The role of inflammatory serum markers and ureteral wall thickness on spontaneous passage of ureteral stone < 10 mm: A prospective cohort study

Ismaeel Aghaways; Rebaz Ibrahim; Rawa Bapir; Rawezh Q Salih; Karzan M Salih; Berwn A Abdulla

doi:10.1016/j.amsu.2022.104198

The role of inflammatory serum markers and ureteral wall thickness on spontaneous passage of ureteral stone < 10 mm: A prospective cohort study

Ann Med Surg (Lond). 2022 Jul 16:80:104198. doi: 10.1016/j.amsu.2022.104198. eCollection 2022 Aug.

Authors

Ismaeel Aghaways¹, Rebaz Ibrahim², Rawa Bapir^{2

3

4}, Rawezh Q Salih^{3

5}, Karzan M Salih⁶, Berwn A Abdulla^{3

5}

Affiliations

¹ Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq.
² Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq.
³ Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq.
⁴ U-merge Ltd. (Urology in Emerging Countries), London, UK.
⁵ Kscien Organization, Hamdi Str, Azadi Mall, Sulaymaniyah, Kurdistan, Iraq.
⁶ Iraqi Board for Medical Specialties, Department of Surgery, Sulaymaniyah Center, Sulaymaniyah, Iraq.

Abstract

Introduction: Ureteral stone is a worldwide disease and accounts for 20% of all urolithiasis. There is a widespread discussion on the preferred initial treatment method, whether medical or surgical, and each has its pros and cons. In this study, we aimed to assess the role of both ureteral wall thickness around the stone and inflammatory markers in guiding the decision-making process.

Methods: In this prospective study, 161 patients who presented with ureteric colic and were diagnosed with ureteral stone with NCCT were included. UWT around the stone was measured, and the NLR and PLR were calculated. The patients were given a single daily dose of tamsulosin 0.4 mg for 4 weeks with weekly follow-up to determine SSP or failure.

Results: Of the 161 patients with a mean age 40.12 ± 12.36 SD, 55.9% had a spontaneous stone passage. Receiver operating characteristics showed a cut off value of 2.45 mm UWT of non SSP patients with an 83% sensitivity and 86% specificity. Moreover, there was a significant correlation between higher NLR, PLR and increased UWT (Pearson correlation of 0.314 and 0.426 respectively). The combined higher NLR, PLR and increased UWT were associated with failure of SSP (p-value <0.001).

Conclusion: Many factors play a role in decision making for management of ureteral stones. Our study concludes that patients with high NLR, PLR, and UWT around the stone have lesser chance of SSP using MET. Their rise can be used as predictors to decide early intervention.

Keywords: Inflammatory serum markers; Medical expulsive therapy; Ureteral stone passage; Ureteral wall thickness; Urolithiasis.