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KMID : 0358320080490121094
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Korean Journal of Urology
2008 Volume.49 No. 12 p.1094 ~ p.1099
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Predicting Factors for Spontaneous Passage of Ureteral Calculi Based on Unenhanced Helical CT Findings
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Song Dong-Woo
Lee Sang-Ik
Jeong Tae-Yoong
Kim Dong-Jun
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Abstract
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Purpose: We performed a prospective study to determine whether unenhanced helical computed tomography(UHCT) findings predict the spontaneous passage of ureteral calculi.
Materials and Methods: Between April 2006 and June 2007, 175 patients with a single ureteral calculus ＜1cm in diameter were enrolled in this study, and a UHCT was performed. All of the patients were managed conservatively for 2 weeks. Patients without spontaneous passage of ureteral calculi within 2 weeks were treated by ureteroscopy or extracorporeal shock wave lithotripsy(ESWL). The secondary signs (hydronephrosis, perinephric edema, and the tissue rim sign) were graded on a scale of 0-3. We evaluated whether spontaneous passage of ureteral calculi was associated with stone diameter, location, Hounsfield units(HU), and the degree of secondary signs.
Results: Ninety-two patients(52.6%) had spontaneous passage of ureteral calculi. The mean stone diameter was significantly smaller in the passage group than the non-passage group(4.28mm vs. 6.73mm, p=0.002). The rate of spontaneous passage was significantly higher involving distal ureteral calculi(66.1%) than proximal ureteral calculi(30.3%, p＜0.001). The incidences of hydronephrosis and perinephric edema were significantly lower in the spontaneous passage group than the non-passage group(8.7% vs. 73.5% and 5.4% vs. 69.9%, respectively). The grades of hydronephrosis and perinephric edema were significantly lower in the spontaneous passage group than the non-passage group(p=0.001). Although there was a tendency toward increasing grades of hydronephrosis and perinephric edema with increasing stone size, the grades were more frequent and severe in the non-passage group in patients with similarly sized stones.
Conclusions: The degree of hydronephrosis and perinephric edema are useful ancillary signs in predicting the likelihood of spontaneous passage of ureteral calculi.
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KEYWORD
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Ureteral calculi, Helical computed tomography
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