Factors affecting the urologist’s decision to administer ureteral stone therapy: a retrospective cohort study.
- Author:
Mun Ki MIN
1
;
Ji Ho RYU
;
Yong In KIM
;
Maeng Real PARK
;
Seok Ran YEOM
;
Sang Kyoon HAN
;
Seong Wook PARK
Author Information
- Publication Type:Original Article
- Keywords: Renal colic; Ureteral calculi; Longitudinal; Computed tomography; Intervention
- MeSH: Cohort Studies*; Emergency Service, Hospital; Humans; Renal Colic; Retrospective Studies*; Sensitivity and Specificity; Ureter*; Ureteral Calculi; Urinary Calculi
- From: Clinical and Experimental Emergency Medicine 2017;4(4):238-243
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: We aimed to evaluate the factors influencing treatment option selection among urologists for patients with ureteral stones, according to the stone diameter and location. METHODS: We retrospectively reviewed the records of 360 consecutive patients who, between January 2009 and June 2014, presented to the emergency department with renal colic and were eventually diagnosed with urinary stones via computed tomography. The maximal horizontal and longitudinal diameter and location of the stones were investigated. We compared parameters between patients who received urological intervention (group 1) and those who received medical treatment (group 2). RESULTS: Among the 360 patients, 179 (49.7%) had stones in the upper ureter and 181 (50.3%) had stones in the lower ureter. Urologic intervention was frequently performed in cases of upper ureteral stones (P<0.001). In groups 1 and 2, the stone horizontal diameters were 5.5 mm (4.8 to 6.8 mm) and 4.0 mm (3.0 to 4.6 mm), stone longitudinal diameters were 7.5 mm (6.0 to 9.5 mm) and 4.4 mm (3.0 to 5.5 mm), and ureter diameters were 6.4 mm (5.0 to 8.0 mm) and 4.7 mm (4.0 to 5.3 mm), respectively (P<0.001). The cut-off values for the horizontal and longitudinal stone diameters in the upper ureter were 4.45 and 6.25 mm, respectively (sensitivity 81.3%, specificity 91.4%); those of the lower ureter were 4.75 and 5.25 mm, respectively (sensitivity 79.4%, specificity 79.4%). CONCLUSION: The probability of a urologic intervention was higher for patients with upper ureteral stones and those with stone diameters exceeding 5 mm horizontally and 6 mm longitudinally.
