safe and efficient outpatient procedure for the initial treatment of urinary stone.
Aged ; Fever ; Hematuria ; Humans ; Lithotripsy* ; Outpatients ; Renal Colic ; Shock* ; Stents ; Ureter ; Urinary Calculi*

PURPOSE: Renal colic is a common disorder with a high rate of recurrence, resulting in a large number of emergency department visits. The aim of this study was to investigate the seasonal variation in renal colic attacks and the association with climatic parameters. METHODS: The time of onset, monthly incidence, and effects of climatic parameters of renal colic were evaluated. Data on climatic parameters were obtained from the Korea Meteorological Administration. Correlation between the number of monthly episodes and climatic parameters was assessed using Pearson's correlation coefficient. RESULTS: A total of 5060 renal colic episodes were retrieved during a period of 84 months (from May 2006 to April 2013). Episodes of renal colic were more common in men (67.4%) than in women(32.6%). The incidence of renal colic showed a circadian variation, with a morning peak (500~1000 h) and an afternoon dip (1500~1900 h). Findings of the current study showed a higher number of renal colic episodes during summer compared with other seasons. Significant positive correlations were observed between the mean monthly temperature and the monthly incidence of renal colic, but not between other climatic parameters (relative humidity, rainfall, sunshine hours, and atmospheric pressure) and incidence of renal colic. CONCLUSION: We conclude that the incidence of renal colic has significant seasonal variation, and only mean monthly temperature showed any consistent association with monthly attack rates.
Climate ; Emergency Service, Hospital* ; Humans ; Humidity ; Incidence ; Korea ; Male ; Recurrence ; Renal Colic* ; Seasons* ; Sunlight ; Urolithiasis

BACKGROUND: Ureteral colic due to acute obstruction of urine flow is a frequent and painful condition presenting in the emergency department. Proper control of ureteral colic is important in the management of such a patient. Many drugs, including narcotics, had been used to control ureteral colic, and of them, nonsteroidal anti-inflammatory drugs are most commonly used. This study was carried out to compare the analgesic effect of diclofenac with that of caroverine which is used empirically in ureteral colic. METHODS: We carried out a randomized, prospective clinical trial in the emergency department of a university hospital. Sixty patients in whom ureteral colic had been diagnosed on the basis of physical signs and symptoms were included in this study. Each patients received an IM dose of diclofenac 75 mg, a IV bolus dose of caroverine 20 mg, or a continuous infusion of caroverine 60 mg. An additional dose of medication was added 20 min after the initial medication if needed. RESULTS: The main outcome was measured by using both the visual analogue scale(VAS), four-point categorial pain scale at times of 20, 40, and 60 min after initial medication. The requirement for supplemental medication was also measured. At 40 min, diclofenac was more effective than the other two treatments according to its pain- relieving capacity(p<0.05) and the categorial pain scale. By 60 min, caroverine continuous infusion was less effective than the other two treatments according to visual analogue scale(VAS) and the categorial pain scale(p<0.05). There were no significant differences between the diclofenac group and the caroverine bolus injection group at this time. The diclofenac group needed significantly less rescue medication for pain control(p<0.05). CONCLUSION: IM diclofenac, a non-steroidal antiinflammatory drug, was superior to the spasmolytics, single bolus or continuous intravenous infused, in treatment of ureteral colic.
Diclofenac* ; Emergency Service, Hospital ; Humans ; Narcotics ; Parasympatholytics ; Prospective Studies ; Renal Colic* ; Ureter*

PURPOSE: We analysed the therapeutic results of 2,585 cases (2,456 patients) of urinary calculi, treated by extracorporeal shock wave lithotripsy (ESWL), using a Dornier MPL 9200X lithotriptor. MATERIALS AND METHODS: The records of all the patients, in whom urinary calculi were treated by ESWL, between October, 1997 and October, 2002, were retrospectively reviewed. The patients were defined as successful if there was no concrement on the X-ray (plain film) or residual fragments renal colic, steinstrasse and fever in 2,158 (83.4%), in 771 (29.8), in 53 (2.1%) and fever in 16 cases (0.6%), respectively, which were successfully controlled by conservative treatment. CONCLUSIONS: We considered ESWL has become a highly effective and minimally invasive treatment modality as the 1st therapeutic option for urinary stones.
Fever ; Hematuria ; Humans ; Kidney ; Lithotripsy* ; Renal Colic ; Retrospective Studies ; Shock* ; Stents ; Ureter ; Urinary Calculi

PURPOSE: We describe our clinical experience of extracorporeal shock wave lithotripsy (SWL) using Modulith SLK in 440 cases of urinary calculi. MATERIALS AND METHODS: The records of 440 cases of urinary stones treated by Modulith SLK lithotriptor, from October, 2002 to June, 2004, were reviewed retrospectively. The size and location of stones, number of sessions, auxiliary procedures, success rate and complications were statistically analysed. RESULTS: The total success rate was 95.7% (421/440 cases), and according to stone location was 98.2% in the kidney and 94.1% in the ureter. The success rate according to stone size was 97.1%, 91.1%, 92.9% and 80% for below 10mm, 11-20mm, 21-30mm and over 30mm, respectively. The success rate within 3 sessions was 82.7%. The average number of treatment session was 2.14. The complications after SWL were gross hematuria in 316 cases (71.8%), renal colic in 83 (18.9%), steinstrasse in 19 (4.3%), and fever in 2 (0.5%). All of the complications were controlled by conservative management only. As an auxiliary procedure, double J stent insertion was done in 22 cases, percutaneous nephrostomy (PCN) in 1, ureteroscopic removal of stone (URS) in 15, percutaneous nephrolithotomy (PNL) in 3, and ureterolithotomy in 1. CONCLUSIONS: Modulith SLK lithotriptor is considered to be an effective and safe tool for the first line treatment of urinary calculi.
Fever ; Hematuria ; Kidney ; Lithotripsy* ; Nephrostomy, Percutaneous ; Renal Colic ; Retrospective Studies ; Shock* ; Stents ; Ureter ; Urinary Calculi*

PURPOSE: The aim of this study was to evaluate the outcome of ureter stones with expectant management and the clinical factors associated with stone passage in Koreans. MATERIALS AND METHODS: We reviewed the charts of patients who visited the emergency room or urological office of our institution with acute renal colic between 2001 and 2008. A total of 656 ureter stone formers were enrolled in this study who had decided to be treated by expectant management. Clinical data such as gender, age, size and location of the stone, body mass index, and previous stone history were analyzed to find the factors related to spontaneous passage of ureter stones. RESULTS: Of the 656 ureter stones, 566 stones (86.3%) were spontaneously expelled. Mean duration of follow-up was 17.5 days (range, 1 to 100 days). Mean time to stone passage was 6.8 days for stones less than 2 mm in size, 12.6 days for stones 2 to 4 mm, 14.8 days for stones 4 to 6 mm, and 21.8 days for stones 6 to 8 mm (p<0.001). The cumulative spontaneous passage rate was 55.3% in 7 days, 73.7% in 14 days, 88.5% in 28 days, and 97.7% in 60 days after the first attack. A total of 90 patients (13.7%) required interventions because of symptom relapse or renal deterioration that was related to the location and size of the stone (each, p<0.001). The more proximal the location and the larger the stone was than 6 mm, the less the chance of spontaneous passage (each, p<0.001). CONCLUSIONS: Size and location of ureter stones are the most important factors for predicting the spontaneous passage of the stone. If a patient has a distal ureter stone of less than 6 mm in size, it is acceptable for the urologist to observe for spontaneous passage for 2 months.
Body Mass Index ; Emergencies ; Follow-Up Studies ; Humans ; Recurrence ; Renal Colic ; Ureter ; Ureteral Calculi ; Watchful Waiting

PURPOSE: We studied to evaluate the safety and effectiveness of the domestic SDS-3000(R) extracorporeal shock wave lithotriptor (SWL). MATERIALS AND METHODS: Between October 1995 and April 2000, 440 patients, 16 to 79 years old, were treated with the domestic SDS-3000(R) lithotriptor using C-arm fluoroscopy without regional or general anesthesia. Distribution of stones, location and size of stones, session, success rate, causes of failure and complications of SWL were retrospectively reviewed. RESULTS: Of 440 patients, renal stones were 133 (30.2%) and ureteral stones 307 (69.8%). The overall success rate (stone free rate) of SDS-3000(R) lithotriptor in 440 patients was 89.8% (81.4%) with 94.9% (91.0%) in 5-9mm, 87.2% (75.8%) in 10-19mm, 66.7% (42.8%) in 20-29mm and 57.1% (35.7%) over 30mm of stone size. The success rate was 94.9% for stones between 5-9mm in diameters and 82.6% for stones more than 10mm (p<0.05). As compaired with success rate for stones less then 20mm, stones more then 20mm had significently higher success rate (92.1% Vs 62.8%) (p<0.05). Ureter stones were more successfully treated than renal stones (93.2% Vs 82.0%) (p<0.05). Main complications of SWL were renal colic in 10.0%, steinstrasse in 4.3%, transient gross hematuria in 1.8% and fever in 1.1%. All of complications were controlled with conservative treatment. CONCLUSIONS: The domestic SDS-3000(R) lithotriptor monotherapy is considered to be a safe and efficient outpatient procedure for the initial treatment of urinary stones.
Aged ; Anesthesia, General ; Fever ; Fluoroscopy ; Hematuria ; Humans ; Outpatients ; Renal Colic ; Retrospective Studies ; Shock ; Ureter ; Urinary Calculi*

PURPOSE: To compare the efficacies and side effects of intravenous hydromorphone and pethidine in the emergency department (ED) treatment of ureteral colic. METHODS: A prospective, controlled, randomized clinical trial was conducted in a university-affiliated tertiary referral center. All adult patients who presented to the ED with severe ureteral colic were included. The patients received either 1 mg of hydromorphone (n=26) or 50 mg of pethidine (n=26) intravenously. Pain intensity was determined using a 10 cm visual analogue scale 0, 15, 30, and 120 minutes after injection. RESULTS: Dermographic characteristics and baseline pain scores of both groups were comparable (p>0.05). The pain intensity level for the hydromorphone group was lower than for the pethidine group at 15, 30, and 120 minutes. Pain relief was better with hydromorphone at 15 minutes (p<0.05). Side effects of the two groups were not statistically significant. CONCLUSION: The ureteral colic patients receiving hydromorphone achieved more pain relief. The side effects were similar for either treatment. Hydromorphone should be the preferred agent in suspected ureteral colic, when an opioid analgesic is to be used.
Adult ; Benzeneacetamides ; Emergencies ; Humans ; Hydromorphone ; Meperidine ; Piperidones ; Prospective Studies ; Renal Colic ; Tertiary Care Centers ; Ureter