The effects of computed tomography parameters, inflammatory markers and sociodemographical data on spontaneous passage prediction of patients with ureteral stones smaller than 10 mm

Allowing spontaneous passage to patients with ureteral stones eliminates the need for surgery and the associated complications. However, keeping a stone with a low probability of spontaneous passage waiting for a long time can lead to serious complications such as pain, infection, and renal atrophy due to delayed treatment, urinary sepsis, and even the need for hemodialysis. Spontaneous passage prediction of ureteral stone is very important in terms of surgical or medical treatment. In our study, we examined the parameters that we think are important in the prediction of spontaneous passage. The data of 183 patients with ureteral stones between 2-10 mm, who applied with renal colic to the Urology Polyclinic of Yozgat Bozok University Training and Research Hospital between 15.06.2019 and 15.06.2021, were analyzed retrospectively. Stone side, location, stone volume, diameter of the stone in three different planes, stone density, ureteral wall thickness, presence of ureteral obstruction and degree of hydronephrosis in the kidney, opacity of the stone, hemogram, biochemistry, sedimentation, CRP, procalcitonin, urinalysis, vital signs, VAS (Visual Analogue Scale) pain scores and the presence of gross hematuria, age, gender, body mass index (BMI), smoking, comorbidities, marital status, educational status, occupation, daily water consumption amounts, previous spontaneous stone removal history, the history of previous urinary stone operation and their stated voiding habits were compared. When the spontaneous passage prediction of the parameters in the logistic regression analysis was examined; Stone diameter (p=0.002), stone location (p=0.034), ureteral wall thickness (p=0.002), and ESWL history (p=0.041) were found to be significantly associated with spontaneous passage prediction and were found to be the strongest predictors. Stone volume, stone Hounsfield Unit, hydronephrosis and stone opacity were also found to be significantly different between groups in single analyzes of parameters and It was concluded that these parameters may also contribute to the spontaneous passage prediction. Inflammatory markers detected insignificant in spontaneous passage prediction. Analyzes showed that especially CT parameters were more significant in the prediction of spontaneous passage and the most important ones among these were ureteral wall thickness, stone diameter and stone localization. This study will help to make the most accurate and fastest treatment decision in the treatment of patients with ureteral stones and to increase the success of treatment. Key Words: ureteral stone, spontaneous passage, urinary stone