MP01-06 PREDICTORS OF FLANK PAIN IN PATIENTS WITH A NON-DILATED COLLECTING SYSTEM: RESULTS FROM RESKU, THE REGISTRY FOR STONES OF THE KIDNEY AND URETER (2017)

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation I1 Apr 2017MP01-06 PREDICTORS OF FLANK PAIN IN PATIENTS WITH A NON-DILATED COLLECTING SYSTEM: RESULTS FROM RESKU, THE REGISTRY FOR STONES OF THE KIDNEY AND URETER Carissa Chu, Manint Usawachintachit, David T. Tzou, Kazumi Taguchi, Marshall Stoller, and Thomas Chi Carissa ChuCarissa Chu More articles by this author , Manint UsawachintachitManint Usawachintachit More articles by this author , David T. TzouDavid T. Tzou More articles by this author , Kazumi TaguchiKazumi Taguchi More articles by this author , Marshall StollerMarshall Stoller More articles by this author , and Thomas ChiThomas Chi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.081AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Classically, acute flank pain and renal colic in nephrolithiasis is attributed to the presence of hydronephrosis and distention of the renal capsule. Patients often present with stones and no collecting system dilation, however, creating a therapeutic dilemma for urologists. Given that the biophysical mechanisms of visceral flank pain are not well understood, we aimed to characterize predictors of renal colic among stone patients without hydronephrosis. METHODS From October 2015 to May 2016, new stone patients at the University of California, San Francisco (UCSF) were prospectively enrolled into the Registry for Stones of the Kidneys and Ureter (ReSKU). This electronic medical record (EMR) based stone registry captures patient clinical and imaging data for research purposes. For this study, we identified all patients with imaging-confirmed upper tract urinary stones and absence of hydronephrosis based on ultrasound or cross-sectional computed tomography imaging. Data analysis was performed on STATA Version 14.1 to identify factors associated with flank pain. RESULTS During the study period, 116 patients with nephrolithiasis and no hydronephrosis were identified. 62.7% (n=74) had no flank pain associated with an ipsilateral stone, while 35.6% (n=42) had flank pain with an ipsilateral stone. There were no statistically significant differences between patients with and without flank pain with respect to age (60.0±2.1 vs. 57.3±2.6 years old), gender (51 vs. 45% male), smoking history (28.2 vs. 32.4% smoker), drinking history (48.7 vs. 42.3% none), BMI (28.4±1.0 vs. 26.4±1.5), or stone burden (1.86±2.6 vs. 1.80±4.0 cm). For patients with flank pain, those with renal stones were more likely to have flank pain compared with patients with ureteral stones (78.7 vs. 21.4%, p=0.018, Pearson chi-squared test). CONCLUSIONS Stones in the renal pelvis or calyces are more likely to cause pain in patients without hydronephrosis when compared with ureteral stones. Alternate mechanisms for acute renal colic must exist beyond obstruction and renal capsule distension. Understanding these mechanisms is critical to developing effective treatments for a subgroup of difficult-to-treat patients and warrants additional study. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e3 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Carissa Chu More articles by this author Manint Usawachintachit More articles by this author David T. Tzou More articles by this author Kazumi Taguchi More articles by this author Marshall Stoller More articles by this author Thomas Chi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...