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CT-related parameters and Framingham score as predictors of spontaneous passage of ureteral stones ≤ 10 mm: results from a prospective, observational, multicenter study

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Abstract

To investigate the reliability of newly defined CT-related parameters and cardiovascular risk factors in groups adjusted for stone size and location to predict spontaneous stone passage (SP) of uncomplicated ureteral stones ≤ 10 mm. The data of 280 adult patients with solitary unilateral ureteral stones ≤ 10 mm in diameter in non-contrast computed tomography were prospectively recorded. All patients undergoing a four-week observation protocol with medical expulsive therapy using tamsulosin were divided into two groups according to SP or no SP. Demographic, clinical and radiological findings of these groups were recorded. Spontaneous stone passage was observed in 176 (62.9%) of the patients, whereas the SP rate was 57.6% for 118 upper ureteral stones and 66.7% for 162 lower ureteral stones. The SP rate was 13.3 times greater with ureteral wall thickness < 1.88 mm, 4.4 times greater with a ratio of ureter to stone diameter of < 1.24, 3.4 times greater with Framingham score of < 11.5%, 2 times greater with neutrophil lymphocyte ratio < 1.96, 1.9 times greater with ureteral diameter < 6.33 mm and 1.5 times greater with stone volume < 38.54 mm3. Lower levels of ureteral wall thickness, ratio of ureter to stone diameter, Framingham score, neutrophil lymphocyte ratio, ureteral diameter, stone volume and absence of hydronephrosis were found to be more successful predictors. We consider that the success rate can be increased by selection of the proper option (observation or active treatment) according to these predictors.

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Funding

The authors declare that they have no relevant financial interests.

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Author notes

  1. Ismail Selvi

    Present address: Department of Urology, Başakşehir Çam ve Sakura City Hospital, Istanbul, 34480, Turkey

Authors and Affiliations

  1. Department of Urology, Karabük University Training and Research Hospital, Karabük, Turkey

    Ismail Selvi

  2. Department of Urology, Erciyes University Medical School, Kayseri, Turkey

    Numan Baydilli & Emre Can Akinsal

  3. Department of Radiology, Kayseri City Training and Research Hospital, Kayseri, Turkey

    Turgut Tursem Tokmak

  4. Department of Urology, Health Science University Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey

    Halil Basar

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  1. Ismail Selvi
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  2. Numan Baydilli
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  4. Emre Can Akinsal
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  5. Halil Basar
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Contributions

IS: Conception and design, acquisition of data, statistical analysis, analysis and ınterpretation of data, drafting of the manuscript. NB: Conception and design, acquisition of data, analysis and ınterpretation of data, critical revision of the manuscript for important intellectual content. TTT: Analysis and ınterpretation of data, critical revision of the manuscript for important intellectual content. ECA: Acquisition of data, analysis and ınterpretation of data, critical revision of the manuscript for important intellectual content. HB: Acquisition of data, critical revision of the manuscript for important intellectual content.

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Correspondence to Ismail Selvi.

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Ethical approval for research involving human participants.

The study was approved by the local ethics committee (the protocol number: 77192459–050.99-E.10736, 6/13; the date of approval: October 7, 2019) at Karabük University Training and Research Hospital. All procedures performed in our study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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A formal written informed consent was obtained from all individual participants included in the study. The data of patients who did not consent was not used.

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Selvi, I., Baydilli, N., Tokmak, T.T. et al. CT-related parameters and Framingham score as predictors of spontaneous passage of ureteral stones ≤ 10 mm: results from a prospective, observational, multicenter study. Urolithiasis 49, 227–237 (2021). https://doi.org/10.1007/s00240-020-01214-6

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