Can ureteral wall thickness (UWT) be used as a potential parameter for decision-making in uncomplicated distal ureteral stones 5-10mm in size? A prospective study.

Abstract

To evaluate the correlation between ureteral wall thickness (UWT) and stone passage (SP) and its cut-off value in distal uncomplicated ureteral stones. In the prospective study from January 2019 to January 2020 at a tertiary care hospital, we reviewed 212 patients aged above 18years with single, symptomatic, radiopaque, and distal ureteric stone sized 5-10mm, who were treated with MET (Silodosin 8mg once daily) until SP or a maximum of 4weeks. There were 2 groups: responders and non-responders. Demographic data of the patients and all stone radiological parameters including stone size, laterality, density, UWT, the diameter of the ureter proximal to the stone (PUD), and the degree of hydronephrosis were recorded and compared between the 2 groups. There were 126 (59.4%) in the responder group and 86 (40.6%) in the non-responder group. On univariate analysis, gender, stone density, stone size, PUD, UWT, and the degree of hydronephrosis were significant factors for stone passage. However, using multivariate analysis, only UWT and the degree of hydronephrosis were significant. ROC analysis showed that 3.75mm is the cut-off value for UWT, with 86% and 87.3% sensitivity and specificity, respectively. UWT and hydronephrosis can be used as potential predictors for SP and can help with decision-making in patients with uncomplicated 5-10mm lower ureteric stones.