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Predictors for spontaneous stone passage in patients with renal colic secondary to ureteral calculi

  • Urology – Original Paper
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Abstract

Objectives

To determine the clinical, laboratory, and imaging variables that can predict spontaneous stone passage in patients with renal colic secondary to ureteral calculi.

Methods

We prospectively analyzed the medical records of 114 patients who admitted to the emergency department for renal colic from June until November of 2010. Forty-six of them were excluded. The presence of ureteral calculi was confirmed by either a kidney-ureter-bladder plain film or an ultrasound or a computer tomography. In all patients, a second visit after 1 month was planned and the stone status was checked by the same imaging techniques.

Results

From the 68 patients, 16 had a calculus in the upper ureter, 10 in the mid ureter, and 42 in lower part. Stone size was ranged from 2.3 to 15 mm, 52.9% of them were located in the left ureter and 51.5% were radiopaque. Stones passed spontaneously in 36 patients. In multivariate analysis, serum white blood cell count found to be the most significant predictor (P = 0.028) for spontaneous passage followed by stone size (P = 0.037). In analysis of patients with stone size <10 mm, left side (P = 0.017) and serum white blood cell count (P= 0.032) found to be significant predictors.

Conclusions

Serum white blood cell count is an easy to assay variable in everyday practice. This study showed that its value, at the acute phase of a renal colic, is a significant predictor for stone spontaneous passage and should be considered. Stone size remains a valuable predictor. Stones <10 mm on the left ureter have a higher likelihood to pass spontaneously.

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References

  1. Stamatelou KK, Francis ME, Jones CA et al (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817–1823

    Article  PubMed  Google Scholar 

  2. Romero V, Akpinar H, Assimos DG (2010) Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol 12:86–96

    Google Scholar 

  3. Meschi T, Maggiore U, Fiaccadori E et al (2004) The effect of fruits and vegetables on urinary stone risk factors. Kidney Int 66:2402–2410

    Article  PubMed  CAS  Google Scholar 

  4. Taylor EN, Curhan GC (2007) Oxalate intake and the risk for nephrolithiasis. J Am Soc Nephrol 18:2198–2204

    Article  PubMed  CAS  Google Scholar 

  5. Sierakowski R, Finlayson B, Landes RR et al (1978) The frequency of urolithiasis in hospital discharge diagnoses in the United States. Invest Urol 15:438–441

    PubMed  CAS  Google Scholar 

  6. Parekattil SJ, Kumar U, Hegarty NJ et al (2006) External validation of outcome prediction model for ureteral/renal calculi. J Urol 175:575–579

    Article  PubMed  Google Scholar 

  7. Skolarikos A, Laguna MP, Alivizatos G et al (2010) The role for active monitoring in urinary stones: a systematic review. J Endourol 24:923–930

    Article  PubMed  CAS  Google Scholar 

  8. Hubner WA, Irby P, Stoller ML (1993) Natural history and current concepts for the treatment of small ureteral calculi. Eur Urol 24:172–176

    PubMed  CAS  Google Scholar 

  9. Preminger GM, Tiselius HG, Assimos DG et al (2007) American Urological Association Education and Research, Inc; European Association of Urology. 2007 Guideline for the management of ureteral calculi. Eur Urol 52:1610–1631

    Article  PubMed  Google Scholar 

  10. Segura JW, Preminger GM, Assimos DG et al (1997) Ureteral stones clinical guidelines panel summary report on the management of ureteral calculi. The American Urological Association. J Urol 158:1915–1921

    Article  PubMed  CAS  Google Scholar 

  11. Morse RM, Resnick MI (1991) Ureteral calculi: natural history and treatment in an era of advanced technology. J Urol 145:263–265

    PubMed  CAS  Google Scholar 

  12. Coll DM, Varanelli MJ, Smith RC (2002) Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT. AJR Am J Roentgenol 178:101–103

    PubMed  Google Scholar 

  13. Miller OF, Kane CJ (1999) Time to stone passage for observed ureteral calculi: a guide for patient education. J Urol 162:688–690

    Article  PubMed  CAS  Google Scholar 

  14. Ibrahim AI, Shetty SD, Awad RM et al (1991) Prognostic factors in the conservative treatment of ureteric stones. Br J Urol 67:358–361

    Article  PubMed  CAS  Google Scholar 

  15. Geavlete P, Georgescu D, Cauni V et al (2002) Value of duplex Doppler ultrasonography in renal colic. Eur Urol 41:71–78

    Article  PubMed  Google Scholar 

  16. Takahashi N, Kawashima A, Ernst RD et al (1998) Ureterolithiasis: can clinical outcome be predicted with unenhanced helical CT? Radiology 208:97–102

    PubMed  CAS  Google Scholar 

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Correspondence to Stavros Sfoungaristos.

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Sfoungaristos, S., Kavouras, A. & Perimenis, P. Predictors for spontaneous stone passage in patients with renal colic secondary to ureteral calculi. Int Urol Nephrol 44, 71–79 (2012). https://doi.org/10.1007/s11255-011-9971-4

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  • DOI: https://doi.org/10.1007/s11255-011-9971-4

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