Spontaneous stone expulsion in patients with history of urolithiasis.

Autor:	Golomb D; Department of Urology, Samson Assuta Ashdod university Hospital, Ashdod, Israel., Shemesh A; Department of Urology, Samson Assuta Ashdod university Hospital, Ashdod, Israel., Goldberg H; Department of Urology, State University of New York, Upstate Medical University, Syracuse, NY, USA., Shalom B; Department of Urology, Samson Assuta Ashdod university Hospital, Ashdod, Israel., Hen E; Department of Urology, Samson Assuta Ashdod university Hospital, Ashdod, Israel., Barkai E; Department of Urology, Samson Assuta Ashdod university Hospital, Ashdod, Israel., Atamna F; Department of Urology, Samson Assuta Ashdod university Hospital, Ashdod, Israel., Abu Nijmeh H; Department of Urology, Samson Assuta Ashdod university Hospital, Ashdod, Israel., Cooper A; Department of Urology, Samson Assuta Ashdod university Hospital, Ashdod, Israel., Raz O; Department of Urology, Samson Assuta Ashdod university Hospital, Ashdod, Israel.
Jazyk:	angličtina
Zdroj:	Urologia [Urologia] 2023 May; Vol. 90 (2), pp. 329-334. Date of Electronic Publication: 2022 Oct 08.
DOI:	10.1177/03915603221126756
Abstrakt:	Objectives: To examine differences in the presentation, management, and outcomes of patients admitted to the emergency department (ED) with ureteral stones, with prior history of urolithiasis compared to patients with a first stone event. Patients and Methods: Retrospective analysis of patients who visited the ED that were found to have a ureteral stone on CT. Patients were stratified into two groups: without history of urolithiasis (Group 1) and with history of urolithiasis (Group 2). Results: Between 2018 and 2020, 778 patients were admitted with ureteral stones. Patients in group 1 presented with a higher mean serum creatinine ( p  = 0.02), larger mean stone size ( p  < 0.0001), and a higher proportion of proximal ureteral stones ( p  < 0.0001) than patients in group 2. The 30 day readmission rate was significantly higher in group 1 ( p  = 0.02). Spontaneous stone expulsion was higher in group 2 ( p  < 0.0001), whereas the need for endourological procedures was higher in group 1 ( p  < 0.0001). On multivariable analysis serum creatinine (OR 0.264, 95% CI 0.091-0.769, p  = 0.01) and stone size (OR 0.623, 95% CI 0.503-0.771, p  < 0.0001) were associated with a lower spontaneous stone expulsion rate. History of prior endourological procedures (OR 0.225, OR 0.066-0.765, p  = 0.01) was associated with a higher spontaneous stone expulsion rate. Conclusions: Our data suggests that patients who are first time stone formers present with larger and more proximal ureteral stones, with a lower likelihood of spontaneous stone expulsion and a subsequent need for surgical intervention. Previous stone surgery and not previous stone expulsion was found to be a predictor for spontaneous stone passage.
Databáze:	MEDLINE
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