Radiological noninvasive assessment of ureteral stone impaction into the ureteric wall: A critical evaluation with objective radiological parameters

Elibol, Özlem; Şafak, Kadihan Yalçın; Buz, Ayse; Eryıldırım, Bilal; Erdem, Kutluhan; Sarıca, Kemal

doi:10.4111/icu.2017.58.5.339

Cited by 19 publications

(19 citation statements)

References 18 publications

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“…The presence of hydronephrosis has been determined to be a preoperative indicator for impaction. [ 10 , 11 ] Hwang et al [ 17 ] showed that patients with ureteral lesions, such as polyps or strictures related with impacted ureteral stones have more severe hydronephrosis. Importantly, hydronephrosis usually highlights a severe ureteral obstruction, and it has also been shown that the stone-free rate after surgery for ureteral calculi was significantly decreased with increased hydronephrosis.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study showed that the diameter of the proximal ureter was found to be associated with stone impaction. [ 11 ] According to our knowledge, this ratio has not been previously studied to assess its impaction status. The results of the present study highlighted that an increased ratio and the upper diameter of the ureter are closely related to stone impaction.…”

Section: Discussionmentioning

confidence: 99%

“…Legemate et al [ 3 ] found that the female gender, ASA score > 1, prior stone treatment, positive preoperative urine culture, and larger stones were predictive variables for stone impaction. Elibol et al [ 11 ] indicated that increased UWT, age, transverse diameter of the stone, ureteral diameter just proximal to the stone, duration of renal colic attack, and renal pelvic diameter were related to impaction. Sarica et al [ 12 ] suggested that increases in the C-reactive protein, erythrocyte sedimentation rate, degree of hydronephrosis, and UWT were closely related to stone impaction.…”

Section: Discussionmentioning

confidence: 99%

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Is there any predictive value of the ratio of the upper to the lower diameter of the ureter for ureteral stone impaction?

Abat¹,

Börekoğlu²,

Altunkol³

et al. 2021

Current Urology

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Background: We aimed to determine if the ratio of the upper to the lower diameter of the ureter could have any predictive value for ureteral stone impaction. Materials and methods: Patients who had a solitary unilateral ureteric stone, determined by noncontrast computerized tomography, were assessed if they had undergone ureteroscopic lithotripsy. A total of 111 patients, 84 males (76%), and 27 females (24%), were recruited to the study. Demographic data of the patients and preoperative radiological parameters based on noncontrast computerized tomography were recorded. The impaction status was also assessed during the operation. Results: Of the 111 patients, ureteral stones in 63 (57%) patients were determined to be impacted, and ureteral stones in 48 (43%) were nonimpacted. Impacted stones were more common in older patients, female patients, and patients with an American Society of Anesthesiologists score of 2. Conclusions: Significant relationships were found between the impaction status and transverse stone length, longest stone length, upper diameter of the ureter, ratio (upper diameter of the ureter/lower diameter of the ureter), and anteroposterior diameter of the pelvis. These parameters were higher in patients with impacted stones.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is there any predictive value of the ratio of the upper to the lower diameter of the ureter for ureteral stone impaction?

Abat¹,

Börekoğlu²,

Altunkol³

et al. 2021

Current Urology

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show abstract

“…Yamaguchi et al [21] reported that impacted stones caused lesions, which may increase the degree of ureteral obstruction and ureteral wall inflammation. Studies of the impaction of ureteral stones in the ureteral wall are mostly based on radiological visualization methods.…”

Section: Discussionmentioning

confidence: 99%

The role of serum acute phase reactant level at prediction of impacted ureteral stone

Hazar¹,

Taş²,

Gezmiş³

et al. 2019

Int J Med Biochem

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The role of serum acute phase reactant levels in the prediction of impacted ureteral stone U rolithiasis is a disease that affects between 4% and 15% of the world population and the rate continues to grow [1]. Some 86% to 97% of ureteral stones are smaller than 3 mm in size and are passed spontaneously without any symptoms or medical treatment. Larger stones, on the other hand, cause dilatation of the ureter through partial or whole acute obstruction, depending on the size and location. Furthermore, they can cause colic pain through smooth muscle and epithelial reactions [2]. An impacted ureteral stone is defined as a case in which the stone remains in the ureter for more than 2 months in the same position and a guidewire cannot be passed endoscopically to the proximal side of the stone [3, 4]. An impacted stone can lead to local inflammatory reactions as a result of remaining in the same place in the ureter for an ex-Objectives: The aim of this study was to investigate the determination of ureteral stone impaction using acute phase reactants. Methods: A total of 110 patients who had a single ureteral stone treated during a single month using medical expulsive therapy of tamsulosin 0.4 mg/day, diclofenac 75 mg upon analgesic requirement, and at least 3 liters fluid per day were evaluated prospectively. The patients underwent ureteroscopy and were divided into 2 groups according to the presence or absence of impaction. The preoperative white blood cell (WBC) count, red blood cell distribution width (RDW), C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), mean platelet volume (MPV), and neutrophil-tolymphocyte ratio (NLR) in the non-impacted stone group (Group 1; n=59) and the impacted group (Group 2; n=51) were statistically compared. Results: There was no statistically significant difference in terms of age, stone diameter, body mass index, grade of hydronephrosis, or stone localization between the 2 groups. The WBC, RDW, and MPV value differences were statistically significant between the groups (p=0.035, p=0.035, and p=0.005, respectively). An MPV cutoff value of 9.55 fL was defined in Group 2 with 66% sensitivity and 62% specificity for impaction. There was no statistically significant difference between the groups in CRP, ESR, or NLR values (p=0.44, p=0.76, p=0.54, respectively). Conclusion: Evaluation of serum MPV with a cutoff value of 9.55 fL may predict ureteral stone impaction.

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“…However, its use is limited due to high costs, availability, and radiation exposure [9]. Although many studies are evaluating the sensitivity and specificity of USG and SCT in patients with ureteral stones, there are not enough studies evaluating the grade of HN depending on the localization and size of ureteral stones [10][11][12]. This study aimed to evaluate the presence rates of HN depending on the localization and size of ureteral stones in patients presenting with renal colic.…”

Section: Introductionmentioning

confidence: 99%

Initial evaluation of patients with renal colic: Should all patients receive non-contrast computed tomography?

2020

Ann Clin Anal Med

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Aim: Although spiral computed tomography (SCT) is the gold standard and the most sensitive diagnostic method for ureterolithiasis, urinary system ultrasonography (USG) is more preferred because it is cheap, widespread, non-invasive, and radiation-free. The purpose of this study was to evaluate the rate of renal colic in patients with ureteral stones and without hydronephrosis at first admission to the outpatient clinics and the data of stone related factors affecting it. Materials and Methods: The files of patients who admitted to the emergency and urology departments of our hospital with renal colic who had ureteral stones which were detected by SCT were evaluated retrospectively. Results: A total of 346 patients with renal colic who admitted to our hospital were evaluated. No statistically significant relation was found between age and gender and the degree of hydronephrosis. The stone size was found to be statistically related to the degree of hydronephrosis, valid for both axial size and coronal craniocaudal lengths. There was a difference between stone localizations in terms of being hydronephrosis, and, in particular, it was found that less hydronephrosis occurs in distal ureter stones compared to other regions. Discussion: Some of the ureteral stones may cause renal colic without hydronephrosis, and the diagnosis of ureteral stone may be missed in patients if evaluated only by urinary system USG. Therefore, the evaluation of these patients with SCT should be recommended.

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Radiological noninvasive assessment of ureteral stone impaction into the ureteric wall: A critical evaluation with objective radiological parameters

Cited by 19 publications

References 18 publications

Is there any predictive value of the ratio of the upper to the lower diameter of the ureter for ureteral stone impaction?

Is there any predictive value of the ratio of the upper to the lower diameter of the ureter for ureteral stone impaction?

The role of serum acute phase reactant level at prediction of impacted ureteral stone

Initial evaluation of patients with renal colic: Should all patients receive non-contrast computed tomography?

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