Analysis of factors affecting spontaneous expulsion of ureteral stones that may predict unfavorable outcomes during watchful waiting periods: What is the influence of diabetes mellitus on the ureter?

다국어 초록 (Multilingual Abstract)

Purpose: The aim of our study was to evaluate the association of several factors with spontaneous stone expulsion, including ureteralstone characteristics (size, location, hydronephrosis, perinephric stranding), types of medications prescribed (α-blocker, lowdosesteroid), and other possible demographic and health-history factors (gender, age, serum creatinine, underlying diabetes mellitus[DM], and hypertension).
Materials and Methods: A total of 366 patients with ureteral stones were enrolled. All patients underwent watchful waitingwithout any invasive procedures. Initial diagnoses of ureteral stones were confirmed by computed tomography scans, which weretaken at approximately 1-month intervals to check for stone expulsion. Univariate and multivariate analyses were conducted toidentify significant factors that contributed to stone expulsion.
Results: Among 366 patients, 335 patients (91.5%) experienced spontaneous stone passage during a mean follow-up period of2.95±2.62 weeks. The patients were divided into two groups depending on the success of spontaneous stone passage. Univariateanalyses revealed that stone location (p=0.003), stone size (p=0.021), and underlying DM (p<0.001) were significant predictors ofstone passage. Multivariate analyses confirmed that stone size (p=0.010), stone location (p=0.008), and underlying DM (p=0.003)were independent predictive factors affecting stone passage.
Conclusions: Stone size, location, and underlying DM were confirmed to be significant predictive factors for spontaneous passageof ureteral stones. Urologists should consider active procedures, such as shock wave lithotripsy or ureteroscopy, rather than conservativemanagement in patients presenting with proximally located stones, large ureteral stones, or underlying DM.

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