Investig Clin Urol.  2017 Sep;58(5):339-345. 10.4111/icu.2017.58.5.339.

Radiological noninvasive assessment of ureteral stone impaction into the ureteric wall: A critical evaluation with objective radiological parameters

• Elibol O
• Safak KY
• Buz A
• Eryildirim B
• Erdem K
• Sarica K

• KMID: 2388050
• DOI: http://doi.org/10.4111/icu.2017.58.5.339

Abstract

PURPOSE
To determine the predictive value of certain radiological parameters for an objective asssessment of the presence of ureteral stone impaction.
MATERIALS AND METHODS
Seventy-nine patients with a single proximal ureteral stones were retrieved from the departmental database. Both clinical and particularly radiological data of all cases were well evaluated on this aspect. In addition to the time period between the first colic attack and definitive management; diameter of proximal ureter and renal pelvis, longitudinal and transverse stone size, Hounsfied unit (HU) of the stone and lastly ureteral wall thickness at the impacted stone site were all carefully evaluated and noted.
RESULTS
Patients had a single proximal ureteral stone. While mean age of the cases was ranged 20 to 78 years; mean stone size was 15.62±4.26 mm. Evaluation of our data demonstrated that although there was a statistically significant correlation between ureteral wall thickness and patients age, transverse diameter of the stone, ureteral diameter just proximal to the stone, renal pelvic diameter and the duration of renal colic attacks; no correlation could be demonstrated between patients sex and the HU of the stone.
CONCLUSIONS
Prediction of the presence and degree of proximal ureteral stone impaction is a challenging issue and our data indicated a highly significant correlation between ureteral wall thickness and the some certain radiological as well as clinical parameters evaluated which will give an objective information about the presence of impaction which may in turn be helpful in the follow-up and also management plans of such calculi.

Keyword

Diagnosis; Therapy; Ureter; Urolithiasis

MeSH Terms

Calculi
Colic
Diagnosis
Follow-Up Studies
Humans
Kidney Pelvis
Renal Colic
Ureter*
Urolithiasis

Figure

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  Fig. 1 Measurement of ureteral wall thickness from an axial computed tomographic image (arrows).

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  Fig. 2 Evaluation of the relationship between ureteral wall thickness and longitudinal/transverse (L/T) size of the stone ratio.

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  Fig. 3 Evaluation of the relationship between ureteral wall thickness and proximal ureteral diameter.

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  Fig. 4 Evaluation of the relationship between ureteral wall thickness and renal pelvic diameter.

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  Fig. 5 Evaluation of the relationship between ureteral wall thickness and the pain period before treatment.

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