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

Ahmed AF, Gabr AH, Emara AA, Ali M, Abdel-Aziz AS, Alshahrani S - Arab J Urol (2014)

Bottom Line: The stone-passage rate and time, and different clinical, laboratory and radiological variables, were analysed.The cumulative stone-passage rate was 1.6%, 15%, 41.7%, 72.4%, 89.8% and 98.4% at 7, 14, 21, 28, 35 and 42 days from the first presentation, respectively.The absence of CT findings of PFS and TRS are significant predictors for stone passage, and should be considered when choosing the expectant management.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Al-Azhar University, Cairo, Egypt ; Department of Urology, Salman Bin Abdul-Aziz University, Al-kharj, Saudi Arabia.

ABSTRACT

Objective: To evaluate the outcome of the expectant management of ureteric stones and to determine the factors predictive of the spontaneous passage of stones.

Patients and methods: We retrospectively reviewed the medical records of patients who had ureteric stones of ⩽10 mm and who were treated conservatively at our institutions during the period 2008-2013. The stone-passage rate and time, and different clinical, laboratory and radiological variables, were analysed.

Results: In all, 163 patients with ureteric stones were enrolled in the study, of whom 127 (77.9%) passed their stones spontaneously, with a mean (SD) passage time of 24.0 (8.09) days. The cumulative stone-passage rate was 1.6%, 15%, 41.7%, 72.4%, 89.8% and 98.4% at 7, 14, 21, 28, 35 and 42 days from the first presentation, respectively. Patients with a high pain-scale score, stones of ⩽5 mm, a lower ureteric stone, a high white blood cell count and those with absent computed tomography (CT) findings of perinephric fat stranding (PFS) and tissue-rim sign (TRS) had a higher likelihood of spontaneous stone passage. Patients with stones of ⩽5 mm, stones in the lower ureter and those with no PFS had a shorter spontaneous passage time. In a multivariate analysis the absence of PFS and TRS were the only significant predictors for spontaneous stone passage (P < 0.001 and 0.002, respectively).

Conclusions: The spontaneous ureteric stone-passage rate and time varies with different factors. The absence of CT findings of PFS and TRS are significant predictors for stone passage, and should be considered when choosing the expectant management.

No MeSH data available.


Related in: MedlinePlus

The cumulative SPR during the observational period.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4561928&req=5

f0005: The cumulative SPR during the observational period.

Mentions: The cumulative SPR was 1.6%, 15%, 41.7%, 72.4%, 89.8% and 98.4% at 7, 14, 21, 28, 35 and 42 days from the first presentation, respectively (Fig. 1). The SPR was 88.6% for stones of ⩽5 mm and 67.9% for stones of 5–10 mm (P = 0.001). According to the level of the stone, the SPR was 33.3% for stones in the upper ureter, 81.6% in the middle ureter and 96.1% in the lower ureter (P < 0.001; Scheffe posthoc test P < 0.001) for the three stone location groups. The SPRs, according to the size and location of stones, during the observation period are shown in Fig. 2(A–C).


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

Ahmed AF, Gabr AH, Emara AA, Ali M, Abdel-Aziz AS, Alshahrani S - Arab J Urol (2014)

The cumulative SPR during the observational period.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4561928&req=5

f0005: The cumulative SPR during the observational period.
Mentions: The cumulative SPR was 1.6%, 15%, 41.7%, 72.4%, 89.8% and 98.4% at 7, 14, 21, 28, 35 and 42 days from the first presentation, respectively (Fig. 1). The SPR was 88.6% for stones of ⩽5 mm and 67.9% for stones of 5–10 mm (P = 0.001). According to the level of the stone, the SPR was 33.3% for stones in the upper ureter, 81.6% in the middle ureter and 96.1% in the lower ureter (P < 0.001; Scheffe posthoc test P < 0.001) for the three stone location groups. The SPRs, according to the size and location of stones, during the observation period are shown in Fig. 2(A–C).

Bottom Line: The stone-passage rate and time, and different clinical, laboratory and radiological variables, were analysed.The cumulative stone-passage rate was 1.6%, 15%, 41.7%, 72.4%, 89.8% and 98.4% at 7, 14, 21, 28, 35 and 42 days from the first presentation, respectively.The absence of CT findings of PFS and TRS are significant predictors for stone passage, and should be considered when choosing the expectant management.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Al-Azhar University, Cairo, Egypt ; Department of Urology, Salman Bin Abdul-Aziz University, Al-kharj, Saudi Arabia.

ABSTRACT

Objective: To evaluate the outcome of the expectant management of ureteric stones and to determine the factors predictive of the spontaneous passage of stones.

Patients and methods: We retrospectively reviewed the medical records of patients who had ureteric stones of ⩽10 mm and who were treated conservatively at our institutions during the period 2008-2013. The stone-passage rate and time, and different clinical, laboratory and radiological variables, were analysed.

Results: In all, 163 patients with ureteric stones were enrolled in the study, of whom 127 (77.9%) passed their stones spontaneously, with a mean (SD) passage time of 24.0 (8.09) days. The cumulative stone-passage rate was 1.6%, 15%, 41.7%, 72.4%, 89.8% and 98.4% at 7, 14, 21, 28, 35 and 42 days from the first presentation, respectively. Patients with a high pain-scale score, stones of ⩽5 mm, a lower ureteric stone, a high white blood cell count and those with absent computed tomography (CT) findings of perinephric fat stranding (PFS) and tissue-rim sign (TRS) had a higher likelihood of spontaneous stone passage. Patients with stones of ⩽5 mm, stones in the lower ureter and those with no PFS had a shorter spontaneous passage time. In a multivariate analysis the absence of PFS and TRS were the only significant predictors for spontaneous stone passage (P < 0.001 and 0.002, respectively).

Conclusions: The spontaneous ureteric stone-passage rate and time varies with different factors. The absence of CT findings of PFS and TRS are significant predictors for stone passage, and should be considered when choosing the expectant management.

No MeSH data available.


Related in: MedlinePlus