Dopplerographic assessment of the ureter elimination ability in patients with non-obstructive nephrolithiasis

Abstract

The work is dedicated to the study of the elimination ability of the ureter in patients with non-obstructive nephrolithiasis, in the aspect of predicting the duration of the period of stone discharge after extracorporeal shock wave lithotripsy (ESWL). The study included 134 patients with non-obstructive renal pelvis stones who underwent ESWL. All studied patients were divided into 2 groups: the 1st group consisted of 105 (78.4%) patients in whom this status was stated within 14 days after ESWL; the 2nd group was represented by 29 (21.6%) patients with longer periods of achieving this condition or the presence of residual stone fragments on the 28th day of observation. The elimination capacity of the urinary tract was determined on the basis of an assessment of the peristaltic activity of the ureter on the side of the lesion, by studying the Doppler parameters of the ureteral jets. The shape of the Doppler spectrum, duration (T), peak (Jetmax) and average (Jetave) velocity of ureteral jets were evaluated. In the studied patients, monophasic, biphasic, triphasic and continuous types of ureteral emissions were found. According to the results of the study, a significantly larger number of patients in the 2nd group of patients had a continuous type of Doppler spectrum and a significantly lower Jetave value. The odds ratio to have a longer period of stone passage in patients with CC<10 cm/sec compared to patients with values of this indicator ≥10 cm/sec was 5.3. The results of the study suggest that the elimination ability of the ureter in patients with nephrolithiasis is determined by its peristaltic activity, a non-invasive method for assessing which is Doppler investigation of ureteral jets. Markers of low elimination ability of the ureter should be considered an continuous type of Doppler spectrum, as well as an average ureteral jet`s velocity of less than 10 cm/sec. Keywords: urolithiasis, ureteric jets, dopplerography, peristaltic activity.