EAU 2019: Factors Predicting the Failure of Spontaneous Passage by Patients of Small Ureteric Stones ≤ 3 mm
In the period between 1996 and 2018, retrospectively collected charts were obtained for patients who presented to Chungbuk National University with small ureteric stones ≤ 3 mm in diameter and who were managed conservatively. The diagnosis was made by spiral computerized tomography and 919 adult patients who fulfilled the criteria were included. This study has two cohorts, patients who reported spontaneous stone passage and those who required intervention and both their clinical and stone variables.
Their results reported for spontaneous small ureteric stones (≤ 3 mm) passage showed similarities to the literature, as 125 out of 919 patients (13.6%) failed to pass the stones spontaneously. Significant differences were seen in age, size, location and associated symptoms. Patients who failed to pass the stones spontaneously were younger, had larger stones and found in the upper or mid-ureter and were less likely to have colic pain. In multivariate linear logistic regression models, failure of spontaneous passage in patients with small ureteric stones ≤ 3 mm can be predicted in the setting of younger patient’s age at symptom presentation, the absence of colic pain, stone located in the upper or mid-ureter with a diameter >2.5 mm. These results were statistically significant. At 2 weeks following their presentation, 91.4% of patients were able to pass the stone spontaneously.
This study can be advantageous as early intervention is better than prolonged conservative management in patients with unfavorable characteristics. This is why detection of these risk factors would probably push urologists towards early intervention in patients with unfavorable characteristics, but waiting for a period of 2 weeks would be an option before doing so.
Presented by: Y. J. Kim, Chungbuk National University, Department of Urology, Cheongju, South Korea
Written by: Faroukh El Khatib, MD, Research Fellow, Department of Urology, University of California, Irvine at the 34th European Association of Urology (EAU 2019) #EAU19, conference in Barcelona, Spain from March 15-19, 2019.