Department of Urology, Jiménez Díaz Foundation Hospital, 28040 Madrid, Spain.
Arch Esp Urol. 2023 May;76(3):175-181. doi: 10.56434/j.arch.esp.urol.20237603.20.
Renal colic is characterized by sharp, intense flank pain. Nonsteroidal anti-inflammatory drugs are the treatment of choice, although extracorporeal shock wave lithotripsy (SWL) is a noninvasive alternative for pain management. The objective of our study is to present results obtained using rapid SWL to treat renal colic in our center.
We analyzed 214 patients undergoing rapid shockwave extracorporeal lithotripsy between October 2014 and June 2018: 69.63% were male, and 30.37% female, with a mean age of 47.35 years (range, 16-84). The average stone size was 6.71 mm (3-16). Stone locations were as follows: The pelviureteric junction (PUJ) (10.75%), proximal ureter (45.79%), midureter (24.77%), and distal ureter (18.69%).
Pain relief was achieved in 81.31% of the patients. The rates of successful pain control according to stone location were 65.22% when the stone was located in the PUJ, 79.59% in the proximal ureter, 88.68% in the midureter, and 85.00% in the distal ureter. Complete or partial stone resolution was achieved 4 weeks postoperatively in 78.50% of cases (64.95% and 13.55%, respectively). According to the stone location, the overall rate of resolution (complete + partial) was 90.00% for distal ureteral stones, 86.80% in the midureter, 73.47% in the proximal ureter, and 60.86% in the PUJ. 44 patients (20.56%) demonstrated complications. The most common complications were persistent pain, acute renal failure and fever.
Immediate SWL was found to be a safe and effective treatment option for pain related to renal colic in 81% of the patients studied.
肾绞痛的特点是剧烈的、剧烈的侧腹痛。非甾体抗炎药是治疗的首选，尽管体外冲击波碎石术（SWL）是一种非侵入性的疼痛管理替代方法。我们研究的目的是介绍在我们中心使用快速 SWL 治疗肾绞痛所获得的结果。
我们分析了 2014 年 10 月至 2018 年 6 月期间接受快速冲击波体外碎石术的 214 例患者：69.63%为男性，30.37%为女性，平均年龄为 47.35 岁（范围 16-84 岁）。结石平均大小为 6.71mm（3-16mm）。结石位置如下：肾盂输尿管连接部（PUJ）（10.75%）、输尿管上段（45.79%）、输尿管中段（24.77%）和输尿管下段（18.69%）。
81.31%的患者疼痛缓解。根据结石位置，结石位于肾盂输尿管连接部时，疼痛控制成功率为 65.22%，输尿管上段为 79.59%，输尿管中段为 88.68%，输尿管下段为 85.00%。78.50%的病例在术后 4 周时完全或部分解决结石（分别为 64.95%和 13.55%）。根据结石位置，完全或部分分辨率的总体发生率为：远端输尿管结石 90.00%，输尿管中段 86.80%，输尿管上段 73.47%，肾盂输尿管连接部 60.86%。44 例（20.56%）患者出现并发症。最常见的并发症是持续性疼痛、急性肾衰竭和发热。
即时 SWL 被发现是一种安全有效的治疗选择，可缓解 81%的研究患者的肾绞痛相关疼痛。
