Çalışmamızın amacı üreter taşı olan hastalarda hidronefroz derecesi ile üreterdeki taşların boyutu ve yerleşimi arasında bir ilişki olup olmadığını bigisayarlı tomografi (BT) ile değerlendirerek araştırmaktır. Malatya Eğitim ve Araştırma Hastanesi'ne renal kolik şikayeti ile başvuran ve BT taraması yapılan 105 hasta bu çalışmaya dahil edildi. Hidronefroz, Fetal Üroloji Derneği tarafından geliştirilen derecelendirme sistemi kullanılarak değerlendirildi. Taş boyutları ise <5 mm, 5 – 10 mm ve ≥ 10 mm olarak belirlendi ve gruplara ayrıldı. Üreterlerin anatomik kısımlarına göre taşların yerleşimi proksimal - orta - distal olarak belirtildi. 61 (%58.1) hastada üreter distal kesiminde, 20 (%19) hastada orta üreter kesiminde, 24 (%22.9) hastada üreter proksimal kesiminde taş vardı. Taş boyutunun hidronefroz derecesine göre istatistiksel olarak anlamlı farklılık gösterdiği belirlendi (p<0.05). Proksimal, orta veya distal üreter segmentinde taş varlığı ile hidronefroz derecesi arasında istatistiksel olarak anlamlı bir ilişki yoktu (p=0.241). Üreter taşlarının boyutu arttıkça hidronefroz derecesi artarken, taşın üreterdeki yerleşiminin hidronefroz ile ilişkisi yoktur.
Ahmed, A. F., Gabr, A. H., Emara, A. A., Ali, M., Abdel-Aziz, A. S. & Alshahrani, S. (2015). Factors predicting the spontaneous passage of a ureteric calculus of ⩽10 mm. Arab Journal of Urology, 13(2), 84–90. https://doi.org/10.1016/j.aju.2014.11.004
Aune, D., Mahamat-Saleh, Y., Norat, T. & Riboli, E. (2018). Body fatness, diabetes, physical activity and risk of kidney stones: a systematic review and meta-analysis of cohort studies. European Journal of Epidemiology, 33(11), 1033–1047. https://doi.org/10.1007/s10654-018-0426-4
Bihl, Geoffrey & Anthony Meyers. (2001). Recurrent renal stone disease—advances in pathogenesis and clinical management. The Lancet, 358(9282), 651–656. https://doi.org/10.1016/S0140-6736(01)05782-8
Brown, Jeremy. (2006). Diagnostic and treatment patterns for renal colic in US emergency departments. International Urology and Nephrology, 38(1), 87–92. https://doi.org/10.1007/s11255-005-3622-6
Daga, S., Wagaskar, V. G., Tanwar, H., Shelke, U., Patil, B. & Patwardhan, S. (2016). efficacy of medical expulsive therapy in renal calculi less than or equal to 5 millimetres in size. Urology Journal, 13(6), 2893–2898. https://doi.org/10.22037/uj.v13i6.3563
Daniels, B., Gross, C. P., Molinaro, A., Singh, D., Luty, S., Jessey, R. & Moore, C. L. (2016). Stone plus: Evaluation of emergency department patients with suspected renal colic, using a clinical prediction tool combined with point-of-care limited ultrasonography. Annals of Emergency Medicine, 67(4), 439–448. https://doi.org/10.1016/j.annemergmed.2015.10.020
Daniels, B., Schoenfeld, E., Taylor, A., Weisenthal, K., Singh, D. & Moore, C. L. (2017). Predictors of hospital admission and urological ıntervention in adult emergency department patients with computerized tomography confirmed ureteral stones. Journal of Urology, 198(6), 1359–1366. https://doi.org/10.1016/j.juro.2017.06.077
Dellabella, M., Milanese, G. & Muzzonigro, G. (2005). Randomızed trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. Journal of Urology, 174(1), 167–172. https://doi.org/10.1097/01.ju.0000161600.54732.86
Fernbach, S. K., Maizels, M. & Conway, J. J. (1993). Ultrasound grading of hydronephrosis: Introduction to the system used by the society for fetal urology. Pediatric Radiology, 23(6), 478-480. https://doi.org/10.1007/BF02012459
Goertz, J. K. & Lotterman, S. (2010). Can the degree of hydronephrosis on ultrasound predict kidney stone size? The American Journal of Emergency Medicine, 28(7), 813–816. https://doi.org/10.1016/j.ajem.2009.06.028
Hollingsworth, J. M., Canales, B. K., Rogers, M. A., Sukumar, S., Yan, P., Kuntz, G. M. & Dahm, P. (2016). Alpha blockers for treatment of ureteric stones: systematic review and meta-analysis. BMJ, i6112. 10.1136/bmj.i6112
Innes, G. D., Scheuermeyer, F. X., McRae, A. D., Teichman, J. M. & Lane, D. J. (2021). Hydronephrosis severity clarifies prognosis and guides management for emergency department patients with acute ureteral colic. Canadian Journal of Emergency Medicine, 23(5), 687–695. https://doi.org/10.1007/s43678-021-00168-x
Innes, G. D., Scheuermeyer, F. X., McRae, A. D., Law, M. R., Teichman, J. M., Grafstein, E. & Andruchow, J. E. (2021). Which patients should have early surgical ıntervention for acute ureteral colic? Journal of Urology, 205(1), 152–158. https://doi.org/10.1097/JU.0000000000001318
Jendeberg, J., Geijer, H., Alshamari, M., Cierzniak, B. & Lidén, M. (2017). Size matters: The width and location of a ureteral stone accurately predict the chance of spontaneous passage. European Radiology, 27(11), 4775–4785. https://doi.org/10.1007/s00330-017-4852-6
Johnson, C. M., Wilson, D. M., O'Fallon, W. M., Malek, R. S. & Kurland, L. T. (1979). Renal stone epidemiology: A 25-year study in rochester, Minnesota. Kidney International, 16(5), 624–631. https://doi.org/10.1038/ki.1979.173
Katz, D. S., Scheer, M., Lumerman, J. H., Mellinger, B. C., Stillman, C. A. & Lane, M. J. (2000). Alternative or additional diagnoses on unenhanced helical computed tomography for suspected renal colic: Experience with 1000 consecutive examinations. Urology, 56(1), 53–57. https://doi.org/10.1016/S0090-4295(00)00584-7
Lee, S. R., Jeon, H. G., Park, D. S. & Choi, Y. D. (2012). Longitudinal stone diameter on coronal reconstruction of computed tomography as a predictor of ureteral stone expulsion in medical expulsive therapy. Urology, 80(4), 784–789. https://doi.org/10.1016/j.urology.2012.06.032
Leo, M. M., Langlois, B. K., Pare, J. R., Mitchell, P., Linden, J., Nelson, K. P., ...Carmody, K. A. (2017). Ultrasound vs. computed tomography for severity of hydronephrosis and ıts ımportance in renal colic. Western Journal of Emergency Medicine, 18(4), 559–568. 10.5811/westjem.2017.04.33119
Moak, J. H., Lyons, M. S. & Lindsell, C. J. (2012). Bedside renal ultrasound in the evaluation of suspected ureterolithiasis. The American Journal of Emergency Medicine, 30(1), 218–21. https://doi.org/10.1016/j.ajem.2010.11.024
Mohammad, E. J., Abbas, K. M., Hassan, A. F. & Abdulrazaq, A. A. (2018). Serum c-reactive protein as a predictive factor for spontaneous stone passage in patients with 4 to 8 mm distal ureteral stones. International Surgery Journal, 5(4), 1195. https://dx.doi.org/10.18203/2349-2902.isj20181034
Pereira, B. M., Ogilvie, M. P., Gomez-Rodriguez, J. C., Ryan, M. L., Peña, D., Marttos, A. C., ...McKenney, M. G. (2010). A review of ureteral ınjuries after external trauma. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 18(1), 6. https://doi.org/10.1186/1757-7241-18-6
Preminger, G. M., Tiselius, H. G., Assimos, D. G., Alken, P., Buck, C., Gallucci, M., ...Wolf, J. S. (2007). 2007 guideline for the management of ureteral calculi. Journal of Urology, 178(6), 2418–34. https://doi.org/10.1016/j.juro.2007.09.107
Riddell, J., Case, A., Wopat, R., Beckham, S., Lucas, M., McClung, C. D. & Swadron, S. (2014). Sensitivity of emergency bedside ultrasound to detect hydronephrosis in patients with computed tomography-proven stones. Western Journal of Emergency Medicine 15(1), 96–100. 10.5811/westjem.2013.9.15874
Schoenfeld, E. M., Pekow, P. S., Shieh, M. S., Scales Jr, C. D., Lagu, T. & Lindenauer, P. K. (2017). The diagnosis and management of patients with renal colic across a sample of us hospitals: High CT utilization despite low rates of admission and ınpatient urologic ıntervention. PloS One, 12(1), e0169160. https://doi.org/10.1371/journal.pone.0169160
Sfoungaristos, S., Kavouras, A., Kanatas, P., Duvdevani, M. & Perimenis, P. (2014). Early hospital admission and treatment onset may positively affect spontaneous passage of ureteral stones in patients with renal colic. Urology, 84(1), 16–21. https://doi.org/10.1016/j.urology.2014.01.005
Smith, R. D., Shah, M. & Patel, A. (2009). Recent advances in management of ureteral calculi. F1000 medicine reports, 1, 53. 10.3410/M1-53
Stamatelou, K. K., Francis, M. E., Jones, C. A., Nyberg Jr, L. M. & Curhan, G. C. (2003). Time trends in reported prevalence of kidney stones in the united states: 1976–199411.See Editorial by Goldfarb, p. 1951. Kidney International, 63(5), 1817–1823. https://doi.org/10.1046/j.1523-1755.2003.00917.x
Teichman, J. M. (2004). Acute renal colic from ureteral calculus. New England Journal of Medicine, 350(7), 684–693. 10.1056/NEJMcp030813
Thotakura, R. & Anjum, F. (2022). Hydronephrosis and hydroureter. In StatPearls, Treasure Island (FL), StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK563217/
THE RELATIONSHIP BETWEEN THE SIZE AND LOCALIZATION OF THE URETERAL STONE AND THE DEGREE OF HYDRONEPHROSIS
Yıl 2023,
Cilt: 11 Sayı: 1, 1101 - 1109, 17.03.2023
The aim of our research is to evaluate whether there is a relationship between the degree of hydronephrosis and, the size and location of the stones in the ureter in patients with ureteral stones, with computed tomography (CT). 105 patients who applied to Malatya Training and Research Hospital with the complaint of renal colic and underwent CT scan were included in the study. Hydronephrosis was evaluated by using the system developed by the Society of Fetal Urology. Stone sizes were grouped as <5 mm, 5 – 10 mm, and ≥ 10 mm. The location of the stones were indicated as proximal - middle - distal according to the anatomical parts of the ureters. 61 (58.1%) patients had stones in the distal ureter, 20 (19%) had stones in the middle ureter, and 24 (22.9%) had stones in the proximal ureter. It was determined that the stone size showed significant difference according to the degree of hydronephrosis (p<0.05). There was no significant relationship between the stone location being in the proximal, middle or distal parts of the ureter and the degree of hydronephrosis (p=0.241). While, as the size of ureteral stones increases the degree of hydronephrosis increases, there is no relation with the location of the stone and hydronephrosis.
Ahmed, A. F., Gabr, A. H., Emara, A. A., Ali, M., Abdel-Aziz, A. S. & Alshahrani, S. (2015). Factors predicting the spontaneous passage of a ureteric calculus of ⩽10 mm. Arab Journal of Urology, 13(2), 84–90. https://doi.org/10.1016/j.aju.2014.11.004
Aune, D., Mahamat-Saleh, Y., Norat, T. & Riboli, E. (2018). Body fatness, diabetes, physical activity and risk of kidney stones: a systematic review and meta-analysis of cohort studies. European Journal of Epidemiology, 33(11), 1033–1047. https://doi.org/10.1007/s10654-018-0426-4
Bihl, Geoffrey & Anthony Meyers. (2001). Recurrent renal stone disease—advances in pathogenesis and clinical management. The Lancet, 358(9282), 651–656. https://doi.org/10.1016/S0140-6736(01)05782-8
Brown, Jeremy. (2006). Diagnostic and treatment patterns for renal colic in US emergency departments. International Urology and Nephrology, 38(1), 87–92. https://doi.org/10.1007/s11255-005-3622-6
Daga, S., Wagaskar, V. G., Tanwar, H., Shelke, U., Patil, B. & Patwardhan, S. (2016). efficacy of medical expulsive therapy in renal calculi less than or equal to 5 millimetres in size. Urology Journal, 13(6), 2893–2898. https://doi.org/10.22037/uj.v13i6.3563
Daniels, B., Gross, C. P., Molinaro, A., Singh, D., Luty, S., Jessey, R. & Moore, C. L. (2016). Stone plus: Evaluation of emergency department patients with suspected renal colic, using a clinical prediction tool combined with point-of-care limited ultrasonography. Annals of Emergency Medicine, 67(4), 439–448. https://doi.org/10.1016/j.annemergmed.2015.10.020
Daniels, B., Schoenfeld, E., Taylor, A., Weisenthal, K., Singh, D. & Moore, C. L. (2017). Predictors of hospital admission and urological ıntervention in adult emergency department patients with computerized tomography confirmed ureteral stones. Journal of Urology, 198(6), 1359–1366. https://doi.org/10.1016/j.juro.2017.06.077
Dellabella, M., Milanese, G. & Muzzonigro, G. (2005). Randomızed trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. Journal of Urology, 174(1), 167–172. https://doi.org/10.1097/01.ju.0000161600.54732.86
Fernbach, S. K., Maizels, M. & Conway, J. J. (1993). Ultrasound grading of hydronephrosis: Introduction to the system used by the society for fetal urology. Pediatric Radiology, 23(6), 478-480. https://doi.org/10.1007/BF02012459
Goertz, J. K. & Lotterman, S. (2010). Can the degree of hydronephrosis on ultrasound predict kidney stone size? The American Journal of Emergency Medicine, 28(7), 813–816. https://doi.org/10.1016/j.ajem.2009.06.028
Hollingsworth, J. M., Canales, B. K., Rogers, M. A., Sukumar, S., Yan, P., Kuntz, G. M. & Dahm, P. (2016). Alpha blockers for treatment of ureteric stones: systematic review and meta-analysis. BMJ, i6112. 10.1136/bmj.i6112
Innes, G. D., Scheuermeyer, F. X., McRae, A. D., Teichman, J. M. & Lane, D. J. (2021). Hydronephrosis severity clarifies prognosis and guides management for emergency department patients with acute ureteral colic. Canadian Journal of Emergency Medicine, 23(5), 687–695. https://doi.org/10.1007/s43678-021-00168-x
Innes, G. D., Scheuermeyer, F. X., McRae, A. D., Law, M. R., Teichman, J. M., Grafstein, E. & Andruchow, J. E. (2021). Which patients should have early surgical ıntervention for acute ureteral colic? Journal of Urology, 205(1), 152–158. https://doi.org/10.1097/JU.0000000000001318
Jendeberg, J., Geijer, H., Alshamari, M., Cierzniak, B. & Lidén, M. (2017). Size matters: The width and location of a ureteral stone accurately predict the chance of spontaneous passage. European Radiology, 27(11), 4775–4785. https://doi.org/10.1007/s00330-017-4852-6
Johnson, C. M., Wilson, D. M., O'Fallon, W. M., Malek, R. S. & Kurland, L. T. (1979). Renal stone epidemiology: A 25-year study in rochester, Minnesota. Kidney International, 16(5), 624–631. https://doi.org/10.1038/ki.1979.173
Katz, D. S., Scheer, M., Lumerman, J. H., Mellinger, B. C., Stillman, C. A. & Lane, M. J. (2000). Alternative or additional diagnoses on unenhanced helical computed tomography for suspected renal colic: Experience with 1000 consecutive examinations. Urology, 56(1), 53–57. https://doi.org/10.1016/S0090-4295(00)00584-7
Lee, S. R., Jeon, H. G., Park, D. S. & Choi, Y. D. (2012). Longitudinal stone diameter on coronal reconstruction of computed tomography as a predictor of ureteral stone expulsion in medical expulsive therapy. Urology, 80(4), 784–789. https://doi.org/10.1016/j.urology.2012.06.032
Leo, M. M., Langlois, B. K., Pare, J. R., Mitchell, P., Linden, J., Nelson, K. P., ...Carmody, K. A. (2017). Ultrasound vs. computed tomography for severity of hydronephrosis and ıts ımportance in renal colic. Western Journal of Emergency Medicine, 18(4), 559–568. 10.5811/westjem.2017.04.33119
Moak, J. H., Lyons, M. S. & Lindsell, C. J. (2012). Bedside renal ultrasound in the evaluation of suspected ureterolithiasis. The American Journal of Emergency Medicine, 30(1), 218–21. https://doi.org/10.1016/j.ajem.2010.11.024
Mohammad, E. J., Abbas, K. M., Hassan, A. F. & Abdulrazaq, A. A. (2018). Serum c-reactive protein as a predictive factor for spontaneous stone passage in patients with 4 to 8 mm distal ureteral stones. International Surgery Journal, 5(4), 1195. https://dx.doi.org/10.18203/2349-2902.isj20181034
Pereira, B. M., Ogilvie, M. P., Gomez-Rodriguez, J. C., Ryan, M. L., Peña, D., Marttos, A. C., ...McKenney, M. G. (2010). A review of ureteral ınjuries after external trauma. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 18(1), 6. https://doi.org/10.1186/1757-7241-18-6
Preminger, G. M., Tiselius, H. G., Assimos, D. G., Alken, P., Buck, C., Gallucci, M., ...Wolf, J. S. (2007). 2007 guideline for the management of ureteral calculi. Journal of Urology, 178(6), 2418–34. https://doi.org/10.1016/j.juro.2007.09.107
Riddell, J., Case, A., Wopat, R., Beckham, S., Lucas, M., McClung, C. D. & Swadron, S. (2014). Sensitivity of emergency bedside ultrasound to detect hydronephrosis in patients with computed tomography-proven stones. Western Journal of Emergency Medicine 15(1), 96–100. 10.5811/westjem.2013.9.15874
Schoenfeld, E. M., Pekow, P. S., Shieh, M. S., Scales Jr, C. D., Lagu, T. & Lindenauer, P. K. (2017). The diagnosis and management of patients with renal colic across a sample of us hospitals: High CT utilization despite low rates of admission and ınpatient urologic ıntervention. PloS One, 12(1), e0169160. https://doi.org/10.1371/journal.pone.0169160
Sfoungaristos, S., Kavouras, A., Kanatas, P., Duvdevani, M. & Perimenis, P. (2014). Early hospital admission and treatment onset may positively affect spontaneous passage of ureteral stones in patients with renal colic. Urology, 84(1), 16–21. https://doi.org/10.1016/j.urology.2014.01.005
Smith, R. D., Shah, M. & Patel, A. (2009). Recent advances in management of ureteral calculi. F1000 medicine reports, 1, 53. 10.3410/M1-53
Stamatelou, K. K., Francis, M. E., Jones, C. A., Nyberg Jr, L. M. & Curhan, G. C. (2003). Time trends in reported prevalence of kidney stones in the united states: 1976–199411.See Editorial by Goldfarb, p. 1951. Kidney International, 63(5), 1817–1823. https://doi.org/10.1046/j.1523-1755.2003.00917.x
Teichman, J. M. (2004). Acute renal colic from ureteral calculus. New England Journal of Medicine, 350(7), 684–693. 10.1056/NEJMcp030813
Thotakura, R. & Anjum, F. (2022). Hydronephrosis and hydroureter. In StatPearls, Treasure Island (FL), StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK563217/
Akçiçek, M., & Buğday, M. S. (2023). THE RELATIONSHIP BETWEEN THE SIZE AND LOCALIZATION OF THE URETERAL STONE AND THE DEGREE OF HYDRONEPHROSIS. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 11(1), 1101-1109. https://doi.org/10.33715/inonusaglik.1198372