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Longitudinal Stone Diameter on Coronal Reconstruction of Computed Tomography as a Predictor of Ureteral Stone Expulsion in Medical Expulsive Therapy

Authors
 Seung Ryeol Lee  ;  Hwang Gyun Jeon  ;  Dong Soo Park  ;  Young Deuk Choi 
Citation
 Urology, Vol.80(4) : 784-789, 2012 
Journal Title
 Urology 
ISSN
 0090-4295 
Issue Date
2012
Abstract
OBJECTIVE: To evaluate stone diameter and ureteral dilation using computerized tomography as a predictor of ureteral stone expulsion after medical expulsive therapy. MATERIALS AND METHODS: We retrospectively reviewed the records of 328 patients with symptomatic ureteral stones <10 mm on axial computerized tomography images, who were treated with alpha blockers for 2 weeks. Computerized tomography scans were also performed 2 weeks after medical expulsive therapy to confirm ureteral stone expulsion. Patients were divided into upper ureteral stones and lower ureteral stones above and below the iliac vessels, respectively. Transverse stone diameter and longitudinal stone diameter were defined as the largest stone diameter determined on the axial and coronal computerized tomography images, respectively. Ureteral diameter was determined on one computerized tomography slice proximal to each ureteral stone on axial computerized tomography images, and the ratio of ureter-to-stone diameter was defined as ureteral diameter divided by transverse stone diameter. RESULTS: Among 328 patients, the stone expulsion rate was 44.1% in 145 upper ureteral stones and 69.4% in 183 lower ureteral stones. Transverse stone diameter, longitudinal stone diameter, ureteral diameter, and the ratio of ureter-to-stone diameter were significantly lower in patients with ureteral stone expulsion in upper ureteral stones and lower ureteral stones (P < .001 for all parameters). Logistic regression analysis revealed that only longitudinal stone diameter was a significant predictor of stone expulsion in patients with upper ureteral stones (odds ratio 0.580, P = .040) and lower ureteral stones (odds ratio 0.415, P = .012). CONCLUSION: Longitudinal stone diameter was a significant predictor of stone expulsion in patients with upper ureteral stones and lower ureteral stones after medical expulsive therapy. Measurement of stone diameters in coronal reconstruction may help to better choose a patient who is suitable for medical expulsive therapy.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91999
DOI
10.1016/j.urology.2012.06.032
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
Yonsei Authors
박동수(Park, Dong Soo) ; 이승렬(Lee, Seung Ryeol) ; 전황균(Jeon, Hwang Gyun) ; 최영득(Choi, Young Deuk)
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http://www.sciencedirect.com/science/article/pii/S0090429512006929
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