Prediction of the ureteric stone outcome by CT scan

  • Suzan Hayder Hassan Erbil Genaral Directionate of Health, Ministry of Health, Erbil, Iraq
  • Sameeah A. Rashid Department of Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq
Keywords: Ureteric stones, CT scan, Stone characteristics, Spontaneous passage

Abstract

Background and objective: Urolithiasis is prevalent in both developed and developing countries, which is attributed to changes in lifestyles. Management of ureteric stones is highly dependent on their characteristics such as volume, size, and density which can be determined based on the images obtained from CT scan. The present study was carried out to examine the association between the final outcomes of the stones and different stone parameters specified by CT scan.

Methods: The present prospective cross-sectional study consisted of 100 patients who had been referred to the Radiology Department of Rizgary and Erbil Teaching Hospitals in Erbil, Kurdistan Region, Iraq, over six months in 2019 to undergo abdominal CT scan with clinical suspicion of ureteric stones. All patients underwent non-contrast MDCT scan, and the CT images were evaluated for the presence of ureteric stone, site of the stone, side, diameter in three planes, volume, and density. The outcome of the stone was correlated with each above variables.

Results: Ureteric stones were more prevalent among the young and middle age group (25-64 years) with an approximate male-to-female ratio of 3.34:1. There were significant associations between stone outcomes (i.e. spontaneous passage or need for intervention) and the stone characteristics including volume (P <0.001), density (P <0.001)site (upper, mid and lower ureter) (P = 0.02), anteroposterior diameter (P <0.001), transverse diameter (P = 0.006), and superior inferior diameter (P <0.001).

Conclusion: Upon the significant correlation between the spontaneous passage of ureteric stones and their characteristics (i.e., volume, density, site, anteroposterior diameter, transverse diameter, and superior inferior diameter), it is highly recommended that all patients with urolithiasis undergo CT scan examination in order to make the proper decision regarding stone management.

References

Parmar MS. Kidney stones. BMJ 2004; 328(7453):1420–4.

Andrabi Y, Patino M, Das CJ, Eisner B, Sahani DV, Kambadakone A. Advances in CT imaging for urolithiasis. Indian J Urol 2015; 31(3):185–93.

Scales CD, Smith AC, Hanley JM, Saigal CS. Urologic Diseases in America Project. Prevalence of kidney stones in the United States. Eur Urol 2012; 62:160–5.

Neisius A, Preminger GM. Stones in 2012: Epidemiology, prevention and redefining therapeutic standards. Nat Rev Urol 2013; 10:75–7.

Barnela SR, Soni SS, Saboo SS, Bhansali AS. Medical management of renal stone. Indian J Endocrinol Metab 2012; 16(2):236–9.

Alelign T, Petros B. Kidney Stone Disease: An Update on Current Concepts. Adv Urol 2018; 2018:3068365.

Knoll T. Epidemiology, pathogenesis and pathophysiology of urolithiasis. Eur Urol Suppl 2010; 9(12):802–6.

Qaader DS, Yousif SY, Mahdi LK. Prevalence and etiology of urinary stones in hospitalized patients in Baghdad. Eastern Mediterranean Health Journal 2006; 12(12):851–63.

Ordon M, Andonian S, Blew B, Schuler T, Chew B, Pace KT. CUA Guideline: Management of ureteral calculi. Can Urol Assoc J 2015; 9(11-12):E837–51.

Brisbane W, Bailey MR, Sorensen MD. An overview of kidney stone imaging techniques. Nat Rev Urol 2016; 13(11):654–62.

Moon YJ, Kim HW, Kim JB, Kim HJ, Chang YS. Distribution of ureteral stones and factors affecting their location and expulsion in patients with renal colic. Korean J Urol 2015; 56(10):717–21.

Eisner BH, McQuaid JW, Hyams E, Matlaga BR. Nephrolithiasis: What surgeons need to know. AJR Am J Roentgenol 2011; 196:1274–8.

Kambadakone AR, Eisner BH, Catalano OA, Sahani DV. New and evolving concepts in the imaging and management of urolithiasis: Urologists’ perspective. Radiographics 2010; 30:603–23.

Ahmed AF, Gabr AH, Emara AA, Ali M, Abdel-Aziz AS, Alshahrani S. Factors predicting the spontaneous passage of a ureteric calculus of <10 mm. Arab J Urol 2015; 13(2):84–90.

Jendeberg J, Geijer H, Alshamari M, Cierzniak B, Lidén M. Size matters: The width and location of a ureteral stone accurately predict the chance of spontaneous passage. Eur Radiol 2017; 27(11):4775–85.

Sfoungaristos S, Kavouras A, Perimenis P. Predictors for spontaneous stone passage in patients with renal colic secondary to ureteral calculi. Int Urol Nephrol 2012; 44:71–9.

Tchey DU, Ha YS, Kim WT, Yun SJ, Lee SC, Kim WJ. Expectant Management of Ureter Stones: Outcome and Clinical Factors of Spontaneous Passage in a Single Institution's Experience. Korean J Urol. 2011; 52(12):847–51.

Zorba OU, Ogullar S, Yazar S, Akca G. CT-based determination of ureteral stone volume: A predictor of spontaneous passage. J Endourol 2016; 30(1):32–6.

Gücük A, Uyetürk U. Usefulness of Hounsfield unit and density in the assessment and treatment of urinary stones. World J Nephrol 2014; 3(4):282–6.

Hada, Ajayraj Y, Sher S, Tomar, Vinay P, Shivam A, et al. Assessment of factors affecting the spontaneous passage of lower ureteric calculus on the basis of lower ureteric calculus diameter, density, and plasma C- reactive protein level. Urol Ann 2018; 10:302.

Ongün Ş, Dursun M. The Effect of Distal Ureteral Stone Size Measurements on Spontaneous Passage. J Urol Surg 2019; 6:139–43.

Bourdoumis A, Papatsoris AG, Chrisofos M, Deliveliotis C. Lower Pole Stone Management. Med Surg Urol 2012; S4:004.

Published
2021-08-09
How to Cite
Hassan, S., & Rashid, S. (2021). Prediction of the ureteric stone outcome by CT scan. Zanco Journal of Medical Sciences (Zanco J Med Sci), 25(2), 560-566. https://doi.org/10.15218/zjms.2021.020
Section
Original Articles