Ureteric stones

This case looks at one of the commonest emergency surgical presentations, ureteric colic. It covers the initial management of such patients in the emergency room, including the evidence behind which analgesia to use and which imaging to undertake. The patient discussed then re-presents with urosepsis, and the discussion centres around management of this, including the options for emergency drainage, with expert comment from an interventional radiology point of view regarding the nephrostomy, and an intensive therapy unit point of view for the identification and management of sepsis. Further management of this patient is with a ureteroscopy, and some of the tips and tricks of ureteroscopy are covered, including the evidence of whether to insert a JJ stent. The case finishes with discussion about metabolic work up and medical management of these patients, who often have a high stone recurrence rate.