Factors predicting the spontaneous passage of a ureteric calculus of ⩽10 mm

Ahmed, Abul-fotouh; Gabr, Ahmed H.; Emara, Amr; Ali, Mahmoud; Abdelaziz, Alsayed Saad; Alshahrani, Saad

doi:10.1016/j.aju.2014.11.004

Cited by 36 publications

(43 citation statements)

References 14 publications

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“…This finding could better explain the relationship between high serum procalcitonin and mucosal inflammation. It has been reported in previous studies that leucocyturia did not effect on spontaneous passage; this finding should be re-evaluated through studies with larger sample sizes [9,27].…”

Section: Discussionmentioning

confidence: 65%

“…In recent years, the effect of some biochemical factors on the SP ratio has been reported. Ahmed et al reported that patients with small stones, distal localization, high serum WBC level, low perinephric fat thickness, and lack of tissue-rim sign had increased SP ratios [27]. Similarly, another study reported significant correlations between the increase of WBC and neutrophil levels and the SP ratio, in < 10 mm ureteral stones (p < 0.001) [11].…”

Section: Discussionmentioning

confidence: 97%

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Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

et al. 2020

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Background: Medical expulsive therapy (MET) is recommended for ureteral stones when there is no indication for interventional treatment. Spontaneous passage (SP) may not always be perceived in patients undergoing MET. We aimed to demonstrate the effects of inflammatory factors on spontaneous ureteral stone passage in patients undergoing MET. Methods: Our study was conducted between August and November, 2016, in healthy volunteers and patients with a single distal ureteral stone between 5 and 10 mm in diameter and no indications for interventional therapy. Blood and urine samples from all patients and healthy volunteers were tested. The patients were followed up every 2 weeks for 1 month unless emergency situations appeared. Patients with stone-free status at follow-up were concluded to have achieved complete stone passage [SP(+)], and failure [SP(−)] was concluded if the patient had not passed the stone by the end of the study. Blood samples of the patients and the control group were analyzed, recording WBC (white blood cell), CRP (c-reactive protein), SED (sedimentation), MPV (mean platelet volume), NLR (neutrophil-tolymphocyte ratio), and serum procalcitonin levels. Abnormalities in urine samples were recorded. All patients received diclofenac sodium 75 mg/day, tamsulosin 0.4 mg/day, and at least 3 l/day fluid intake. Patients were followed for a month with kidney, ureter, bladder (KUB) plain films, ultrasonography (USG), and unenhanced abdominal CT scans while undergoing MET. Comparative statistical analyses were performed between the SP(+) and SP(−) groups. Results: The procalcitonin levels of the SP(−) group were significantly higher (207 ± 145.1 pg/ml) than in the SP(+) group (132.7 ± 28.1 pg/ml) (p = 0.000). The leucocyturia rate of the SP(−) group was significantly higher than in the SP(+) group (p = 0.004). Based on the ROC curve analysis, 160 pg/ml (86.7% sensitivity, 70.8% specificity, p < 0.001; AUC: 0.788 95% CI (0.658-0.917) was identified as the optimal cut-off value for procalcitonin. In logistic regression analysis, a significant efficacy of procalcitonin and leucocyturia was observed in the univariate analysis on spontaneous passage. In the multivariate analysis, significant independent activity was observed with procalcitonin. (p < 0.05). Conclusion: Our findings suggest that high procalcitonin levels and the presence of leucocyturia have a strong negative effect on SP of ureteral stones between 5 and 10 mm in diameter. This relationship can be explained by stone impaction, possibly caused by increased mucosal inflammation.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 97%

Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

et al. 2020

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“…Tamsulosin is a selective alpha -blocker and is a known agent for medical expulsive therapy [28]. Studies have shown that spontaneous passage of stone depends on the size of the calculus and its actual site in the ureter [29][30][31]. Most of the patients in our study were however treated by open surgery.…”

Section: Discussionmentioning

confidence: 92%

A 5-Year Review of the Presentation and Management of Urolithiasis in a Nigerian Teaching Hospital

Omisanjo¹,

Bioku²,

Williams³

et al. 2019

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“…2 While 60% of ureteral stones spontaneously pass, 40% require intervention. 3 The decision for treatment is affected by many factors such as size of the ureteral stone, localization and patient choice. Ureteral stones larger than 1 cm generally have intervention planned with minimally invasive or invasive methods.…”

Section: Introductionmentioning

confidence: 99%

“…It is reported that these secondary signs may provide clues related to the spontaneous passage of stones. 3,6 However, there is no study evaluating NCCT only for ureteral stones from 4-10 mm. In our study we planned to evaluate NCCT images of patients with 4-10 mm ureteral stones to determine the similarities and differences between patients who passed stones spontaneously (PPSS) and patients who required intervention (PRI).…”

Section: Introductionmentioning

confidence: 99%

Noncontrast Ct Findings for Spontaneous Passage of Ureteral Stones

Sancak¹,

Sınık²,

Turan³

2016

ARC Journal of Urology

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Objective: The majority of ureteral stones with diameter smaller than 4 mm pass, while the majority of stones larger than 10 mm require intervention. The aim of this study is to evaluate patients with stones identified as 4-10 mm in size and determine the similarities and differences between patients who passed stones spontaneously (PPSS) and patients who required intervention (PRI). Methods: The study included 34 patients with complaint of acute flank pain and ureteral stones identified as 4-10 mm in size. The clinical data and non-contrast computed tomography (NCCT) images of patients were evaluated. Results: The mean age of patients was 42.5 ± 14.5 (20-62) years. While 13 patients spontaneously passed stones, 21 patients required intervention. The mean length of stones in the PPSS group was 5.86 ± 1.46 mm, while this was 7.38 ± 1.76 mm in the PRI group (p=0.025). The mean volume of PPSS stones was calculated as 181.67 ± 148.41 mm³, while the mean volume of PRI stones was 424.22 ± 273.22 mm³ (p=0.004). Findings identified to be in favor of spontaneous passage included small volume of ureteral stones and distal location, presence of perinephric fat stranding (PFS), hydronephrosis and lack of tissue-rim sign (TRS). The presence of PFS and absence of TRS had specificity of 100% and positive predictive value of 100% to determine spontaneous passage. Conclusions: In patients applying with renal colic linked to ureteral stones, evaluating ureteral stones and secondary signs with NCCT may determine which patients do not require intervention.

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Factors predicting the spontaneous passage of a ureteric calculus of ⩽10 mm

Cited by 36 publications

References 14 publications

Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

Can serum procalcitonin levels be useful in predicting spontaneous ureteral stone passage?

A 5-Year Review of the Presentation and Management of Urolithiasis in a Nigerian Teaching Hospital

Noncontrast Ct Findings for Spontaneous Passage of Ureteral Stones

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