2229 DOPPLER ULTRASOUND AS EFFICIENT PRIMARY DIAGNOSTIC TOOL FOR URETERAL STONES IN YOUNG ADULTS

Abstract

You have accessJournal of UrologyStone Disease: Evaluation & Medical Management1 Apr 20112229 DOPPLER ULTRASOUND AS EFFICIENT PRIMARY DIAGNOSTIC TOOL FOR URETERAL STONES IN YOUNG ADULTS Renate Pichler, Viktor Skradski, Friedrich Aigner, Nicolai Leonhartsberger, and Hannes Steiner Renate PichlerRenate Pichler Innsbruck, Austria More articles by this author , Viktor SkradskiViktor Skradski Innsbruck, Austria More articles by this author , Friedrich AignerFriedrich Aigner Innsbruck, Austria More articles by this author , Nicolai LeonhartsbergerNicolai Leonhartsberger Innsbruck, Austria More articles by this author , and Hannes SteinerHannes Steiner Innsbruck, Austria More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2470AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To determine additional factors which might improve the sonographic diagnosis of ureteral calculi using Doppler ultrasound (US) as primary diagnostic method. METHODS We performed a retrospective study with 228 patients who underwent rigid ureteroscopy (URS) for obstructive ureteral stones. Patient age, sex, BMI (body mass index), stone localisation and stone size were recorded. All patients underwent Doppler ultrasound and B-mode imaging for stone detection preoperatively. If no cause of the flank pain was found by US, computer tomography (CT) was performed to confirm the absence of ureteral stones and other pathologies. RESULTS Between 2008 and 2009, 176 (77.2%) men and 52 (22.8%) women with a mean age of 48 presented ureteral stones. In 57 (25%), 15 (6.6%) and 156 (68.4%) patients a stone was localised on the proximal, mid and distal ureter. In 96 (42.1%), 122 (53.5%) and 10 (4.4%) patients the stone measured 0–5, 6–10 and >10 mm. The mean BMI was 24.7 (range 17.3–37.2) kg/m2. The overall stone detection rate using Doppler US was 86.4% and 96.4% in adults ≤35 years. 72 of 197 (36.5%) calculi on US versus 24 of 31 (77.4%) stones using CT measured 0–5 mm. Performing binary logistic regression, age (p=0.008), stone size (p<0.001) and BMI (p=0.013) were independent parameters affecting ureteral stone diagnosis on ultrasound. The overall success rate of URS was 79.8%: 66.7%, 73.3% and 85.3% in patients with proximal, mid and distal ureteral stones (p=0.009). CONCLUSIONS Although CT is an excellent method and served as the “gold standard” for stone detection, regarding high costs and radiation dose lead us to say that US in the hands of experienced radiologists should be preferred as first choice for primary diagnostic, especially in young patients with a high detection rate of 96.4%. For distal ureteral stones we recommend ureteroscopy as first line treatment with a success rate of 85.3%. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e894-e895 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Renate Pichler Innsbruck, Austria More articles by this author Viktor Skradski Innsbruck, Austria More articles by this author Friedrich Aigner Innsbruck, Austria More articles by this author Nicolai Leonhartsberger Innsbruck, Austria More articles by this author Hannes Steiner Innsbruck, Austria More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...