Management of acute ureteric colic; a single unit experience and comparison to current BAUS guidelines
BAUS ePoster online library. Fitzpatrick J. Jun 24, 2019; 259459; P1-14
Mr. John Fitzpatrick
Mr. John Fitzpatrick
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Abstract
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INTRODUCTION

There is considerable pressure on units to deliver treatment of patients with acute ureteric colic in a timely fashion in accordance with current BAUS guidelines. We aim to audit our practice in line with these guidelines and look to improve our current acute stone service.

Patients and Methods
A prospective analysis of 219 patients admitted during a 6 month period (January to June 2018) with acute ureteric colic. Data was collected from electronic records.

RESULTS

On average, 37 patients per month were admitted with acute ureteric colic. The average age was 53 years (18-94yr) and median stone size was 5mm (2-25mm). Stone locations were 108 distal-, 86 proximal-, 24 mid-ureteric and one renal pelvis. Patients with sepsis (17.3%) were managed with ureteric stent insertion. For non-septic patients, 76 (42%) underwent primary treatment (43 ureteroscopy, 28 ESWL), 74 (41%) conservative management and 31 (17%) ureteric stent/nephrostomy insertion. The median time to primary ureteroscopy was ≤24 hours; primary ESWL was ≤72 hours (target <48 hours). Median time from stent insertion to definitive ureteroscopy was 6.6 weeks (target <4 weeks). For patients managed conservatively, median time to outpatient review was 5.4 weeks (target <4 weeks). Where a ureteric stent was inserted, 89% were removed within two weeks (100% stent-on-strings, 75% cystoscopic removal).

Conclusions
Although our patients are receiving appropriate treatment, delivering this within the proposed timeframes is challenging. We have now looked at ways of optimising our acute stone service to achieve the targets recommended by BAUS.

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