Time to Stone Passage for Observed Ureteral Calculi: A Guide for Patient Education

Miller, O. Fred; Kane, Christopher J.

doi:10.1097/00005392-199909010-00014

Cited by 416 publications

(253 citation statements)

References 9 publications

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“…With close controls and in absence of risk factors like impaired renal function, pain, urinary tract infection or fever, these stones can be followed safely until spontaneously cleared. However, most authors recommend not exceeding 4-6 weeks, especially for obstructive ureteric calculi (14,15). These data show that the success rate is strongly influenced by the timing of therapeutic intervention (9).…”

Section: Commentsmentioning

confidence: 90%

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction

2006

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Objective: We compared the efficacy of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) for the treatment of distal ureteral calculi with respect to patient satisfaction. Materials and Methods: This is a prospective study where a total of 212 patients with solitary, radiopaque distal ureteral calculi were treated with ESWL (n = 92) using Dornier lithotriptor S (MedTech Europe GmbH) or URS (n = 120). Patient and stone characteristics, treatment parameters, clinical outcomes, and patient satisfaction were assessed for each group. Results: The 2 groups were comparable in regard to patient age, sex, stone size, and side of treatment. The stone-free status for ESWL and URS at 3 months was 81.5% and 97.5%, respectively (p < 0.0001). In addition, 88% of patients who underwent ESWL versus 20% who underwent URS were discharged home the day of procedure. Minor complications occurred in 3.3% and 8.3% of the ESWL and URS groups, respectively (p = 0.127). No ureteral perforation or stricture occurred in the URS group. Postoperative flank pain and dysuria were more severe in the URS than ESWL group, although the differences were not statistically significant (p = 0.16). Patient satisfaction was high for both groups, including 94% for URS and 80% for ESWL (p = 0.002). Conclusions: URS is more effective than ESWL for the treatment of distal ureteral calculi. ESWL was more often performed on an outpatient basis, and showed a trend towards less flank pain and dysuria, fewer complications and quicker convalescence. Patient satisfaction was significantly higher for URS according to the questionnaire used in this study.

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Section: Commentsmentioning

confidence: 90%

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction

2006

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“…3 The efficiency of the minimal invasive techniques, such as extracorporeal shock wave lithotripsy (ESWL) and ureterorenoscopy (URS) are shown in several studies. [4][5][6][7] Nevertheless, these techniques are not totally risk-free and they are not cost-effective treatment options. Thus, conservative treatment is an attractive alternative to invasive procedures for many patients.…”

Section: Introductionmentioning

confidence: 99%

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

et al. 2014

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We evaluated the efficacy of tamsulosin and nifedipine in medical expulsive therapy (MET) in patients with distal ureteral stone. In addition, we tried to determine the predictive value of Hounsfield Unit (HU) of the stone in the success of MET. A total of 75 patients with a distal ureteral stone of 5-10 mm diameter were randomly divided into three groups. Group 1 (n ¼ 25) received tamsulosin 0.4 mg/d; group 2 (n ¼ 25) received nifedipine 10 mg/day p.o and group 3 (n ¼ 25) received diclofenac sodium 50 mg p.o. when required. At the beginning of each treatment, the HU of the stone was also measured using a non-contrast computerized tomography in all the patients. The results were evaluated at week four. The mean age of the patients was 36.8 (range, 16-68) years. Stone expulsion was observed in 19 (76%) patients in group 1, 16 (64%) patients in group 2 and 9 (36%) patients in group 3 (p group1-3 ¼ 0.004, p group2-3 ¼ 0.048 and p group1-2 ¼ 0.355). The mean expulsion time was 9, 9.1 and 10.3 d, respectively (p group1-3 50.001, p group2-3 50.001 and p group1-2 ¼ 0.619). The mean diclofenac sodium dose per patient was 544, 602 and 1408 mg in groups 1, 2 and 3, respectively (p group1-3 50.001, p group2-3 50.001 and p group1-2 ¼ 0.977). The mean HU of the stone in patients with and without a successful MET was 363 and 389, respectively (p ¼ 0.462). Our results showed that MET with both nifedipine and tamsulosin provided a similar increase in the expulsion rate for distal ureteral stones. HU does not seem to be a predictive parameter for stone expulsion.

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“…Treatment may be required in 50% of ureteral calculi greater than 5mm Conservative management to permit spontaneous passing of stone is preferable provided that passing is in all likelihood in a reasonable period of time, with satisfactory patient symptoms and a low risk of complications. 16 Conservative management is not suitable if infectious symptoms are present, and patient symptoms are intolerable, or if conservative management is considered a potential threat to kidney function. In yet another study, spontaneous passing of ureteral calculi occurred in 76% of the patients with ureteral stones of <5mm, in 60% of the patients with stones of 5-7mm and in 48% of the patients with stones of 7-9mm.…”

Section: Discussionmentioning

confidence: 99%

Role of dilatation of intramural ureter in patients with lower urinary tract symptoms (LUTS) in UVJ and pre UVJ calculus: an observational study

2017

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Background: Various literature sources describe three narrowest anatomic spots in the ureter as the most potential points for ureteric calculi to form and these are: the pelvi-ureteric junction (PUJ), the point where the ureters cross over the iliac vessels and the ureterovesical junction (UVJ).Methods: This study included patients who presented with symptomatic obstructing ureteric calculi and who required uretero renoscopic lithotripsy (URSL). The procedure was selected according to stone size, location and degree of impaction.Results: Of the total of 100 patients, 43 were females and 57 were males. 69 patients had Lower Urinary Tract Symptoms and 31 patients had no Lower Urinary Tract Symptoms with the calculi. The age of the patients ranged from 17 years to 65 years and the stone size ranged from 7mm to 15mm. Lower ureteric calculi with LUTS are good indicators.Conclusions: We can approach lower ureteric calculi without use of dilators or 6/7.5ureteroscope in patients with LUTS.

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Time to Stone Passage for Observed Ureteral Calculi: A Guide for Patient Education

Cited by 416 publications

References 9 publications

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction

Tamsulosin versus nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion

Role of dilatation of intramural ureter in patients with lower urinary tract symptoms (LUTS) in UVJ and pre UVJ calculus: an observational study

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