Clinical Presentations and Management of Patients with Ureteric Colic: A Retrospective Study

Objectives: This study aims to describe the clinical presentations and management of patients with ureteric colic attending the emergency department. Methods: A retrospective chart review at King Abdulaziz Hospital analyzed medical records from 2018 to 2022, focusing on adult patients aged 18-80, presenting to the emergency department with a confirmed diagnosis of ureteric stones. Patients with incomplete records or unverified diagnoses were excluded. The results of patients were collected and statistically analyzed. Results: This study involved 221 patients with ureteric colic, with a mean age of 44.9 ± 12.6 years and a majority of males (77.7%); most of the patients presented in the summer season (n = 133, 60.2%). About 47.5% (n = 105) of them had a history of urolithiasis, and 21.3% (n = 47) had a positive family history of urolithiasis. The most common symptoms and signs were fluctuating pain (n = 170, 76.9%), pain localized to the side, back, or below the ribs (n = 161, 72.9%), Nausea/vomiting (n = 114, 51.6%), dysuria (n = 100, 45.2%). Over half of the 117 patients (52.9%), reported severe pain as measured by the Numerical Pain Rating Scale (NPRS). In older patients, the presence of hematuria, pyuria, and stones located in the lower and middle ureter were associated with increased pain severity. The majority of patients (99.1%) received analgesics, while 71.0% (n=157) underwent medical explosive therapy (MET). The invasive procedures showed that about 67.9% (n = 150) required double-J stent insertion, and 32.1% (n = 71) of them had ureteroscopy (URS). More than half of the patients were discharged on the same day of attending the emergency department (n = 122, 55.2%). Most patients improved by the given treatment (n = 192, 87.3%), while few of them had some complications. Conclusion: The majority of patients with ureteric colic were effectively managed through conservative treatment, with significant improvement. Timely intervention using minimally invasive techniques led to positive outcomes and shorter hospital stays.