Skip to main content
SpringerLink
Log in

Ureteral wall thickness as a significant factor in predicting spontaneous passage of ureteral stones of ≤ 10 mm: a preliminary report

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the clinical significance of ureteral wall thickness (UWT) for predicting spontaneous passage (SP) of uncomplicated ureteral stones of ≤ 10 mm.

Methods

We retrospectively reviewed 418 patients with a diagnosis of uncomplicated ureteral stones who presented to Kori Hospital from 2011 to 2018. The maximum stone diameter and UWT at the stone site were measured from axial computed tomography images. Clinical predictors of 4-week SP were assessed using univariate and multivariate analyses. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the accuracy of factors in predicting SP of ureteral stones.

Results

Of the 418 patients, 202 (48.3%) spontaneously passed their stones within 4 weeks of their initial visit. Multivariate analysis showed that stone location, stone size, and UWT (odds ratio, 0.40; P < 0.001) were independent predictors of 4-week SP. ROC analysis showed that 2.71 mm was the optimal cut-off value for UWT, with a predictive accuracy of 0.83. Low UWT had a significantly higher 4-week SP rate than high UWT (76.4% vs. 14.7%, respectively; P < 0.001). In addition, high UWT was associated with a higher risk of stone-related complications within 4 weeks compared with low UWT (16.4% vs. 7.2%, respectively; P = 0.0044).

Conclusions

UWT can serve as a potential predictive factor for 4-week SP and may help physicians to select patients who require immediate interventions among those with ≤ 10-mm ureteral stones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

ESWL:

Extracorporeal shock wave lithotripsy

MET:

Medical expulsive therapy

NCCT:

Non-contrast computed tomography

ROC:

Receiver operating characteristic

SP:

Spontaneous passage

SRC:

Stone-related complication

URS:

Ureteroscopy

UTI:

Urinary tract infection

UWT:

Ureteral wall thickness

References

  1. Elton TJ, Roth CS, Berquist TH, Silverstein MD (1993) A clinical prediction rule for the diagnosis of ureteral calculi in emergency departments. J Gen Intern Med 8:57–62

    Article  CAS  Google Scholar 

  2. Stewart C (1988) Nephrolithiasis. Emerg Med Clin North Am 6:617–630

    CAS  PubMed  Google Scholar 

  3. Assimos D, Krambeck A, Miller NL et al (2016) Surgical management of stones: American Urological Association/Endourological Society Guideline, PART II. J Urol 196:1161–1169

    Article  Google Scholar 

  4. Türk C, Petřík A, Sarica K et al (2016) EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 69:468–474

    Article  Google Scholar 

  5. 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

    Article  Google Scholar 

  6. Mugiya S, Ito T, Maruyama S, Hadano S, Nagae H (2004) Endoscopic features of impacted ureteral stones. J Urol 171:89–91

    Article  Google Scholar 

  7. Deliveliotis C, Chrisofos M, Albanis S, Serafetinides E, Varkarakis J, Protogerou V (2003) Management and follow-up of impacted ureteral stones. Urol Int 70:269–272

    Article  CAS  Google Scholar 

  8. Sarica K, Kafkasli A, Yazici Ö et al (2015) Ureteral wall thickness at the impacted ureteral stone site: a critical predictor for success rates after SWL. Urolithiasis 43:83–88

    Article  CAS  Google Scholar 

  9. Yoshida T, Inoue T, Omura N et al (2017) Ureteral wall thickness as a preoperative indicator of impacted stones in patients with ureteral stones undergoing ureteroscopic lithotripsy. Urology 106:45–49

    Article  Google Scholar 

  10. Fernbach SK, Maizels M, Conway JJ (1993) Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol 23:478–480

    Article  CAS  Google Scholar 

  11. Kaneko T, Matsushima H, Morimoto H, Tsuzaka Y, Homma Y (2010) Efficacy of low dose tamsulosin in medical expulsive therapy for ureteral stones in Japanese male patients: a randomized controlled study. Int J Urol 17:462–465

    Article  CAS  PubMed  Google Scholar 

  12. Li J, Tang Z, Gao L, Qin F, Yuan J (2017) Efficacy and safety of naftopidil in the medical expulsion therapy for distal ureteral stone: a systematic review and meta-analysis. J Endourol 31:427–437

    Article  PubMed  Google Scholar 

  13. Sur RL, Shore N, L’Esperance J et al (2015) Silodosin to facilitate passage of ureteral stones: a multi-institutional, randomized, double-blinded, placebo-controlled trial. Eur Urol 67:959–964

    Article  CAS  PubMed  Google Scholar 

  14. Bensalah K, Pearle M, Lotan Y (2008) Cost-effectiveness of medical expulsive therapy using alpha-blockers for the treatment of distal ureteral stones. Eur Urol 53:411–418

    Article  PubMed  Google Scholar 

  15. Skolarikos A, Laguna MP, Alivizatos G, Kural AR, de la Rosette JJ (2010) The role for active monitoring in urinary stones: a systematic review. J Endourol 24:923–930

    Article  CAS  PubMed  Google Scholar 

  16. Nazim SM, Ather MH, Khan N (2014) Measurement of ureteric stone diameter in different planes on multidetector computed tomography–impact on the clinical decision making. Urology 83:288–292

    Article  PubMed  Google Scholar 

  17. Metser U, Ghai S, Ong YY, Lockwood G, Radomski SB (2009) Assessment of urinary tract calculi with 64-MDCT: the axial versus coronal plane. AJR Am J Roentgenol 192:1509–1513

    Article  PubMed  Google Scholar 

  18. Kadihasanoglu M, Marien T, Miller NL (2017) Ureteral stone diameter on computerized tomography coronal reconstructions is clinically important and under-reported. Urology 102:54–60

    Article  PubMed  Google Scholar 

  19. Sfoungaristos S, Kavouras A, Katafigiotis I, Perimenis P (2012) Role of white blood cell and neutrophil counts in predicting spontaneous stone passage in patients with renal colic. BJU Int 110:E339–E345

    Article  Google Scholar 

  20. Özcan C, Aydoğdu O, Senocak C et al (2015) Predictive factors for spontaneous stone passage and the potential role of serum C-reactive protein in patients with 4 to 10 mm distal ureteral stones: a prospective clinical study. J Urol 194:1009–1013

    Article  Google Scholar 

Download references

Acknowledgements

None.

Author information

Authors and Affiliations

  1. Department of Urology and Andrology, Kori Hospital, Kansai Medical University, 8-45 Kori Hondori cyou, Neyagawa, Osaka, 572-8551, Japan

    Takashi Yoshida & Makoto Taguchi

  2. Department of Urology and Andrology, Kansai Medical University, Osaka, Japan

    Takashi Yoshida, Takaaki Inoue, Makoto Taguchi, Hidefumi Kinoshita & Tadashi Matsuda

  3. Department of Radiology, Kori Hospital, Kansai Medical University, Osaka, Japan

    Naoto Omura

Authors
  1. Takashi Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takaaki Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Makoto Taguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Naoto Omura
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hidefumi Kinoshita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tadashi Matsuda
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

TY: project development, data collection and analysis, manuscript writing and editing; TI: manuscript review and editing; TM: data collection and manuscript review; NO: data collection and manuscript review; HK: data collection and manuscript review; and TM: manuscript review and editing.

Corresponding author

Correspondence to Takashi Yoshida.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This quality assurance audit was approved by the Institutional Review Board.

Informed consent

Informed consent was not obtained as this study is a retrospective audit.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yoshida, T., Inoue, T., Taguchi, M. et al. Ureteral wall thickness as a significant factor in predicting spontaneous passage of ureteral stones of ≤ 10 mm: a preliminary report. World J Urol 37, 913–919 (2019). https://doi.org/10.1007/s00345-018-2461-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-018-2461-x

Keywords

Search

Navigation