ABSTRACT
Renal colic is a severe paroxysmal pain that occurs from obstruction of the ureter at any point along its course. The most common cause of ureteral obstruction is a kidney stone that formed within the calyceal system of the kidney, became dislodged, and has been passed along the path of urine flow. In attempting to do so, however, the stone becomes wedged within the ureter somewhere along its course between the point at which the ureter joins the collecting system of the kidney (ureteropelvic junction) and the point at which the ureter enters the bladder (ureterovesical junction). It is estimated that approximately 12% of the population is expected to have urinary stone disease at some time in their lives (Sierakowski, Finlayson, Landes, Finlayson, & Sierakowski, 1978). In 55.4% of these individuals, it has been found that at least one first-degree relative had experienced renal stones, demonstrating that a hereditary component plays a significant role in urolithiasis (Ljunghall et al., 1985). The natural cumulative recurrence rate of calcium oxalate renal stones is approximately 14% within 1 year, 35% within 5 years, and 52% within 10 years (Uribarri, Oh, & Carroll, 1989). The gravity of this pathophysiological process is reflected in the cost incurred to the U.S. economy in 1993 that totaled $1.7 billion, including indirect costs from loss of productivity (Menon & Resnick, 2002). Although discussion of all causes of ureteral obstruction is beyond the scope of this chapter, the etiologies are multiple and diverse: they may be intrinsic or extrinsic, including, for example, congenital anomalies such as ureteral stricture and ureterocele; neoplastic processes such as primary or metastatic carcinomas of the ureter; inflammatory processes such as tuberculosis, schistosomiasis, or endometriosis; and other pathologic processes such as retroperitoneal fibrosis and pelvic lipomatosis.
