Fluids and diuretics for acute ureteric colic

A Prospective Randomized Comparison Between Early (<48 Hours of Onset of Colicky Pain) Versus Delayed Shockwave Lithotripsy for Symptomatic Upper Ureteral Calculi: A Single Center Experience

“…[8][9][10][11] Deferring the definitive treatment, however, usually results in more episodes of colicky pain along with other complications, such as urinary tract infection, azotemia, thus increasing morbidity. Very few studies, however, have reported the role of early=emergency SWL in the management of upper ureteral calculi immediately after colicky pain.…”

“…The usual management of acute renal colic from upper ureteral calculi is administration of analgesics and hydration therapy for relief of symptoms, except in complications such as acute pyelonephritis and acute renal failure. [8][9][10][11][12][13][14] The definitive management of stones in these patients is usually deferred because approximately 80% of stones <4 mm are expected to pass spontaneously. 10,15 As stone size increases, however, spontaneous passage becomes less likely.…”

Managing Urolithiasis

“…Intravenous hydration will benefit patients who are dehydrated or have been unable to drink as a result of vomiting; however, this use of such fluids to "flush out" a stone has not been shown to improve clinical outcomes. 33…”

A multicentre, prospective, randomized trial: comparative efficacy of tamsulosin and nifedipine in medical expulsive therapy for distal ureteric stones with renal colic

“…In the debate about URSL and ESWL, conservative therapy is obviously a desirable therapeutic option for ureteric stones. A systematic review evaluating the efficacies of fluids and diuretics found no credible evidence supporting a diuretic approach for pain relief and stone expulsion [8]. Expulsion of the stone requires ureteric peristalsis, diuresis must be discouraged in the presence of obstruction as it will increase intraluminal pressure that will reduce effective peristalsis [9].…”