Box 154 Pain treatment options urolithiasis [4851

Kidney Function Restoration Program

Alternative Cure for Kidney Disease

Get Instant Access

Treatments with Grade A or B evidence

Agents to assist stone passage [51] NSAIDs (Level I)

Calcium channel blockers (nifedipine) (Level I) a-Adrenoceptor antagonists (tamsulosin, terazocin, doxazocine) (Level II) Nitroglycerine and other nitrates (Level IV) Lithotripsy (Level I) Analgesics, antispasmodics Opioids including tramadol (Level II or III) Antimuscurinics (Level III or IV) Phosphodiesterase IV inhibitors (Level II) Surgical procedures for stone removal (Level III) Acupuncture (Level III) TENS (Level II)

Drug and dietary modification to prevent stone formation

[52, 53]. Eventually the disorder leads to kidney failure. Renal stone formation and liver cyst formation are both common co-morbidities. Therapeutic regimens have been proposed which suggest a general progression from nonpharmacologic methods to non-narcotic analgesics and minimally invasive procedures to progressively more invasive procedures and the use of opioids [54]. Procedures unique to polycystic kidney disease include surgical or percutaneous drainage of the cysts to decompress the lesions, sometimes followed by marsupialization to avoid fluid reaccumulation. In a study by Brown et al. [55], 50% of patients were pain free 12-28 months after laparoscopic marsupialization. More recently, Casale and colleagues [56] reported treating 12 patients aged 8-19 years (mean age 12.4) with laparoscopic renal denervation and nephropexy. All these patients had autosomal dominant polycystic kidney disease with chronic pain that was refractory to narcotic use. All patients were reportedly pain free following surgery with a mean follow-up period of 25.5 months.

Was this article helpful?

0 0
Natural Pain Management

Natural Pain Management

Do You Suffer From Chronic Pain? Do You Feel Like You Might Be Addicted to Pain Killers For Life? Are You Trapped on a Merry-Go-Round of Escalating Pain Tolerance That Might Eventually Mean That No Pain Killer Treats Your Condition Anymore? Have you been prescribed pain killers with dangerous side effects?

Get My Free Ebook

Post a comment