Mp30-09 Prospective Evaluation of Ureteral Wall Thickness to Predict Spontaneous Stone Passage

You have accessJournal of UrologyImaging/Uroradiology II (MP30)1 May 2024MP30-09 PROSPECTIVE EVALUATION OF URETERAL WALL THICKNESS TO PREDICT SPONTANEOUS STONE PASSAGE Andrei D. Cumpanas, Brandon Camp, Candices M. Tran, Thao N. Vu, Kelvin Vo, Jacob C. Tsai, Jaime Altamirano-Villarroel, Seyedamirvala Saadat, Mark Hanna, Bruce Gao, Zachary E. Tano, Pengbo Jiang, Roshan M. Patel, Jaime Landman, and Ralph V. Clayman Andrei D. CumpanasAndrei D. Cumpanas , Brandon CampBrandon Camp , Candices M. TranCandices M. Tran , Thao N. VuThao N. Vu , Kelvin VoKelvin Vo , Jacob C. TsaiJacob C. Tsai , Jaime Altamirano-VillarroelJaime Altamirano-Villarroel , Seyedamirvala SaadatSeyedamirvala Saadat , Mark HannaMark Hanna , Bruce GaoBruce Gao , Zachary E. TanoZachary E. Tano , Pengbo JiangPengbo Jiang , Roshan M. PatelRoshan M. Patel , Jaime LandmanJaime Landman , and Ralph V. ClaymanRalph V. Clayman View All Author Informationhttps://doi.org/10.1097/01.JU.0001009416.90901.7b.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To date, the most reliable indicator of spontaneous passage of a ureteral stone is stone size. A recently published meta-analysis evaluated the impact of non-contrast computerized tomography (NCCT) determined, ureteral wall thickness (UWT) as a predictor of spontaneous ureteral stone passage. In a properly powered, prospective cohort study, we sought to assess whether UWT alone or in combination with stone size, would improve the predictability of spontaneous stone passage. METHODS: Between November 2020 and August 2023, we enrolled 140 patients presenting with acute renal colic to our emergency department who had a single ureteral stone visible on NCCT and who opted for a trial of spontaneous stone passage. NCCT scans were analyzed by a blinded reviewer to assess for each stone's linear dimensions, volume, area, and density as well as the grade of hydronephrosis, ureteral location and UWT at the point of greatest soft-tissue thickness adjacent to the stone. Simple binary logistic regression models were used to assess the correlation between previously established risk factors and spontaneous stone passage. A multivariate binary logistic regression model was built to validate the univariate relationships by adjusting for confounding variables. RESULTS: Bigger (OR: 0.67, p<0.001), wider (OR: 0.48, p<0.001) and denser (OR: 0.997, p=0.005) stones, surrounded by a thicker UWT (OR: 0.625; 95% CI: 0.440 - 0.889, p=0.009) had a lower likelihood of spontaneous passage. While significant on a univariate model, UWT lost its significance in the multivariate model, suggesting that the initial correlation was likely confounded by stone size/volume (p=0.165). Only stone width retained significance upon a multivariate analysis (Table 1, Figure 1). There was no positive effect of tamsulosin on spontaneous stone passage (OR: 0.694; 95% CI: 0.332-1.454, p=0.333). CONCLUSIONS: In a prospective cohort study, the spontaneous passage of a ureteral stone was best predicted by stone width. When adjusting for stone size, UWT was not found to be a significant predictive factor. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e494 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Andrei D. Cumpanas More articles by this author Brandon Camp More articles by this author Candices M. Tran More articles by this author Thao N. Vu More articles by this author Kelvin Vo More articles by this author Jacob C. Tsai More articles by this author Jaime Altamirano-Villarroel More articles by this author Seyedamirvala Saadat More articles by this author Mark Hanna More articles by this author Bruce Gao More articles by this author Zachary E. Tano More articles by this author Pengbo Jiang More articles by this author Roshan M. Patel More articles by this author Jaime Landman More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...