The Clinical Characteristics For Spontaneous Stone Passage In Patients With Renal Colic Secondary To Uretral Calculi

Objectives: The prevalence and incidence of ureteral calculi have reported to be increased inrecent years. Most ureteral stones can pass spontaneously. But the method of predicting thespontaneous passage is not perfect. The prospective study is needed to find the clinicalcharacteristics of patients with renal colic secondary to ureteral calculi, and investigate the role ofclinical, laboratory and imaging variables, for the prediction of spontaneous passage of ureteralstones.Methods: We prospectively analyzed the medical records of the patients who admitted to theurology department of our hospital for renal colic, from January until August of2013. The medicalrecords include clinical, laboratory and imaging variables. All patients receive the same drugtreatment, who meet the diagnostic standards and inclusion standard.In all patients, a second visitafter1month was planned to check stone status.The stone status was checked by the same image.Patients were divided into stone expulsion group and no stone expulsion group. Using univariateanalysis and multivariate Logistic regression analysis the predictors.Results:275patients were enrolled,235patients completed the study. The mean age of patientswas41.77±14.86years and the male-to-female ratio was3.1:1. Spontaneous stone expulsionwithin4weeks was recorded in138patients (59.23%).The mean hydronephrosis in the group ofstone size≤0.6cm was less than the group of stones>0.6cm, the difference was statisticallysignificant (P<0.01).The mean stone size of upper ureter, middle ureter, lower ureter and bladderwall segment was (0.78±0.16) cm,(0.76±0.15) cm,(0.69±0.14) cm and (0.74±0.19) cmrespectively, and the difference was statistically significant (P<0.05), LSD-t test was used formultiple comparison among four groups, and the difference of stone size in upper ureter and lowerureter was statistically significant (P<0.01).The mean stone size of patients with moderate pain,severe pain and very severe pain were (0.85±0.11) cm,(0.74±0.15) cm and (0.63±0.14) cmrespectively, and the difference was statistically significant (P<0.05). LSD-t test was used formultiple comparison among three sets, and the differences among three groups were statisticallysignificant (P<0.05).The rate of microscopic hematuria with patients’ ureteral calculi located inupper ureter, middle ureter, lower ureter and bladder wall segment were62.50%,30.00%,66.20%and42.10%respectively, the difference between them was statistically significant (P<0.05).Univariate analysis found stone size and location, age, pain grading, white blood cell,neutrophil percentage, neutrophil count, lymphocyte percentage and CRP were significant(P<0.05). Logistic regression analysis showed that white blood cell, CRP, stone size and locationwere significant (P<0.05).Conclusions: The more severe pain grade is, the smaller stone size is. The larger stone size is, themore serious degree of hydronephrosis.The study showed that white blood cell, CRP, stone sizeand location may be independent predictive factors for stone spontaneous passage.