{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T01:03:02Z","timestamp":1778202182491,"version":"3.51.4"},"reference-count":13,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,4,3]]},"abstract":"<jats:p>A patient with loin pain haematuria syndrome suffering chronic throbbing pulsing pain overlaid with prolonged periods of incapacitating colic and overnight vomiting was presented 10\u2005months following diagnosis. Ultrasound was normal. No renal or ureteral stones, or filling defects were seen on CT. At cytoscopy, bladder and urethra were normal, and bloody urine effluxed from the left ureteric orifice. The ureters were normal at diagnosis, and developed new abutting non-penetrating calcifications by 8\u2005months. Pain episodes of complete incapacitating intensity of 2\u20134\u2005h duration were reduced to 10\u2005min with 5\u2005mg crushed tadalafil administered at onset. If tadalafil was delayed to after onset, the original course of agony resulted. Daily tadalafil reduced loin pain intensity, but not the exacerbations. Tadalafil efficacy may indicate that the pain exacerbations are due to spasm of ureter smooth muscle. 5\u2005mg tadalafil taken at onset alleviated severe loin pain exacerbations in this case of loin pain haematuria syndrome.<\/jats:p>","DOI":"10.1136\/bcr-2014-209165","type":"journal-article","created":{"date-parts":[[2015,4,27]],"date-time":"2015-04-27T06:50:11Z","timestamp":1430117411000},"page":"bcr2014209165","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Does this case hold the answer to one of the worse types of pain in medicine\u2014that of loin pain haematuria syndrome (LPHS)"],"prefix":"10.1136","volume":"2015","author":[{"given":"Alan","family":"Russell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suman","family":"Chatterjee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Seed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,4,26]]},"reference":[{"key":"2025042706065237000_2015.apr26_1.bcr2014209165.1","first-page":"253","article-title":"A syndrome of loin pain and haematuria associated with disease of renal peripheral arteries","volume":"36","author":"Little","year":"1967","journal-title":"Q J Med"},{"key":"2025042706065237000_2015.apr26_1.bcr2014209165.2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.01.439"},{"key":"2025042706065237000_2015.apr26_1.bcr2014209165.3","unstructured":"Herbert LA , Bendetti C , Parikh SV , et al . 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