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When should we give up on expectant management for patients with proximal ureteral stones?

当代泌尿学（英文） 2022年第1期16卷 9-14页

作者： Igal Shpunt Etay Elbaz Yuval Avda Jonathan Modai Dan Leibovici brian berkowitz Yaniv Shilo Department of Urology Kaplan Medical CenterRehovotIsrael Department of Earth and Planetary Sciences Weizmann Institute of ScienceRehovotIsrael

Background:Proximal ureteral stones(PUS)have relatively low rates of spontaneous ***,some patients do on expectant *** aim was to compare risk factors for surgical intervention in patients with PUS who underwent primary intervention to those subjected to expectant management.Materials and methods:We retrospectively reviewed the medical charts of patients presented to the emergency room with symptoms of renal colic and underwent computerized tomography between August 2016 and August 2017.A total of 97 consecutive patients were identified with up to 10 mm *** collected patient demographics,clinical,and imaging data,and performed binary regression analysis for risk of intervention.Results:The average age was 49years(range 17-97)and average stone size was 7.1 mm(range 3-10).Forty-one patients underwent immediate intervention while the remaining 56 patients were treated *** the 56 patients treated conservatively,26 underwent delayed intervention while 30 reported spontaneous stone *** univariate analysis of all 97 patients,statistically significant risk factors for intervention were found based on stone size,age,serum lymphocyte,platelet counts,and stone *** these risk factors,stone size≥7mm(p=0.012,odds ratio=5.4)and platelet count?230K/mL(p=0.027,odds ratio=4.9)remained statistically significant on multivariate analysis.Conclusion:Stone size and platelet count were found to be risk factors for surgical intervention in patients with up to 10 mm *** findings may assist in identifying patients who are more suitable for conservative approach.

关键词： Nephrolithiasis Renal colic Ureteral calculi Ureterolithiasis Urolithiasis

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