A 51-year-old male presents to the emergency department with a sudden-onset, severe, left-sided flank pain radiating to his groin. It began an hour before arrival. The pain was associated with nausea, vomiting, and difficulty urinating. He does not have a history of kidney stones and is currently writhing around on the stretcher.
About 1 to 5 percent of the U.S. population suffers from kidney stones.1 The typical ED presentation is sudden onset of pain radiating from the flank to lower abdomen accompanied by nausea, vomiting, and microscopic hematuria.2
Renal colic is very painful condition. Opioids are often used for pain relief, along with intravenous nonsteroidal anti-inflammatory drugs. Alpha blockers have been repeatedly studied for use with renal colic. An excellent randomized controlled trial, published in Annals of Emergency Medicine, showed no significant difference in stone passage or time to stone passage with tamsulosin compared with placebo in calculi <10mm.3