Prognostic Factors in the Conservative Treatment of Ureteric Stones

Aliyu, Ibrahim; Shetty, Sugandh D.; Awad, Radwa; Patel, Kush

doi:10.1111/j.1464-410x.1991.tb15161.x

Cited by 60 publications

(42 citation statements)

References 6 publications

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“…The important question of predicting intervention in renal colic has, for decades, only been addressed through retrospective studies showing that persistence of pain, size of calculus, location along the ureter, impaired renal function, obstruction and signs of infection are important factors influencing intervention. 8,15,[19][20][21][22][23] Our predictive variables for intervention are remarkably similar to other studies 8,12,15,[23][24][25] and demonstrate that our sample of renal colic patients is comparable to other populations described in the literature. 14,[26][27][28] Although not all patients had an intervention or were enrolled in the study, we Not enrolled in study n = 81…”

Section: Discussionsupporting

confidence: 76%

Predicting intervention in renal colic patients after emergency department evaluation

Papa

Stiell

Wells

et al. 2005

CJEM

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Objectives:There is no set of prospectively validated criteria to identify the emergency department (ED) patients with renal colic who are most likely to eventually have to undergo an intervention. This study prospectively assessed predictors of intervention in this patient population. Methods: This prospective cohort study included adult patients with renal colic who presented to 2 tertiary care hospital EDs. Patients had an 18-variable data form completed by an emergency physician and a radiological study to confirm urolithiasis. After discharge, patients were followed at 1 and 4 weeks to assess for intervention. The outcome criteria included the patient having had at least 1 of the following procedures performed: extracorporeal shockwave lithotripsy (ESWL), ureteroscopy, percutaneous nephrostomy or open surgery. Data were analyzed using appropriate univariate techniques, and those variables associated with intervention were combined using logistic regression analysis. Results: Over an 8-month period, 245 patients with confirmed urolithiasis were followed; 20% (95% confidence interval [CI] 15%-25%) eventually had a procedure to remove their calculi. Three variables were significantly correlated with having a procedure: i) size of calculus ≥ 6 mm (odds ratio [OR] 10.7, 95% CI 4.6-24.8), ii) location of calculus above mid-ureter (OR 6.9, 95% CI 3.0-15.9), and iii) Visual Analogue Scale score for pain at discharge from the ED ≥ 2 cm (OR 2.6, 95% CI 1.0-6.8). The area under receiver operating characteristic curve was 0.77 (95% C I 0.70-0.84) (p < 0.001). If all variables were present there was a 90% probability of the patient having an intervention performed within 4 weeks of discharge from the ED. Conversely, if none of the variables were present there was only a 4% probability of an intervention. Overall, the model had a sensitivity of 92% (95% CI 89%-96%) and a specificity of 63% (95% CI 57%-69%). Conclusions: This study has identified variables that could potentially be used to identify those renal colic patients who require an intervention after ED evaluation. Future studies will prospectively validate this model. RÉSUMÉObjectifs : Il n'existe pas d'ensemble de critères validés prospectivement pour identifier les patients reçus au département d'urgence pour une colique néphrétique qui sont les plus susceptibles EM ADVANCES • INNOVATIONS EN MU

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Section: Discussionsupporting

confidence: 76%

Predicting intervention in renal colic patients after emergency department evaluation

Papa

Stiell

Wells

et al. 2005

CJEM

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“…Resim et al did not identify a significant difference in distal stone passage rates between the tamsulosin and control groups. Similar expulsion rates were seen when patients with 6 mm stones were evaluated separately from those with stones larger than 6 mm [20]. In that trial, the average time to stone passage was not reported, the similar passage rates may be related to the longer treatment duration of 42 days, approaching the time when stone passage would spontaneously occur.…”

Section: Discussionsupporting

confidence: 51%

Determine the Effectiveness of Low Dose Tamsulosin as a Medical Expulsive Therapy in Patients with Lower Ureteric Stones

Jatoi¹,

Altaf²,

Mahesar³

2017

J Biomedical Sci

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“…Studies have shown stone passage rates from 71-98% for distal ureteral stones less than 5 mm and from 25-53% for those between 5 and 10 mm. 16 Although two thirds of the ureteral stones passed spontaneously within 4 weeks after the onset of symptoms, the rate of complications such as sepsis was directly related to the symptom duration, reaching 20% when the symptom lasted for more than 4 weeks. 17 The presence of alpha-and beta-adrenergic receptors in the human ureter was first described in 1970.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of low dose tamsulosin in medical expulsive therapy for ureteral stones in Japanese male patients: A randomized controlled study

et al. 2010

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Objective: To evaluate the efficacy of low dose tamsulosin for facilitating spontaneous passage of ureteral stones in Japanese male patients. Methods: A total of 71 patients with symptomatic ureteral stones, 10 mm or smaller in size, were randomly allocated into groups 1 and 2. Group 1 received tamsulosin (0.2 mg/day) for a maximum of 4 weeks and group 2 received no medication. The primary endpoint was the stone expulsion rate and the secondary endpoints were stone expulsion time and analgesic use. Results: There were no significant differences between the groups in terms of age, stone size and location. The stone expulsion rate was significantly higher in group 1 than in group 2 (77% vs 50%, P = 0.002). No significant differences were noted in the stone expulsion time and analgesic use between the groups. Conclusion: Low dose tamsulosin can significantly facilitate spontaneous passage of ureteral stones without significant side-effects in Japanese male patients.

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Prognostic Factors in the Conservative Treatment of Ureteric Stones

Cited by 60 publications

References 6 publications

Predicting intervention in renal colic patients after emergency department evaluation

Predicting intervention in renal colic patients after emergency department evaluation

Determine the Effectiveness of Low Dose Tamsulosin as a Medical Expulsive Therapy in Patients with Lower Ureteric Stones

Efficacy of low dose tamsulosin in medical expulsive therapy for ureteral stones in Japanese male patients: A randomized controlled study

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