Renal colic and ureteric stones
A ureteric stone causes severe colicky loin-to-groin pain by obstructing urine flow and triggering ureteric spasm; fever, anuria, renal impairment or a solitary kidney changes this into an urgent urological pathway.
Definition
Renal or ureteric colic is severe pain caused by ureteric obstruction, most commonly by a migrating urinary stone. It may be accompanied by haematuria, nausea and vomiting, but the diagnosis and urgency depend on the whole clinical picture.
First principles
Colic starts when a stone obstructs the ureter
Urinary supersaturation allows crystals to grow into stones, often from calcium oxalate or phosphate, uric acid, struvite or cystine. A renal stone can be silent until it enters the ureter. Obstruction raises pressure in the collecting system and provokes ureteric smooth-muscle spasm, producing severe waxing-and-waning pain.
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