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

Primary localized amyloidosis is a rare disease. A 75-year-old woman with a history of intermittent right-sided renal colic and hematuria had a stricture of lower ureter which was suspected to be caused by tumor or fibrosis. Intraoperative frozen biopsy of the ureter showed no evidence of malignancy. So we report a case of primary amyloidosis of the ureter which was treated successfully with segmental resection and end to end anastomosis.
Aged ; Amyloidosis* ; Biopsy ; Constriction, Pathologic ; Female ; Fibrosis ; Hematuria ; Humans ; Rare Diseases ; Renal Colic ; Ureter*

Endometriosis affecting the urinary tract is very rare disease. The ureteral endometriosis is mostly asymptomatic for a long time, and associated with nonspecific symptoms such as abdominal or flank pain, renal colic, voiding difficulty and gross hematuria. Radiologic and laboratory findings show nonspecific findings, and the diagnosis is difficult. We report a case of obstructive ureteral endometriosis associated with right hydronephorsis. This case is operated under the impression of direct compression of ureter by uterine myoma. Total abdominal hysterectomy and ureteroureterostomy were performed. Final diagnosis of ureteral endometriosis is documented by pathologic findings.
Diagnosis ; Endometriosis* ; Female ; Flank Pain ; Hematuria ; Hydronephrosis* ; Hysterectomy ; Leiomyoma ; Rare Diseases ; Renal Colic ; Ureter* ; Urinary Tract

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: Our aim was to determine the efficacy of hematuria testing in suspected urinary stone disease using contrast enhanced multidetector computed tomography (MDCT) as the reference standard. METHODS: Records of all patients who presented to the emergency department with suspicion of urinary stone that undergone MDCT during a 2-year period were reviewed. The sensitivity, specificity, positive predictive value, and negative predictive value of the positive hematuria on the urinalysis for renal colic were calculated. The rates of incidence of negative hematuria were obtained. In addition, significant alternative CT findings requiring immediate or deferred treatment were classified. RESULTS: A total of 492 enhanced MDCTs were performed. Urinary stone had been identified in 414(84.1%) of the 492 patients, and 78 patients had a negative stone, including 33 (6.7%) with clinically significant alternative diagnoses in the latter group. Microscopic urinalysis had a sensitivity, specificity, positive predictive value, and negative predictive value of 89.4%, 41.1, 88.9%, and 42.1%, respectively. The combination of microscopic urinalysis and Urine Dipstick test (UDT) yielded a sensitivity, specificity, positive predictive value, and negative predictive value of 96.9%, 28.2%, 87.5%, 62.9%, respectively. The incidence of negative hematuria for microscopic urinalysis, UDT, and the combination were 10.6%, 4.4%, 3.1%, respectively. CONCLUSION: The presence or absence of blood on urinalysis alone cannot be used to reliably determine which patients actually have urinary stone. Therefore, patients presenting with an episode of clinically suspected urinary stone should undergo CT scanning because it enhances diagnostic certainty by identifying alternative significant diagnoses not suspected on clinical grounds alone.
Emergencies ; Hematuria ; Humans ; Incidence ; Multidetector Computed Tomography ; Renal Colic ; Sensitivity and Specificity ; Urinalysis ; Urinary Calculi ; Urolithiasis

During 5 years, from January 1976 to December 1980, clinical observation on management of ureteral stones was made on 169 admitted patients with ureter stones. Following results were obtained. 1) Among total 1054 in-patients, 169 cases (16.0%) had ureteral stones, and male to female ratio was 2 : 1. 2) Patients with 20-40 of his age was half. 3) On seasonal distribution, it was most prevalent on Summer. 4) 113 cases were located on lower ureter, and laterality was even. 5) Most common symptoms were renal colic and hematuria (91.8%) 6) Ureterolithotomy was done in 127 cases. In 86 cases of lower ureter stones, less than 1cm in size. conservative fluid therapy and cystoscopic extraction was successful in 44 cases. 7) Post-operative complications were urinary leaking (16 cages), wound infection(12 cases), hematuria (3 cases), ureteral stricture (1 case), and pyelonephritis (1 case).
Constriction, Pathologic ; Female ; Fluid Therapy ; Hematuria ; Humans ; Male ; Pyelonephritis ; Renal Colic ; Seasons ; Ureter* ; Wounds and Injuries

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

Extracorporeal shock wave lithotripsy monotheraphy was performed in 315 urinary stones from 278 patients with the Domestic SDS-2 lithotriptor using C-arm fluoroscopy between December 1991 and December 1994. Of 315 cases, renal stones were 150 cases(47.6%) and ureteral stones 165 cases(36.1%). No regional or general anesthesia was required but parenteral or oral analgesics were required in some patients. Among 315 cases who completed extracorporeal shock wave lithotripsy, the overall success rate of treatment was 90.5% with 92.4% in 5-9 mm, 94.8% in 10-19 mm, 89.7% in 20-29 mm and 61.5% over 30 mm or staghorn stones. Post lithotripsy complications were transient gross hematuria in 17.1%, renal colic in 11.4%, steinstrasse in 4.8%, petechia in 2.9% and fever in 1.9% and these complications were controlled with conservative treatment or repeated session of extracorporeal shock wave lothotropsy, percutaneous nephrodtomy, Double-J stent insertion or ureterolithotomy. We suggest that extracorporeal shock wave lithotripsy monotheraphy with the Domestic SDS-2 lithotriptor was considered to be effective and safe procedure for the initial treatment of urinary stones.
Analgesics ; Anesthesia, General ; Fever ; Fluoroscopy ; Hematuria ; Humans ; Lithotripsy ; Renal Colic ; Shock* ; Stents ; Ureter ; Urinary Calculi*

PURPOSE: This study was designed to correlate the size and position of ureteral stones to their clinical manifestation. METHODS: This study was a retrospective review of medical records of 201 patients who visited the emergency department complaining of renal colic and diagnosed with ureteral stone(s) by use of computed tomography from July to December 2011. The size and position of a stone and the corresponding ipsilateral hydronephrosis, as well as the number and type of administered analgesics, were evaluated. RESULTS: Ureteral stones were located at the ureteropelvic junction in 2.0% of cases, at the proximal ureter between the ureteropelvic junction and the iliac vessels in 41.8% of cases, at the ureter crossing external iliac vessels in 1.0% of cases, at the distal ureter between the iliac vessels and the ureterovesical junction in 12.9% of cases, and at the ureterovesical junction in 42.3% of cases. Where the ureter crossed external iliac vessels, the mean size of stones was significantly larger in the upper ureter, as 5.3+/-2.3 mm, than in the lower ureter, as 4.2+/-1.8 mm. Pain duration and stone size were significant factors associated with hydronephrosis by logistic regression analysis. Ketorolac was selected as the first-line analgesics in 169 patients (94.9%). The factor affecting the response to analgesic treatment was stone size. Patients needing analgesic administration three times or more, had smaller stones. CONCLUSION: Most of the ureteral stones observed were located in the proximal ureter and at the ureterovesical junction. Hydronephrosis occurred more often in patients who had longer periods of pain and larger stones. Patients with smaller stones needed more frequent administration of pain killers.
Analgesics ; Emergencies ; Humans ; Hydronephrosis ; Ketorolac ; Logistic Models ; Medical Records ; Renal Colic ; Retrospective Studies ; Ureter ; Ureteral Calculi