+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Severe unexplained loin pain (loin pain haematuria syndrome): management and long-term outcome



Severe unexplained loin pain (loin pain haematuria syndrome): management and long-term outcome



Qjm 100(6): 369-381



The intractable and unexplained loin pain of severe 'loin pain haematuria syndrome' (LPHS) causes great psychosocial distress and disability. To examine the psychological factors in LPHS patients who had failed to respond to non-opiate analgesia, and explore the feasibility of conservative management. Retrospective review of case notes, medical and GP records, with follow up. We studied 21 consecutive patients referred from specialist renal centres to a regional pain clinic. All records were reviewed, and patients received a comprehensive psychiatric and social assessment. Medication with pain-coping strategies was emphasized, and surgical solutions were discouraged. Patients' median age was 43 years (range 21-64) and duration of symptoms 11 (1-34) years. Sixteen were receiving opiates, and none had enduring benefit from surgery. Patients were divisible into three groups: twelve (57%) gave a history of recurrent, unexplained symptoms involving other parts of the body (somatoform disorder); seven had chronic loin pain; dissimulation was suspected in two. At follow-up (median 42 months), eight (38%) rated their pain absent or improved. Of the 11 whose pain was the same or worse, all were on opiates and seven had a somatoform disorder. A further two patients had developed 'other' medical problems. Despite our advice, three patients underwent major surgery for pain. We recommend that patients be managed in a regional pain clinic, where a multidisciplinary approach promotes self-management of pain. Patients who were able to accept conservative treatment, and taper or withdraw opiate analgesia, had a better prognosis.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 017022312

Download citation: RISBibTeXText

PMID: 17525133

DOI: 10.1093/qjmed/hcm034


Related references

Lumbar sympathetic chain neuromodulation with implanted electrodes for long-term pain relief in loin pain haematuria syndrome. Neuromodulation 12(4): 284-291, 2009

Loin Pain Haematuria Syndrome - A Narrative Review of Pain Management Strategies. Korean Journal of Pain 29(2): 78-85, 2016

The outcome of renal denervation for managing loin pain haematuria syndrome. Bju International 93(6): 818-821, 2004

Outcome of renal denervation for the treatment of loin pain haematuria syndrome. European Urology Suppl.s 1(1): 124, 2002

Bilateral nephrectomy and haemodialysis for the treatment of severe loin pain haematuria syndrome. Nephrology Dialysis Transplantation 9(11): 1640-1641, 1994

The natural history and management of the loin pain/haematuria syndrome. British Journal of Urology 54(6): 613-615, 1982

Transperitoneal laparoscopic renal denervation for the management of loin pain haematuria syndrome. Minimally Invasive Therapy and Allied Technologies 22(6): 346-351, 2013

Recurrent graft pain following renal autotransplantation for loin pain haematuria syndrome. British Journal of Urology 78(1): 25-28, 1996

Loin pain haematuria syndrome: Distress resolved by pain relief. Pain 76(1-2): 209-213, 1998

Does this case hold the answer to one of the worse types of pain in medicine--that of loin pain haematuria syndrome (LPHS). Bmj Case Reports 2015:, 2015

Dorsal Root Ganglion Stimulation: A Treatment Option for Chronic Pain Due to Refractory Loin Pain Haematuria Syndrome. Neuromodulation: Technology at the Neural Interface 20(8): 841-843, 2017

Dorsal Root Ganglion Stimulation: A Treatment Option for Chronic Pain Due to Refractory Loin Pain Haematuria Syndrome. Neuromodulation 20(8): 841-843, 2017

Loin pain haematuria syndrome. Pediatric Nephrology. 10(2): 216-220, 1996

Loin pain/haematuria syndrome. Lancet 1(8124): 1033-1034, 1979

The loin-pain/haematuria syndrome. Lancet 1(8122): 897-900, 1979