Renal Colic Research Articles

Contribution of Imaging in the Diagnosis of Urinary Tract Lithiasis at the Fertilia Medical Clinic in Bamako

Aims: Urolithiasis is a common pathology which affects, depending on the country, from 4 to 20% of the population. Several epidemiological studies have shown over the last 30 years that the frequency of lithiasis continues to increase in industrialized countries. The objective of our study was to evaluate the contribution of imaging methods in the management of lithiasis of the urinary tree at the Fertilia medical clinic in Bamako. Subjects And Methods: This was a 24-month cross-sectional and prospective study, between January 2020 and January 2022, which involved 160 patients who came for imaging examinations looking for urinary tract lithiasis. Data were entered and analyzed using SPSS. Results: A total of 2,875 radiological examinations were carried out during our study period and we retained 160 cases of urinary tract lithiasis, i.e. a frequency of 05.56%. The most represented age group was 21-30 years old with 24.37%. The male sex represented 65%, pupils and students were the most numerous with 24.34%. 90.62% of our patients were referred to us by other doctors. The most common urological antecedent was urinary bilharziasis. The most cited reason for consultation was acute renal colic. The radiological examination that was performed the most was the combination of plain abdominal radiography and ultrasound. The ASP was normal in 28.75% of cases. The renal site was the most common location of lithiasis (63%) and mainly on the left (46.25%). The calyx location of lithiasis was the most common with 58.75%. The number of lithiasis was two or more in 54.38%. The most cited ureteral location was the terminal ureter (60%). The complication on the upper urinary tract was hydronephrosis (60%). Creatinine was normal in 76.87% of cases. Conclusion: Urolithiasis remains a fairly common condition in Gao. It is especially seen among the working population. It is common at all ages and more frequently in males. Urolithiasis is responsible for temporary professional ..........

The efficacy of intradermal sterile water application in severe renal colic: a randomised clinical trial.

It is important to do a fast and effective treatment for patients with renal colic pain in emergency departments for both patients' comfort and clinicians' patient management. In this study, we aimed primarily to test the efficacy of intradermal sterile water application as a rapid and effective treatment in severe renal colic. This is a single-centre, prospective, randomised controlled trial. Study group consists of patients with severe renal colic related to urolithiasis. Patients were randomly divided into three groups. The first group received only intramuscular diclofenac sodium, the second group received intramuscular diclofenac sodium and intradermal sterile water, and the third group received intramuscular diclofenac sodium together with intravenous fentanyl. Numerical Rating Scale was used to determine the level of pain before and after the treatment at the 1st, 5th, 15th, 30th, 60th and 120th minutes. 95 out of 201 patients with severe renal colic pain randomly divided into 3 groups. The pre-treatment pain severity of the groups was similar (p = 0.228). We found thatthe decrease in pain intensity was significantly faster in the intradermal sterile water group than the other groups even in the first minute. Percentages of patients who had 50% pain reduction, which is considered as successful treatment, was higher in the intradermal sterile water group (which had 75.9% success rate) in the first 5min compared to the IM diclofenac sodium group (which had 7.1% success rate) and IV fentanyl group (which had 25% success rate) (p < 0.001). According to the results, pain control was achieved much faster than the other methods with intradermal sterile water injection. All methods were found to be effective in relieving the pain of the patients.

Gender-related differences and its effects on ureteroscopy success

Introduction. The prevalence of urinary stone disease (USD) historically considered a predominantly male disease. It has been rising over the last several decades with the rate of increase being higher among females. However, factors such as stone localisation, size, and density are usually analysed in postureteroscopic complications, and reports on gender-specific differences in the treatment of USD are scarce.Objective. To investigate the impact of gender differences on treatment success, intraoperative and postoperative complications in patients undergoing ureteroscopy.Materials &amp; methods. A total of 300 patients with USD, who were performed ureteroscopic interventions in the period from September 2021 to November 2022 in Yudin City Clinical Hospital. Depending on gender, patients were divided into two groups — 194 (64.7%) men and 106 (35.3%) women. Recurrent USD was observed in 71 (36.6%) cases in Group I and in 45 (42.5%) cases in Group II, with an average recurrence time of 4.3 and 6.3 years, respectively. Male and female patients have had stone location in the upper third in 14.4% and 18.9% of cases, in the middle third in 18% and 6.6% (p = 0.005), in the lower third in 36 .1% and 49.1% (p = 0.04), in the intramural ureter in 28.9% and 21.7%, and in several localisations in 2.6% and 3.8% of cases, respectively.Results. The duration of surgery did not differ in both groups and composed 41.6 minutes. Internal ureteral stent placement was in 37 (19.1%) male patients and in 14 (13.2%) female patients. Based on specialised postureteroscopic lesion scales such as PULS and Satava, the percentage of complications in Groups I and II was 2.1 and 2.8 and 4.1 and 9.4 (p = 0.03) respectively.Conclusion. The development of acute renal colic in women with patients less intensity than in the male group leads to hospitalisation in the delayed period. In female patients, the number of postureteroscopic complications has higher rates due to the size and density of the stone and its location.

Chinese mini percutaneous nephrolithotomy for upper urinary calculi under local infiltration anesthesia.

Percutaneous nephrolithotomy is generally performed under general or regional anesthesia; however, it is rarely performed under local infiltration anesthesia (LIA). This study aimed to assess the safety and effectiveness of Chinese mini percutaneous nephrolithotomy (MPCNL) for upper urinary calculi under LIA. A retrospective analysis of 52 patients with upper urinary stones who underwent MPCNL under LIA from April 2019 to May 2022 was performed. Pethidine and Phenergan were intramuscularly injected 30 minutes preoperatively. Oxybuprocaine hydrochloride gel was applied to the urethra for lubricating and mucosal anesthesia. Ropivacaine hydrochloride and lidocaine were injected into the whole percutaneous channel for local anesthesia. An 8/9.8F ureteroscope and an 18F vacuum-assisted access sheath were applied in MPCNL. All 52 patients tolerated procedures and underwent operations successfully; none of them converted the anesthesia method or required additional analgesia. The mean visual analogue scale scores intraoperatively and at 6 hours, 24 hours, and 48 hours after surgery were 3.25 ± 0.52, 3.13 ± 0.69, 2.25 ± 0.56, and 1.58 ± 0.50, respectively. The stone free rate was 84.6%. Complications were seen in 6 (11.5%) patients, including fever in 2 patients (Clavien I), renal colic in 1 patient (Clavien I), clinically insignificant bleeding in 2 patients (Clavien I), and urinary tract infection in 1 patient (Clavien II). No severe complications were observed in any patients. Chinese MPCNL under LIA was a feasible option and achieved good outcomes in appropriately selected patients, and it may become the routine procedure for general patients.

Septic and febrile kidney stone presentations during the COVID-19 pandemic What is the effect of reduced access to care during pandemic restrictions?

During the early stages of the COVID-19 pandemic, hospitals shifted their resources and focus toward COVID-19 care and non-deferrable conditions. Renal colic is one of the most common urologic presentations to the emergency department (ED ). In our study, we examined whether there was an increase in septic/febrile stone presentations to the ED requiring ureteral stent insertion after the public health restrictions during the COVID-19 pandemic. We carried out a retrospective cohort study and reviewed charts of septic/febrile stone patients requiring ureteral stent insertion from January 1, 2019, to March 16, 2020 (pre-COVID) and July 1, 2020, to December 31, 2021 (intra-COVID) at the Queen Elizabeth II Health Sciences Centre in Halifax, NS. The incidence of septic/febrile stone presentation, baseline characteristics, and perioperative outcomes were captured. There were 54 patients in the pre-COVID group and 74 patients in the intra- COVID group. There were no statistically significant differences found in baseline or stone characteristics between the two groups (p>0.05). Patients in the intra-COVID group were found to have a longer presentation to operating room time when compared to the pre- COVID cohort (U=961.00, p=0.04). The intra-COVID group had 20 more cases of septic stone presentations compared to the pre-COVID group at the 15-month mark (pre-COVID, n=54; intra-COVID, n=74). We found increased time to operative intervention in the intra-COVID cohort compared to the pre-COVID cohort. The overall number of urgent and/or critically ill ureteric stone patients increased between cohorts but was not statistically significant.

Diagnostic Validity Of Low Dose CT KUB In Demonstration Of Genitourinary Tract Calculi Compared To Normal Dose Ct Kub: A Provisional Study

Objective: Renal colic is a common clinical condition. Our objective is to evaluate the diagnostic accuracy of low dose CT KUB for detection of urinary stones, to minimize radiation dose to the patients, and to analyze diagnostic accuracy of LDCT KUB in comparison to standard dose CT KUB. We speculate the LDCT KUB may reduce patient radiation dose while maintaining diagnostic value.&#x0D; Materials and Methods: This comparative cross sectional validation study was conducted at Department of Radiology in Benazir Bhutto Hospital, Rawalpindi June 2021 to Feb 2022. After approval of hospital ethical committee, a sample of 49 kidneys of 31 patients was collected by non-probability consecutive sampling technique. Included were the patients diagnosed with renal calculi referred from other departments. All the included patients were scanned by Toshiba Aquilion 16 slices, using automated tube current modulation, without any oral or IV contrast. CT scan started from diaphragm down to pubic symphysis with standard dose CT (SDCT) followed by low dose CT (LDCT). After the data was recorded, statistical package for social sciences, version 20.0 (SPSS Inc., Chicago, Illinois, USA) was used to analyse the data and generate results. Mean + standard deviation was calculated for qualitative data while frequency and percentage for qualitative variables. The means were compared by independent sample t test while the agreement between standard and low dose was depicted by kappa value.&#x0D; Results: A total of 49 kidneys of 31 patients with renal stones was included in this study. The mean age of the patients ranged from 27 years to 48 years with a mean of 36.42 + 9.97 year. In gender distribution, 75.5 % (37) were male while 24.5 % (12) were females. More than half 59 % (29) were right while 41 % (20) were left kidneys.&#x0D; Conclusion: This study demonstrated that LDCT was a productive and effective technique in the detection of urothelial stones despite considerable reduction in radiation dose and exposure as seen in SDCT.

Prevalence and implications of perinephric fluid on renal point-of-care ultrasound in the emergency department

BackgroundPoint-of-care ultrasound (PoCUS) is commonly utilized in the setting of renal colic. The presence of perinephric fluid may be an overlooked finding associated with ureteral obstruction. Our aims were to determine the prevalence of perinephric fluid on emergency physician-performed PoCUS and to determine whether perinephric fluid was associated with stone size or urologic intervention. MethodsThis was a 12-month cross-sectional study at an academic emergency department (ED) that took place from January 1, 2022, to December 31, 2022. All adult ED patients ≥18 years of age who had a renal PoCUS examination performed were included. Patients with missing or inadequate PoCUS images were excluded. Investigators blinded to PoCUS images and interpretations performed chart review for demographic data and outcome variables, while separate investigators blinded to clinical data reviewed PoCUS images to assess for perinephric fluid and hydronephrosis. A chi-square analysis was used to determine significance of association between perinephric fluid and outcome variables (stone size, urologic intervention). ResultsThere were 442 patients screened; 18 were excluded due to inadequate images and 4 were repeat visits of which only the initial visit was analyzed. Of the remaining 420 patients included, the prevalence of perinephric fluid was 6.2% (n = 26). Most patients (23/26) with perinephric fluid had final diagnoses consistent with ureterolithiasis. Hydronephrosis was present in 115 of the 420 patients (27.4%) and of these, 22 (19.1%) had perinephric fluid which was significantly associated with a need for urologic intervention; odds ratio (OR) 10.38 (95% CI 2.70–39.85), p < 0.01. Among the 67 patients with confirmed ureterolithiasis on computed tomography, perinephric fluid was associated with stone size ≥5 mm; OR 4.00 (95% CI 1.01–15.85), p = 0.04. ConclusionThe prevalence of perinephric fluid on emergency physician-performed renal PoCUS was 6.2% of all studies and 19.1% of patients with hydronephrosis. In the setting of ureterolithiasis, perinephric fluid was associated with larger stone size and need for urologic intervention.

634 Analgesia Use in Acute Renal Colic Patients- Complete Audit Cycle

Abstract Aim Prevalence of renal colic is up to 20% worldwide, with recurrence rates approaching 50% within 10 years- making it a common acute presentation. NICE guidance (NG118) states NSAIDs are first-line analgesia for renal colic, followed by intravenous paracetamol and opiates. Our aim was to assess compliance with NG118 within one acute NHS teaching Trust. Method All patients with renal colic as the primary differential diagnosis during March and April 2022 (1st cycle) and September and October 2022 (2nd cycle) were included. Data was extracted retrospectively from electronic patient records into a pre-designed proforma. Findings from the 1st cycle were presented within local departmental meetings. Posters were also installed reminding clinicians of the analgesic pathway within the relevant clinical areas. Subsequently, a re-audit was performed. Results 90 patients were included (60- 1st cycle, 30- 2nd cycle). There was a significant improvement in compliance between the 1st and 2nd audit cycles (60% versus 83%, p = 0.0193). However in cases of non-compliance, documentation was poor (&amp;gt;70% did not state a reason) during both cycles. Imaging confirmed renal colic in 82% of patients in the 1st cycle and 93% of patients in the 2nd cycle. PR Diclofenac was the most common NSAID prescribed. Conclusions Low-cost, easily reproducible interventions resulted in significant prescribing practice changes. Findings from the latest national renal colic audit (2012-13) showed analgesia compliance in only 69% of cases nationally- similar to our 1st audit cycle results. Disseminating our findings to other hospitals regionally and nationally will hopefully result in better outcomes for renal colic patients.

1080 A Quality Improvement Project Developing a 'Return to Scan' Failsafe Protocol for Barnsley Hospital Emergency Department Patients with Suspected Cauda Equina and Renal Colic

Abstract Aim A staff survey noted patients returning for scans for suspected cauda equina and renal colic were on occasion not returning or returning late. Overall, staff and patient experience were poor and posed risk to patients. To improve this, aims were to develop a standard process for recording ED patients due to return for scan and formalised information about this process to be provided to the patient. Method Three cycles were completed. Staff surveys identified areas of concern, supported by a fishbone diagram and process map. A proforma and patient information sheet were developed. Further staff surveys assessed satisfaction and effectiveness of the changes, leading to replacement of the proforma with a patient notes sticker. A booking system was created identifying patients to reception staff. Further cycles identified 64 patients in a 3-month period by suspected diagnosis using SNOMED codes. Records were accessed electronically using Mediviewer to review documentation and time returned for scan. Results 98% of patients returned for scan. Process followed: 36% of patients returned late, with an average of 22 minutes and maximum of 40 minutes late. Process not followed: 36% of patients returned late, with an average of 58 minutes and maximum of 219 minutes late. The process was followed correctly in 17% of cases. Conclusions Patients were late by a shorter on average time when the process was followed - with providing patient information having the greatest positive impact. Staff education may improve process compliance which is poor. Patient experience and barriers to returning on time must be explored.

Congenital ureteral valve as a diagnostically challenging congenital ureteral defect

The authors present two cases of ureteral valves. This rare urinary tract defect, causing abnormal urine flow from the upper urinary tract, is usually diagnosed intraoperatively. A 15-year-old girl with renal colic was admitted to hospital. Abdominal ultrasonography showed pelvicalyceal dilation in the right kidney and the X-ray showed a shadow in the orifice of the left ureter. She underwent bilateral ureterorenoscopy. A left ureteral valve was visualised during the examination. A 13-year-old boy was admitted to the Department of Surgery due to pelvicalyceal and left ureteral dilatation. Based on imaging and clinical findings, both patients underwent surgical treatment. Valves were found in the distal part of the left ureters. They were resected and the ureters were transplanted. Histopathological examination showed the presence of smooth muscle in the folds of the valve, confirming the final diagnosis.

Calcutta position: A new modified supine decubitus for supine PCNL.

PCNL (percutaneous nephrolithotripsy) is considered the gold standard treatment for renal stone more than 2 cm. In today's scenario, supine PCNL is considered equally effective as prone PCNL. The ideal position for supine PCNL is still debatable. We hereby describe our initial experiences of supine PCNL in a novel position. This prospective study includes 60 patients who underwent supine PCNL in the 'Calcutta position' in our institute from August 2021 to August 2022. Successful procedure was defined as a complete stone free rate or a clinically insignificant residual stone (<4 mm). Average Operative room (OR) occupancy time was 130.9 ± 19.63 min. The immediate stone free rate was 84.2%, 71.4% and 37.5% for single, multiple and staghorn calculus respectively. Complications include fever, requirement of blood transfusions and renal colic. The average hospital stay was 83.6 ± 17.42 h. Eight patients (13.3%) required secondary procedures like extracorporeal shock wave lithotripsy (ESWL) or relook PCNL. At 3 months average stone free rates were 92%, 85%, 75% for single, multiple and staghorn calculus respectively. We performed supine PCNL in Calcutta position in obese, kyphoscoliosis, poliomyelitis, autosomal polycystic kidney disease (ADPKD), malrotated kidney and diverticular stone with comparable success. Supine PCNL in Calcutta position is a safe and effective option for nephrolithiasis management. Apart from the inherent advantages of supine PCNL it also has the advantages of better C-Arm and nephroscope manoeuvrability. Supine PCNL in Calcutta position was performed in a variety of scenarios with comparable results.

Stone Density and Skin to Stone Distance in Non-Contrast Computed Tomography as Prognostic Indicators for the Success of Extra Corporeal Shockwave Lithotripsy in Ureteral Stone Disease

Background Ureteral stones are a major health concern with a worldwide rising prevalence. Ureteral stones formed in the kidney and then descending the ureter commonly manifest themselves as renal colic. Extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy are the two primary treatment modalities for the management of symptomatic ureteral calculi, Aim of the Work In this study we tried to assess the prognostic value of patient and stone characteristics in potential candidates for ESWL in ureteral stones. Patients and Methods We studied the records of 66 patients with upper ureteral calculi who underwent ESWL. We considered patients being stone free (SF) or when &amp;lt; 4 mm fragments were detected. Age, gender, skin to-stone distance, maximum stone length, stone Hounsfield units (HU) were explored in uni- and multivariate regression analysis. Results We found that obesity (BMI &amp;gt; 29.3), high stone density (HU) &amp;gt;935, skin to stone distance &amp;gt;10 and presence of ureteral stent were all factors impeding success of treatment. On the other hand, higher shock intensity and number of shocks per session were positive predictors of treatment success. Conclusion It was concluded that the evaluation of patient and stone characteristics pre ESWL can predict the success of treatment for ureteric stones and we recommend thorough evaluation of the parameters before treatment to determine the best treatment modality for each patient. To date there seems to be value in using these variables to aid in better selecting patients for ESWL and thus improving the efficacy of ESWL. Our study was limited by the number of centers and participants. A wider range of participants would probably achieve more efficient results. Further studies on a larger scale would be better to further validate these results.

Comparison of acetaminophen, ketamine, or ketorolac versus morphine in the treatment of acute renal colic: A network meta-analysis

BackgroundRenal colic is a disease in which a calculus obstructs the urinary tract, resulting in severe pain do ureteric peristaltic movements. Other symptoms, such as hematuria, nausea, and vomiting, may accompany the pain. This network meta-analysis aimed to compare the efficacy and safety of different analgesic agents for the treatment of acute renal colic. MethodsMedline, Embase, and CENTRAL databases were searched. Randomized controlled trials (RCTs) that compared different analgesic agents, either alone or in combination were included. For the management of acute renal colic, analgesic agents were selected based on the current standard medical practice. The medications included intravenous acetaminophen, ketamine, ketorolac, and morphine. This study sought to evaluate the pain score on the visual analog scale (VAS) at 15, 30, and 60 min; adverse events; and the utilization of rescue therapy. The efficacy of different analgesic agents was explored through a frequentist network meta-analysis using the Netmeta statistical package in R software. All treatments were ranked using the Netrank function, yielding P-scores. ResultsTwelve RCTs were deemed eligible. As per the P-scores, acetaminophen was the most effective in reducing pain score at 15 min (P-score = 0.74). Ketorolac was the most effective in reducing the pain score at 30 and 60 min (P-score = 0.84) (P-score = 0.99), whereas morphine was the least effective (P-score = 0.07). Moreover, morphine was correlated with the highest odds of adverse events after treatment (P-score = 0.89). Morphine was the most frequently required rescue therapy in cases of suboptimal pain relief (P-score = 0.96). ConclusionThis network meta-analysis demonstrated that ketorolac and acetaminophen were the most effective analgesic agents according to the pain score. Morphine showed the highest adverse event profile and the highest rate at which rescue therapy was required for the management of acute renal colic.

Evaluation of the effect of oral Ketamine compared to placebo on pain reduction in patients with renal colic: a double-blind randomized clinical trial study

Introduction: Renal colic caused by urolithiasis is one of the common causes of severe pain and referral to the emergency room. Using a multimodal method in controlling this type of pain by available anesthetics such as ketamine can help relieve pain, increase satisfaction and reduce hospitalization. Method: This study was conducted as a double-blind clinical trial. 44 patients with renal colic with ASA class 1 were divided into two intervention and control groups. Pethidine (1mg/kg) was administered to both groups. In the intervention group, oral ketamine (0.5 mg/kg) dissolved in 5% dextrose was prescribed, and in the control group, 5% dextrose serum (0.1 ml/kg) was used. Pain intensity was measured by numerical method (NRS) before the treatment and half, one, two and three hours after the intervention. Findings: The median age of the intervention group was 35.2 and the control group was 38.9 (p=0.092). The average amount of pethidine consumed in the intervention group was 94 mg and in the control group was 89 mg, and there was no significant difference between the two groups (p=0.095). In the intervention group, 27.3% and in the control group, 72.7% needed additional pethidine (p=0.000). In hours one, two and three after treatment, the intensity of pain in the intervention group was lower than in the control group, and only in the third hour this difference was statistically significant (p = 0.03). Conclusion: The use of oral ketamine can reduce restlessness without causing side effects and along with pethidine can help relieve the pain of renal colic in the emergency department

«Forgotten» encrusted ureteral stents

The article presents a rare clinical observation of patient S., 50 years old, a long-term sufferer of urolithiasis, who was admitted to the urological department of the hospital with a clinical picture of renal colic on the leſt side, exacerbation of chronic pyelonephritis. From the anamnesis: in 2021, internal stenting of both ureters was performed as indicated. Despite detailed recommendations at discharge, the patient did not consult doctors or take any medications until 2023. The examination revealed that the cause of exacerbation of chronic pyelonephritis and impaired urine outflow were encrusted (“forgotten”) stents in both ureters, in the leſt of which there was a concrement obstructing urine outflow. Ureteroscopy on the right side, stent fragments extraction; ureteroscopy on the leſt side, contact lithotripsy, removal of the encrusted ureteral stent; urinary passage and independent urination were restored. Despite technical difficulties during the surgical intervention, the postoperative period proceeded without complications.

Assessment of clinically significant urolithiasis positivity rate using CT KUB for suspected renal colic.

Unenhanced low-dose computed tomography of the kidneys, ureter and bladder (CT KUB) is the gold standard diagnostic imaging modality in the assessment of suspected renal colic. As the radiation dose is not negligible, it is important to monitor the diagnostic yield of CT KUBs. The aim of this study is to evaluate the diagnostic yield of CT KUB studies performed for suspected renal colic in patients presenting to the emergency department. A retrospective review was performed of 500 patients who underwent CT KUB for suspected renal colic over a seven month period from June 2019 to January 2020. Clinical information and imaging was reviewed for each patient. Statistical analysis was performed using GraphPad Prism 8 (GraphPad Software, San Diego, CA, USA). Forty-nine percent of patients in the series were female (248/500) and the mean age was 45. The positivity rate for obstructing ureteral calculus was 34% (169/500). Concerningly, there was a significantly lower positivity rate in females compared to males (19% versus 48%; p < 0.0001) which raises the issue of unnecessary radiation exposure to this cohort. In the 200 female patients who were negative for obstructing urolithiasis, the mean age was 43. Females also had a significantly higher rate of negative CT KUB (62% versus 37%; p < 0.0001) where no underlying alternative pathology was diagnosed. Women are less likely than men to have obstructing urolithiasis on CT KUB for suspected renal colic. This difference is not accounted for by a higher rate of alternative diagnoses among female patients. The findings of this study should prompt clinicians to exercise caution when considering this imaging modality in this patient cohort.

Translation and validation of the Italian version of the Wisconsin Stone Quality of Life Questionnaire (I-WISQOL) for assessing quality of life in patients with urolithiasis

Urolithiasis is a chronic condition, and it has been associated with a significant negative impact on patients' health-related quality of life (HRQOL). Several tools to assess patients' HRQOL have been validated in Italian, however disease-specific HRQOL instruments are still lacking. We aimed to develop and validate the Italian version of the WISQOL (I-WISQOL) in patients with urolithiasis. The Italian version of the WISQOL was developed in a multistep process involving primary translation, back-translation, and pilot testing among a group of patients (N.=10). Patients presenting with urolithiasis were prospectively recruited from the outpatient stone clinics and completed both questionnaire WISQOL and SF-36. Demographic information, as well as medical and surgical data, were obtained through an interview. Internal consistency of the I-WISQOL was obtained with Cronbach's α. Correlation of total scores of the I-WISQOL and SF36 was assessed to determine convergent validity using Spearman Rho. Correlations between clinical variables and results from the I-WISQOL were analyzed to descriptively assess the association of interest. A total of 93 participants were evaluated and completed the Italian version of the I-WISQOL. The I-WISQOL demonstrated excellent internal consistency (Cronbach's α 0.95) and good convergent validity with the validated SF-36 (Spearman Rho r=0.70, P<0.001). Using ANOVA analysis, a significant decline in WISQOL Score was noted with the increasing number of renal colics (P=0.0543), ER visits (P=0.037), number of inpatient hospitalization (P=0.025). At multivariate analysis, worse WISQOL total score was predicted by a greater number of renal colic events (ß=-4.92 [-8.81-1.04], P=0.014) and by a greater number inpatient hospitalization (ß=-7.31 [-14.35 -0.26], P=0.042). The I-WISQOL is an internally consistent and valid instrument to assess HRQOL in Italian-speaking patients with kidney stones. Its use in clinical practice should be implemented in order to tailor the management of each patient.

Detection of Renal Stones by Ultrasonography

Background: Kidney stones also known as renal stones are hard deposits made of minerals that develop in the urinary system or kidneys. Numerous symptoms, including excruciating pain in the lower back, abdomen, or groin, nausea, and vomiting, can be brought on by renal stone. Objective: To evaluate the accuracy of ultrasonography for the presence, location, and site of stones in patients with acute renal colic Methods: This research was conducted in the radiology department of the Jalal Pur Diagnostic Centre. Data were acquired from October 2022 to March 2023.100 patients were included in the study. Patient-informed permission was acquired following the ethical standards outlined by the research committee. Results. The study shows that 74% of patients have unilateral renal stones while 26% have bilateral renal stones. About 43 people had urolithiasis on the left side. The majority of stones were present in the lower pole of the kidney. Conclusion: Ultrasonography can be utilized as a primary evaluation technique in patients presenting with acute renal colic. Males are most commonly affected by renal stones than females and patients between the ages of 31 and 45 are the most usually affected.

A comparative study of intranasal desmopressin and intranasal ketamine for pain management in renal colic patients: a randomized double-blind clinical trial.

Urolithiasis is one of the most common urological diseases worldwide, usually presenting as renal colic that leads to severe pain that requires analgesic treatment. This study aimed to compare the efficacy of ketamine and desmopressin in the pain management of renal colic patients. This double-blind, randomized clinical trial was conducted on renal colic patients referred to the emergency department from June 2021 to July 2022. Patients were randomly assigned to three groups. In the desmopressin group, patients were treated with intranasal desmopressin and intravenous ketorolac. The ketamine group was treated with intranasal ketamine and ketorolac. The control group received ketorolac and an intranasal placebo. Vital signs were evaluated at baseline and 60 minutes; and pain scores were assessed at baseline, 10, 30, and 60 minutes after treatment. Enrollment included 135 patients, the mean (standard deviation) age was 44.1±11.4 years, and 82 (60.7%) were men. The mean visual analog scale scores were significantly lower at 10, 30, and 60 minutes in the ketamine group (5.6±1.2, 3.0±1.1, and 0.9±0.9, respectively) compared to the control (8.2±1.1, 5.1±2.0, and 2.3±2.6, respectively) and desmopressin (6.7±1.8, 4.2±2.2, and 1.3±1.4, respectively) groups (P<0.05). Although patients in the desmopressin group had lower mean pain scores than the control group at 10, 30, and 60 minutes, this difference was only significant at 10 minutes after the intervention (P<0.05). No significant differences in vital signs were found at 60 minutes after treatment. Ketamine showed more favorable analgesic effects in renal colic patients than desmopressin, although desmopressin showed efficacy in the first minutes posttreatment.

Complementary and Alternative Medicine Usage and Quality of Life in Patients With Renal Colic Attack.

Decreased quality of life is observed in individuals who fear surgery or experience severe symptoms due to urinary system stone disease (USSD). As a result, some patients seek complementary and alternative medicine (CAM) methods. This research evaluates preoperative CAM usage and its effects on quality of life for patients who experience renal colic (RC) due to USSD. The research was conducted between April 2020 and 2021 in the application and research center of a university. One hundred ten patients who were scheduled to have surgery due to USSD were included in the study. The data were collected using the "personal information form," "Use of CAM Methods of Individuals," and 36-item Short-Form Health Survey (SF-36) forms. Of research participants, 47.3% reported using at least one CAM method. The most common methods were exercise combined with phytotherapy (16.4%) and dietary supplements (15.5%). The proportion of participants who reported using 1 or multiple CAM methods for pain was 48.1%. The Social Functioning scores obtained from the SF-36 of the CAM users were statistically significant. For the participants who used a CAM method, the average Role-Emotional score obtained from the SF-36 was statistically significant. Health professionals should know which CAM methods patients may prefer and to what extent various CAM methods affect quality of life. More studies are needed to identify factors affecting the use of CAM methods in patients with RC attacks and to understand the relationship between CAM method(s) and quality of life.