What are renal colic symptoms? Renal colic in women: causes, symptoms and treatment, emergency care

Renal colic is acute, unbearable, paroxysmal pain in the lumbar spine caused by impaired outflow of urine from the kidney. At the same time, the blood supply to the organ is reduced, nutrients and oxygen are not supplied. The attack occurs unexpectedly, at any time of the day or night.

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Pathogenesis

Difficulty in the process of urination leads to overflow of the pelvis and calyces with urine, increased pressure, and as a result, blood circulation in the kidney is impaired.

Renal colic is an attack with serious impairment of organ functionality and injuries to the surfaces of the ureter.

The consequences of the condition pose a danger to a woman’s life.

Ureteral stones are usually small in size – up to 5 mm in diameter. They leave the body freely. Stones with a diameter of 5–10 mm pass away unexpectedly, and large ones (from 1 cm) are removed only in a hospital, for example, surgically. If the stone does not pass within 2 months, it will not pass away on its own.

Symptoms in women

Unpleasant painful sensations occur suddenly, without any preliminary signs. Renal colic has one main symptom is pain. There is no relief when changing body position. It is characterized by severity, contractions, and often occurs at night, during sleep.

In some patients with a low sensitivity threshold, vomiting and nausea are added. Pregnant women experience increased uterine tone, which poses a danger to the fetus. Spasms are transmitted to nearby organs. The intestines create false urges to empty. Hematuria (blood in the urine) and dysuria (impaired urination) are present. Elevated temperature occurs against the background inflammation and infection.

This depends on the degree of inflammation of the urinary tract. If there are stones in the pelvis, the source of pain is located above in the lumbar region, sensations are distributed to the rectum and abdomen.

When obstruction is present in the ureter, the source of pain is located in the lower back on the side of inflammation, pain can be felt in the groin, urethra, and external genitalia. In most patients the stomach and genitals hurt more than the kidneys. Parts of stones, blood and salts are found in the urine.

Only a doctor should diagnose an attack of renal colic so as not to confuse it with other causes of pain. These include running, sports games, excessive physical activity, drinking plenty of fluids, and using diuretics.

During an attack, additional symptoms appear:

• constant urge to urinate;
• drying of the oral mucosa;
• cutting, drawing pain in the rectum;
• chills;
• disruption of the heart;
• loose stool.

If these symptoms occur, you should immediately consult a doctor.

Causes of colic

An attack of renal colic is caused by the following pathological phenomena:

• contraction of the ureteral muscles;
• increased pressure in the pelvis;
• kidney ischemia;
• swelling of the parenchyma;
• stretching of the fibrous capsule;
• venous stasis;
• glucocorticoid therapy;
• blockage by blood clots;
• detached part of the tumor.

Urinary retention occurs due to concomitant diseases:

• pyelonephritis;
• kidney tuberculosis;
• allergic diseases;
• infectious diseases;
• urolithiasis disease. Stones in the pelvis move, become pinched in the ureter (usually in the lower section);
• compression of the ureter under the influence of tumors of neighboring organs;
• kidney injuries;
• bladder tumor.

Kinking of the ureter cause the following reasons:

• dystopia (improper arrangement of organs);
• nephroptosis;
• ureteral stricture (narrowed lumen);
• inflammatory process;
• heart attack;
• embolism;
• renal vein thrombosis;
• congenital anomalies;
• renal tumors;
• prostate cancer;
• prostate gland;
• venous phlebostenosis.

Duration of renal colic

Attack always lasts for a long period, in most cases from 12 to 24 hours.

Often the pain is observed for several days in a row, sometimes there are moments of weakening, but the unpleasant sensations do not disappear completely.

They increase progressively, the character is constant with intensified attacks.

The pain goes through three phases. Sometimes renal colic lasts less (from 3 hours). Highlight:

• Acute period. The attack appears at night or in the morning. During the day, it most often proceeds slowly. The peak intensity occurs in the 1st–2nd and 5th–6th hours of the attack.
• Constant period. The phase begins after 1–4 hours and lasts up to 12 hours. It is then that patients are given help and a course of treatment is prescribed.
• Fading period. For several hours, patients feel relief from pain relief.

Female characteristics

A condition associated with blockage of the urinary tract sometimes indicates surgical pathologies of the female reproductive system, which is not related to kidney function. This could be one of the following factors:

• fallopian tube ruptures;
• ovarian apoplexy;
• ovarian cyst when damaged.

Gynecological diseases are accompanied by additional symptoms:

• hypotension (low blood pressure);
• increased heart rate;
• pale skin;
• dizziness;
• cold sweat.

Syndrome in pregnant women

Symptoms of renal colic: pain with contractions, hematuria, passage of stones.

It is important for a pregnant woman to monitor her health in order to detect and diagnose the disease in time, stop pain, and prevent consequences.

The hardest thing complication – premature birth.

Painful spasms are relieved with antispasmodics. Manipulations are carried out under the supervision of a doctor.

Important! When providing first aid for renal colic, thermal procedures are strictly prohibited.

Complications

If the difficulty in the outflow of urine continues throughout the day, while the outflow of urine is blocked completely, this leads to to irreversible kidney damage. So, a stone that is located in the ureter manifests symptoms a month after its appearance.

Complications of renal colic:

• deterioration of kidney function;
• (purulent inflammation);
• difficulty in patency of the ureter;
• development of pyelonephritis.

Timely recognition of renal colic and qualified medical care will ensure the preservation of the kidney.

First aid

At home, first aid measures must be taken. The woman herself, under the influence of the syndrome, does not always know how to help herself. What to do in this state?

First aid consists of several stages:

1. Warming compress. The heating pad is applied to the area where painful spasms are felt (abdomen or back).
2. Sitz bath. Effective relief occurs when taking a hot bath, the temperature of which is 40 degrees.
3. Taking medications. Relief from spasm is achieved by taking No-shpa. Painkillers will temporarily reduce the pain threshold (Ketanov, Ibuprofen). An attack cannot be treated with painkillers; they do not affect the course of the disease, so simply stopping the symptoms is not worth it.

Repeated attacks of renal colic require mandatory hospitalization.

Doctor's help

1. Creating complete peace for the patient.
2. Measures to relieve spasms, stabilize the outflow of urine (thermal physiotherapy).
3. Administration of painkillers.
4. The use of medications that reduce spasms and antiemetics.
5. Taking drugs of the narcotic group (morphine, promedol, tramadol).
6. Carrying out a blockade according to Lorin-Epstein implies administration of novocaine solution in the area of ​​the peripheral part of the round ligament of the uterus. The procedure is performed for pelvic stones.
7. The use of intrapelvic blockade according to Shkolnikov is indicated for stones in the upper ureter.
8. Physiotherapy (vibration procedure, ultrasound therapy, exposure to Bernard's diadynamic currents) is carried out to facilitate the removal of small stones.

If these methods do not lead to positive results, treatment at home is prohibited, and urgent hospitalization of the patient is necessary.

Treatment of kidney diseases in a hospital includes the following procedures:

• ureteral catheterization;
• puncture nephrostomy;
• surgical intervention.

Diet for renal colic

Women should limit their intake of fats and carbohydrates. Eliminate heavy foods from your diet(fried, salty, spices, chocolate, coffee).

• light chicken broth;
• boiled sea fish;
• dairy products;
• fresh fruits, especially pears and apricots;
• cranberry juice;
• rosehip decoction.

Proper nutrition reduces the likelihood of recurrence of renal colic by 75%.

Preventive measures help avoid an attack. Key recommendations include:

• Drink enough water(at least 2-2.5 l). The liquid dilutes the urine.
• Eat a balanced diet
• Limit salt intake.
• Avoid overheating the kidneys.
• Drink urological drinks (herbs, berries).

Attention! Long-term blockades negatively affect the functionality of the kidneys, leading to hydronephrosis and complete loss of the kidney.

Video: symptoms and treatment of renal colic

Conclusion

Having identified the symptoms of renal colic, you should immediately provide first aid and contact a medical facility for further treatment. Timely diagnosis and compliance with preventive measures will save the woman not only her kidney, but also her life.

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Renal colic should be considered not as a pathology, but as a concomitant symptom. An attack of sharp, unbearable pain in the lower back or sides of the abdomen develops suddenly - the condition is caused by impaired urine passage.

The pain in renal colic is cramping in nature and spreads to the groin. Either complete anuria (lack of urination) or frequent urge with painful passage of small portions is observed.

Causes of renal colic

The pain caused by an attack of renal colic occurs due to stretching or compression of the ureter when calculi come out into its opening: urinary stone, blood clot, mucous and purulent lumps. The muscles of the ureter contract, preventing the free flow of urine.

The fluid pressure in the renal pelvis increases sharply, venous outflow is disrupted, and the organ parenchyma tissue swells. The fibrous capsule of the kidney is overstretched. An attack of renal colic requires strong medicinal pain relief (narcotic group of drugs) or urgent surgical intervention.

The main reason is urolithiasis. In 60% of attacks, the “plug” is formed by urinary stones. With - blood and mucous clots; for kidney tuberculosis - pieces of dead epithelium.

Twisting (kinking) of the ureter occurs, which is provoked by nephroptosis or kidney dystopia. Organ tumors and traumatic hematomas are the cause of external compression of the ureter. Vascular pathologies (renal vein thrombosis, organ infarction, etc.) and congenital anomalies are considered.

A group of inflammatory and congestive diseases responsible for the onset of renal colic in women:

• hydronephrosis, nephritis and cystitis;
• pathology of the uterus;
• polycystic kidney disease;
• inflammation of the appendages () and damage to the fallopian tube;
• twisting of the “leg” of the ovarian cyst;
• ovarian apoplexy (rupture of organ tissue);
• pregnancy ectopic ();
• spontaneous abortion;
• pregnancy.

Symptoms of renal colic in women, attack

The main symptom of renal colic is suddenness of pain. There is no pattern of occurrence. After physical activity, a long walk or shaking while driving, the likelihood of feeling a “knife in the back” increases. The lower back and stomach hurt - bilateral renal colic, only on one side the pain is unilateral.

A woman experiences an acute pain attack, moves chaotically in bed in the hope of finding a comfortable position and relieving the condition. The pain spreads to the thigh, perineum. The skin is pale, cold, damp from sweat. Severe weakness, attacks of nausea interspersed with vomiting, blood pressure rises. Later the temperature will rise.

An attack of renal colic lasts from 3 hours or more, sometimes up to a day, if there is no medical assistance. During this period of time, the nature of the pain and its irradiation changes. The patient develops thirst, flatulence, and chills. Shock develops from severe pain. As soon as renal colic ends, urine comes out freely. When it settles, a precipitate forms.

During an attack, it is important that the doctor is able to correctly “read” the clinical symptoms and differentiate the woman’s condition. The examination is carried out by a gynecologist together with a urologist.

Conditions with similar symptoms and pain:

• acute appendicitis;
• acute pancreatitis;
• perforated gastric ulcer;
• spinal hernia.

Treatment of renal colic in women, drugs

In most cases, treatment of renal colic in women takes place in a hospital, although some attacks successfully end in the passage of a stone. For the first three days, the woman is under medical supervision in order to provide timely assistance in case of relapse.

Indications for mandatory hospitalization:

• it is not possible to relieve the patient’s pain;
• single kidney or donor;
• high temperature and suspicion of infection in the body.

Drug treatment:

• pain-relieving drugs;
• anti-spasm agents;
• reducing urine production;
• antiemetics.

At the same time, vitamins and nutritional supplements are prescribed to treat the cause of urolithiasis.

The surgical method of stone removal is used when it is impossible to do this with conservative treatment. Modern methods are less traumatic. It is not always necessary to even puncture the skin. Ultrasound, laser, endoscopic devices, and stents are used.

Open operations are performed only when it is impossible to carry out other treatment methods and severe damage to the kidney.

Emergency care for renal colic

Emergency assistance to a woman should be provided by loved ones before doctors arrive. At home, use local warming compresses and apply a heating pad to the area of ​​intense pain in the abdomen or back. If possible, take a sitz bath. Water temperature is about 40º C.

If you are sure that the cause of the pain is renal colic, first aid should be provided immediately.

It is necessary to take a medicine that will relieve spasm from smooth muscles (No-spa). You can confidently take an anti-pain medication (Ibuprofen, Ketanov, etc.) at home if it is localized on the left. Otherwise, the symptoms of other acute inflammations may be blurred.

Upon arrival, doctors assess the patient’s condition. Renal colic in a woman requires immediate response. Emergency care is provided by doctors, the algorithm is as follows:

• Complete rest for the patient;
• Thermal procedures to relieve spasms and urine outflow;
• An anesthetic is administered for renal colic, sometimes of a narcotic group;
• Drugs that relieve spasms and antiemetics are used;
• The absence of an effect on the above measures is a signal for the introduction of narcotic drugs (morphine, promedol, etc.);
• Localization of the stone in the pelvic ureter allows for a Lorin-Epstein blockade (injection of novocaine 0.5% into the round ligament of the uterus);
• When the stone is located in the upper part of the ureter, an intrapelvic blockade according to Shkolnikov is used.
• Physiotherapy (vibration therapy, ultrasound therapy, diadynamic therapy) are aimed at removing small stones

The absence of positive dynamics is a signal for urgent hospitalization of the patient. In the hospital, measures are taken: ureteral catheterization, puncture nephrostomy, or surgery.

Attention! The algorithm is only for renal colic. If concomitant pathology of the abdominal organs is suspected, thermal procedures are prohibited.

Diagnosis of the disease

The doctor needs to ask the patient in detail about her lifestyle, daily diet, and hereditary diseases. During palpation, part of the back will be painful.

• Urinalysis will reveal inclusions of red blood cells, protein, elevated white blood cells and epithelial cells.
• To exclude abdominal pathology, radiography is prescribed.
• Intravenous urography. The result of changes in the contours of the calyces and pelvis of the kidneys, the position of the ureter and its bend tells the doctor the cause of the pain.
• Ultrasound of the pelvic and abdominal organs.
• Chromocystoscopy. Determines the slowdown in the release of indigo carmine from the blocked ureter.
• Kidney MRI.
• Clinical blood test and creatine level.

Due to urinary retention, there is a risk of developing pyonephrosis or hydronephrosis. The accumulation of urine forces the kidneys to increase in size, overstretches the tissue, and leads to loss of organ function.

The lack of adequate treatment for urolithiasis leads to obstructive pyelonephritis, and then the risk of urosepsis and bacterial shock increases.

Features of renal colic in pregnant women

When carrying a child, the load on the kidneys increases, the likelihood of exacerbation of chronic pathologies and the risk of an attack of colic increases. In pregnant women, renal colic has the same symptoms and treatment as in other women.

Pain occurs against the background of pyelonephritis or urolithiasis. Localization of pain is often on the right.

You can try to change your body position and find a more comfortable one that causes less pain. Hot baths and heating pads on the lower back are prohibited for pregnant women.

Symptoms during pregnancy

Renal colic can be determined by the tone of the uterus. The remaining symptoms are not much different from a normal attack in non-pregnant women. The same abrupt onset, pain, chills, thirst and weakness.

The danger is the increased tone of the uterus, which increases the likelihood of labor occurring. You can’t hesitate, pregnant women call an ambulance.

In the absence of a doctor or a long wait for a team, they independently take antispasmodics in the form of tablets or intramuscularly (no-spa, baralgin). They will relieve spasms and facilitate urine excretion.

Prevention of renal colic in women

With a timely response to an attack, pain relief and restoration of urine passage, complications and relapse can be avoided. If adequate treatment is not followed, then the changes that have occurred in the kidneys are an irreversible process.

You can prevent a recurrent attack if you exclude risk factors that contribute to the development of urolithiasis:

• Look at what kind of water you drink. The formation of stones is influenced by the content of salts and minerals.
• It is necessary to reduce the proportion of chocolate, smoked meats and marinades in the diet. Limit sorrel and parsley.
• Low intake of vitamin A desquamates the epithelium in the renal pelvis. Such “garbage” serves as building material for future stones.
• Vitamin D is essential for calcium absorption. It, in turn, neutralizes oxalic acid inside the intestines. Its danger is expressed by the formation of oxalate stones in the kidneys.
• Excessive vitamin D is also bad for the body, causing dehydration, which thickens the urine and increases the accumulation of calcium salts.
• Congenital anomalies of the urinary tract and kidneys cannot be excluded, but knowing about your peculiarities, it is necessary to monitor your health status.
• Avoid genitourinary tract infections. Pathogens change the composition of urine, its properties and contribute to the crystallization of stones. Certain bacteria damage kidney tissue and create material for stones to form.
• Protect yourself from drafts and hypothermia.
• Lead an active, mobile lifestyle.

Urolithiasis does not manifest itself before renal colic. It is important to follow a diet that prevents or reduces the likelihood of stone formation. Limit:

1. Green salad, sorrel, potatoes, cheese, chocolate and tea. These foods promote oxalate stones.
2. Eggs, beans, chicken, corn, peanuts to avoid the formation of cysteine ​​stones.
3. Dairy products, vegetables (phosphate stones).
4. Meat, legumes, chocolate, coffee. Increases the formation of uric acid stones.

It is not always possible to avoid renal colic. But preventive measures significantly reduce the likelihood of a recurrence of an attack. Pay attention to herbal infusions and decoctions. Enrich your diet with vitamins and calcium. Drink more clean water and do not neglect physical exercise.

Pain caused by obstructed urine flow is very painful and indicates a serious health hazard.

If acute pain in the kidney area does not go away, no matter how you change your body position, it is quite possible that it has begun. Symptoms in women differ in that with this disease the pain “radiates” not only to the lower back, but also much lower - even to the vaginal area.

Those who have given birth compare the signs of renal colic in women with prenatal contractions. The pain occurs suddenly, without any visible preconditions, and can last for a very long time.

Signs that indicate colic are:

1. pain localized on one side only;
2. its paroxysmal nature;
3. increased pain when urinating;
4. clots of blood and pus, sometimes appearing in the urine;
5. high body temperature and surges in blood pressure.

Changes in urine flow are especially noticeable with this kidney problem. The fluid leaving the body becomes noticeably less, and sometimes the fluid that provoked the disease is eliminated along with it.