The acute pain caused by kidney stones often occurs suddenly. This happens when a stone, moving along with the urine flow, suddenly blocks the outlet of the renal pelvis or the ureter, causing urine to accumulate in the kidney and resulting in hydronephrosis. At this point, there is a sharp increase in pressure inside the renal pelvis, which can produce intense pain. This pain usually has no obvious warning signs and, once it appears, progressively worsens in a paroxysmal manner.
Patients need to go to the hospital immediately for symptomatic treatment, such as intramuscular injection of analgesics, extracorporeal shock-wave lithotripsy, or inpatient surgery. With the above treatments, renal colic caused by most kidney stones can be effectively relieved. For smaller stones, extracorporeal shock-wave lithotripsy combined with medication to facilitate stone passage can lead to complete expulsion and cure. However, for patients with larger stones, after pain and any infection are controlled, inpatient surgery is recommended to remove the stones and prevent future episodes of severe pain or infection.
| Aspect | Details |
|---|---|
| Onset of Pain | Sudden; no obvious warning signs. |
| Mechanism | Stone moves with urine → blocks renal-pelvis outlet or ureter → urine accumulates (hydronephrosis) → rapid rise in intrarenal pressure → intense pain. |
| Pain Character | Paroxysmal, progressively worsening. |
| Immediate Management | Seek hospital care at once. |
| Acute Treatments | 1. I.M. analgesics 2. Extracorporeal shock-wave lithotripsy (ESWL) 3. In-patient surgery (if indicated) |
| Outcome for Small Stones | ESWL + medical expulsion → stone passage & cure. |
| Outcome for Large Stones | Pain/infection controlled → elective in-patient surgery to clear stones and prevent recurrence. |