PREDICTIVE FACTORS AFFECTING THE SUCCESS OF MEDICAL EXPULSIVE THERAPY IN PATIENTS WITH DISTAL URETERAL STONE

Yıl 2024, , 443 - 447, 21.10.2024

Kaan Karamık , Hakan Anıl , Ekrem İslamoğlu

https://doi.org/10.18229/kocatepetip.1390134

Öz

OBJECTIVE: In this study, we aimed to investigate the factors affecting spontaneous stone passing in patients who received medical expulsive therapy due to distal ureteral stones.
MATERIAL AND METHODS: From September 2022 to October 2023, a total of 148 patients with distal ureteral stones sized 4-10 mm were included. Patients received silodosin 4 mg as medical expulsive therapy and were followed up for a maximum of four weeks. The patient- and stone-related variables affecting spontaneous stone passage were evaluated.
RESULTS: The mean age of the participants was 42.92±12.78 years. The stone expulsion rate was 64.2%. The rate of spontaneous stone passage was significantly higher in patients with lower stone size, stone burden, ureteral wall thickness, distance of the stone to the ureterovesical junction, neutrophil-lymphocyte ratio and hydronephrosis grade. (all, p<0.05). The distance of the stone to the ureterovesical junction, ureteral wall thickness, and neutrophil-to-lymphocyte ratio were independent predictors of spontaneous passage (p:0.036, p:0.001, p:0.001, respectively).
CONCLUSIONS: The distance of stone to the ureterovesical junction, ureteral wall thickness, and neutrophil-to-lymphocyte ratio can be useful parameters to estimate spontaneous stone expulsion. These factors play important roles in decision-making for the management of distal ureteral stones.

Anahtar Kelimeler

Ureteral Calculi, Urolithiasis, Medical expulsive therapy.

DİSTAL ÜRETER TAŞI OLAN HASTALARDA MEDİKAL EKSPULSİF TEDAVİNİN BAŞARISINI ETKİLEYEN ÖNGÖRÜCÜ FAKTÖRLER

Öz

AMAÇ: Bu çalışmada distal üreter taşı nedeniyle medikal ekspulsif tedavi başlanan hastalarda spontan taş düşürmeyi etkileyen faktörleri araştırmayı amaçladık.
GEREÇ VE YÖNTEM: Eylül 2022 ve Ekim 2023 tarihleri arasında 4-10 mm boyutlarında distal üreter taşı olan toplam 148 hasta dahil edildi. Hastalara medikal ekspülsif tedavi olarak silodosin 4 mg başlandı ve en fazla dört hafta takip edildi. Spontan taş düşürmeyi etkileyen hasta ve taşa bağlı değişkenler değerlendirildi.
BULGULAR: Katılımcıların yaş ortalaması 42,92±12,78 yıldı. Taş düşürme oranı %64,2 idi. Taş boyutu, taş yükü, üreter duvar kalınlığı, taşın üreterovezikal bileşkeye olan uzaklığı, nötrofil lenfosit oranı ve hidronefroz derecesi daha düşük olan hastalarda spontan taş düşürme oranı anlamlı olarak daha yüksekti (hepsi için p<0.05). Çok değişkenli analizde, taşın üreterovezikal bileşkeye olan mesafesi, üreter duvar kalınlığı ve nötrofil-lenfosit oranı spontan pasajın bağımsız belirleyicileriydi (sırasıyla p:0.036, p:0.001, p:0.001).
SONUÇ: Taşın üreterovezikal bileşkeye olan mesafesi, üreter duvar kalınlığı ve nötrofil-lenfosit oranı, spontan taş düşürmeyi tahmin etmede yararlı parametreler olabilir. Bu faktörler distal üreter taşlarının tedavisine yönelik karar verme sürecinde önemli bir rol oynamaktadır.

Anahtar Kelimeler

Üreter taşları, Ürolitiyaz, Medikal ekspulsif tedavi.

Etik Beyan

Ethics committee approval was received from Antalya Training and Research Hospital. (Approval number: 2023-14/8).

Kaynakça

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