Renal colic

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Relieve the crisis and treat the cause

Renal colic: causes, symptoms, imaging, treatments, and emergencies. Dr. Dominique explains how to diagnose and relieve this intense pain.

Coliques néphrétiques

What is renal colic?

Renal colic is an acute, sudden, and intense pain , most often caused by the migration of a kidney stone (urolithiasis) that blocks the flow of urine, usually in the ureter. It is a common urological emergency requiring rapid diagnosis and appropriate management to relieve pain and prevent complications. Dr. Sébastien Dominique , a urological surgeon in Paris, manages renal colic at all stages, from diagnosis to treatment, including in cases of complications or recurrence.

Warning signs

  • It occurs suddenly, often without any triggering factor.
  • Located on the flank or lumbar region, on one side only (unilateral).
  • It radiates towards the lower abdomen, groin or genitals.
  • Sometimes described as one of the most violent pains a patient can experience.
  • It progresses in (paroxysmal) crises, interspersed with periods of calm.
  • Irritation of the urinary tract lining by the stone can lead to hematuria, which may or may not be visible to the naked eye.
  • It can accompany the pain or be isolated.
  • This sign should always be investigated to rule out other causes.
  • The pain follows the path of the stone, from the kidney to the bladder
  • It typically descends towards the iliac fossa, the pelvic region, or the groin.
  • These signs are common during attacks, linked to intense pain.
  • They can mistakenly lead to suspicion of a digestive origin (appendicitis, colitis, etc.).
  • In cases of complete ureteral blockage, urine production may be significantly reduced or absent.
  • Anuria is a serious condition that warrants urgent evaluation.

Expertise

Academic background

Diagnosis of renal colic

  • Painful lumbar palpation
  • Check for fever, blood pressure, and associated digestive problems
  • Context assessment: history of kidney stones, similar episodes, diet, hydration…
  • Urine culture (ECBU): to detect an associated infection
  • Kidney function tests (creatinine, urea): to assess kidney function
  • Complete blood count (CBC), CRP: looking for inflammation or infection

Management of renal colic

  • Strong painkillers (NSAIDs, morphine if necessary)
  • Antispasmodics
  • Appropriate hydration (in the absence of vomiting or severe obstruction)
  • Rest and monitoring of development
  • Ureteroscopy: removal of the stone or laser fragmentation via the natural route
  • Insertion of a double J stent: allows for emergency kidney drainage
  • Percutaneous nephrostomy: if the natural route is inaccessible or in case of severe infection
  • Extracorporeal shock wave lithotripsy: possible depending on the size and location of the stone

Experience

Kidney stones: why do they always happen at the worst possible time? | Dr. Sébastien Dominique

Prevention of relapse

Prevention of relapse

Renal colic can recur. Preventive management is therefore essential:

  • Metabolic assessment (blood and urine analysis) to look for a cause contributing to the formation of kidney stones
  • Dietary advice tailored to the patient’s profile
    • Abundant hydration (> 2 liters of water per day)
    • Limiting salt, animal protein, and sodas
    • Avoid excess or deficiency of dietary calcium
  • Drug treatment if necessary (citrates, thiazides, etc.)

Dr. Sébastien Dominique also provides this long-term follow-up to reduce the risk of recurrence.

When should you seek emergency medical attention?

  • Intense unilateral lower back pain
  • A complete absence of urine
  • Fever associated with lower back pain (risk of serious infection)
  • Visible blood in the urine
  • A history of renal colic or urinary stones

My journey

Let me introduce you to my background, my expertise in urology and the methodical way in which I support each patient, from the first consultation to personalized follow-up.

Are you suffering from kidney stones?

The practice handles urological emergencies, particularly renal colic. Don’t wait for the pain to become chronic before seeking medical help. Urology Practice Paris Opéra – Paris 17th Arrondissement. In-person or telehealth consultations available. Book your appointment today.

FAQ – Frequently Asked Questions

How to recognize renal colic?

It is a sudden and very intense lower back pain, radiating towards the groin and genitals, occurring in attacks, without any position providing pain relief. It is often accompanied by nausea and characteristic restlessness.

What to do in case of a crisis?

Take an anti-inflammatory (if there are no contraindications), limit fluid intake during the attack—contrary to popular belief—and consult a doctor promptly. A CT scan will confirm the diagnosis and locate the kidney stone.

When is renal colic an emergency?

In case of fever (risk of pyelonephritis due to obstruction, potentially serious), pain resistant to analgesics, single kidney, renal failure or pregnancy: you must then consult the emergency room without delay to drain the kidney if necessary.

How to prevent recurrences of renal colic?

Drink at least 2 liters of water throughout the day, adjust your diet (limit excess salt and protein), and have a metabolic assessment with gallstone analysis to target prevention. Without prevention, the risk of recurrence is approximately 50% within 5 years.

Dr Sébastien Dominique's expertise

Chirurgien Urologue à Paris

Dr Sébastien Dominique

Renal colic: there are solutions.

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