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      KCI등재후보

      Factors affecting the urologist’s decision to administer ureteral stone therapy: a retrospective cohort study

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      https://www.riss.kr/link?id=A106842407

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      다국어 초록 (Multilingual Abstract)

      Objective We aimed to evaluate the factors influencing treatment option selection among urologists for patients with ureteral stones, according to the stone diameter and location. Methods We retrospectively reviewed the records of 360 consecutive pat...

      Objective We aimed to evaluate the factors influencing treatment option selection among urologists for patients with ureteral stones, according to the stone diameter and location.
      Methods We retrospectively reviewed the records of 360 consecutive patients who, between January 2009 and June 2014, presented to the emergency department with renal colic and were eventually diagnosed with urinary stones via computed tomography. The maximal horizontal and longitudinal diameter and location of the stones were investigated. We compared parameters between patients who received urological intervention (group 1) and those who received medical treatment (group 2).
      Results Among the 360 patients, 179 (49.7%) had stones in the upper ureter and 181 (50.3%) had stones in the lower ureter. Urologic intervention was frequently performed in cases of upper ureteral stones (P<0.001). In groups 1 and 2, the stone horizontal diameters were 5.5 mm (4.8 to 6.8 mm) and 4.0 mm (3.0 to 4.6 mm), stone longitudinal diameters were 7.5 mm (6.0 to 9.5 mm) and 4.4 mm (3.0 to 5.5 mm), and ureter diameters were 6.4 mm (5.0 to 8.0 mm) and 4.7 mm (4.0 to 5.3 mm), respectively (P<0.001). The cut-off values for the horizontal and longitudinal stone diameters in the upper ureter were 4.45 and 6.25 mm, respectively (sensitivity 81.3%, specificity 91.4%); those of the lower ureter were 4.75 and 5.25 mm, respectively (sensitivity 79.4%, specificity 79.4%).
      Conclusion The probability of a urologic intervention was higher for patients with upper ureteral stones and those with stone diameters exceeding 5 mm horizontally and 6 mm longitudinally

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      참고문헌 (Reference)

      1 Eisner BH, "Ureteral stone location at emergency room presentation with colic" 182 : 165-168, 2009

      2 Segura JW, "Ureteral Stones Clinical Guidelines Panel summary report on the management of ureteral calculi. The American Urological Association" 158 : 1915-1921, 1997

      3 Miller OF, "Unenhanced helical computed tomography in the evaluation of acute flank pain" 10 : 123-129, 2000

      4 Chen MY, "Trends in the use of unenhanced helical CT for acute urinary colic" 173 : 1447-1450, 1999

      5 Wen CC, "Treatment selection and outcomes: renal calculi" 34 : 409-419, 2007

      6 Dalrymple NC, "The value of unenhanced helical computerized tomography in the management of acute flank pain" 159 : 735-740, 1998

      7 Fielding JR, "Spiral computerized tomography in the evaluation of acute flank pain: a replacement for excretory urography" 157 : 2071-2073, 1997

      8 Coll DM, "Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT" 178 : 101-103, 2002

      9 Sourtzis S, "Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography" 172 : 1491-1494, 1999

      10 Boridy IC, "Noncontrast helical CT for ureteral stones" 16 : 18-21, 1998

      1 Eisner BH, "Ureteral stone location at emergency room presentation with colic" 182 : 165-168, 2009

      2 Segura JW, "Ureteral Stones Clinical Guidelines Panel summary report on the management of ureteral calculi. The American Urological Association" 158 : 1915-1921, 1997

      3 Miller OF, "Unenhanced helical computed tomography in the evaluation of acute flank pain" 10 : 123-129, 2000

      4 Chen MY, "Trends in the use of unenhanced helical CT for acute urinary colic" 173 : 1447-1450, 1999

      5 Wen CC, "Treatment selection and outcomes: renal calculi" 34 : 409-419, 2007

      6 Dalrymple NC, "The value of unenhanced helical computerized tomography in the management of acute flank pain" 159 : 735-740, 1998

      7 Fielding JR, "Spiral computerized tomography in the evaluation of acute flank pain: a replacement for excretory urography" 157 : 2071-2073, 1997

      8 Coll DM, "Relationship of spontaneous passage of ureteral calculi to stone size and location as revealed by unenhanced helical CT" 178 : 101-103, 2002

      9 Sourtzis S, "Radiologic investigation of renal colic: unenhanced helical CT compared with excretory urography" 172 : 1491-1494, 1999

      10 Boridy IC, "Noncontrast helical CT for ureteral stones" 16 : 18-21, 1998

      11 Flohr TG, "Multi-detector row CT systems and image-reconstruction techniques" 235 : 756-773, 2005

      12 Miller NL, "Management of kidney stones" 334 : 468-472, 2007

      13 Lee SR, "Longitudinal stone diameter on coronal reconstruction of computed tomography as a predictor of ureteral stone expulsion in medical expulsive therapy" 80 : 784-789, 2012

      14 송하정, "Investigation of the Location of the Ureteral Stone and Diameter of the Ureter in Patients with Renal Colic" 대한비뇨기과학회 51 (51): 198-201, 2010

      15 Smith RC, "Helical CT of urinary tract stones. Epidemiology, origin, pathophysiology, diagnosis, and management" 37 : 911-952, 1999

      16 Preminger GM, "Guideline for the management of ureteral calculi" 52 : 1610-1631, 2007

      17 Kishore TA, "Estimation of size of distal ureteral stones: noncontrast CT scan versus actual size" 72 : 761-764, 2008

      18 Smith RC, "Diagnosis of acute flank pain: value of unenhanced helical CT" 166 : 97-101, 1996

      19 Berkovitz N, "Coronal reconstruction of unenhanced abdominal CT for correct ureteral stone size classification" 20 : 1047-1051, 2010

      20 Nadler RB, "Coronal imaging to assess urinary tract stone size" 172 : 962-964, 2004

      21 Narepalem N, "Comparison of helical computerized tomography and plain radiography for estimating urinary stone size" 167 : 1235-1238, 2002

      22 Metser U, "Assessment of urinary tract calculi with 64-MDCT: the axial versus coronal plane" 192 : 1509-1513, 2009

      23 Niall O, "A comparison of noncontrast computerized tomography with excretory urography in the assessment of acute flank pain" 161 : 534-537, 1999

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