Is it possible to predict spontaneous passage of a ureteral stone? An up-to-date comment on the current problem with new concepts concerning the patient and the stone.

Abstract

Introduction: The aim of this article was to determine a predictive factor by examining the patient's characteristics and the stone to predict the ureteral stone spontaneous passage.

Material and methods: A total of 200 patients aged 18-55 who were referred with middle and distal ureter ureteral stones between 5-7 mm were analyzed retrospectively. Patients were randomized as 50 spontaneous stone passage positive (SSPP) and 50 negative patients. Body mass index (BMI), waist-to-hip ratio (WHR), stone size, ureter length, ureter diameter, stone Hounsfield unit value (SHU), ureteral wall thickness (UWT), kidney parenchymal thickness (KPT), kidney parenchymal density, neutrophil-lymphocyte ratio (NLR) and thrombocyte-lymphocyte ratio (TLR) values were recorded.

Results: The average SHU of the SSPP group was 579 and 970 in the negative group (p: 0.000). While the mean was 1.7 mm in the UWT SSPP group, it was 2.4 mm in the negative group (p: 0.000). SHU and UWT were statistically significantly different in univariate and multivariate logistic regression analyses. WHR values were 39.6 and 29.3 for SSPP and the negative group, respectively (p: 0.032). The ureter diameter was 7.6 mm for the SSPP group and 8.9 mm in the negative group (p: 0.01).

Conclusions: Low SHU value is related to the ureteral stone's positive spontaneous passage, and the increase of UWT is inversely related to the spontaneous passage. WHR is higher in people who can passage ureteral stones. A narrow ureter diameter is correlated with spontaneous stone passage. Ureter length, KPT, and kidney parenchymal density were not associated with spontaneous passage.