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KMID : 0385920110220060728
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Journal of the Korean Society of Emergency Medicine
2011 Volume.22 No. 6 p.728 ~ p.734
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Relationship of Clinical Manifestation of Renal Colic to Ureteral Stone Size and Location
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Lee June-Young
Choa Min-Hong
Kim Hyun-Jong
Rhee Nu-Ga
Chung Sung-Phil
Lee Hahn-Shick
Kim Min-Joung
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Abstract
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Purpose: This study was designed to correlate the size and position of ureteral stones to their clinical manifestation.
Methods: This study was a retrospective review of medical records of 201 patients who visited the emergency department complaining of renal colic and diagnosed with ureteral stone(s) by use of computed tomography from July to
December 2011. The size and position of a stone and the corresponding ipsilateral hydronephrosis, as well as the number
and type of administered analgesics, were evaluated.
Results: Ureteral stones were located at the ureteropelvic junction in 2.0% of cases, at the proximal ureter between the ureteropelvic junction and the iliac vessels in 41.8% of cases, at the ureter crossing external iliac vessels in 1.0% of cases, at the distal ureter between the iliac vessels and the ureterovesical junction in 12.9% of cases, and at the
ureterovesical junction in 42.3% of cases. Where the ureter crossed external iliac vessels, the mean size of stones was
significantly larger in the upper ureter, as 5.3±2.3 mm, than in the lower ureter, as 4.2±1.8 mm. Pain duration and stone size were significant factors associated with hydronephrosis by logistic regression analysis. Ketorolac was selected as the first-line analgesics in 169 patients (94.9%). The factor affecting the response to analgesic treatment was stone size. Patients needing analgesic administration three times or more, had smaller stones.
Conclusion: Most of the ureteral stones observed were located in the proximal ureter and at the ureterovesical junction. Hydronephrosis occurred more often in patients who had longer periods of pain and larger stones. Patients with smaller stones needed more frequent administration of pain killers.
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KEYWORD
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Ureteral calculi, Hydronephrosis, Pain
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