Ureteral Stone Location at Emergency Room Presentation With Colic (2009)

No AccessJournal of UrologyAdult Urology1 Jul 2009Ureteral Stone Location at Emergency Room Presentation With Colicis accompanied byA Simple Objective Method to Assess the Radiopacity of Urinary Calculi and its Use to Predict Extracorporeal Shock Wave Lithotripsy Outcomes Brian H. Eisner, Adam Reese, Sonali Sheth, and Marshall L. Stoller Brian H. EisnerBrian H. Eisner , Adam ReeseAdam Reese , Sonali ShethSonali Sheth , and Marshall L. StollerMarshall L. Stoller View All Author Informationhttps://doi.org/10.1016/j.juro.2009.02.131AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: It is thought that the 3 narrowest points of the ureter are the ureteropelvic junction, the point where the ureter crosses anterior to the iliac vessels and the ureterovesical junction. Textbooks describe these 3 sites as the most likely places for ureteral stones to lodge. We defined the stone position in the ureter when patients first present to the emergency department with colic. Materials and Methods: We retrospectively reviewed the records of 94 consecutive patients who presented to the emergency department with a chief complaint of colic and computerized tomography showing a single unilateral ureteral calculus. Axial, coronal and 3-dimensional reformatted computerized tomography scans were evaluated, and stone position and size (maximal axial and coronal diameters) were recorded, as were the position of the ureteropelvic junction, the iliac vessels (where the ureter crosses anterior to the iliac vessels) and the ureterovesical junction. Patients with a history of nephrolithiasis, shock wave lithotripsy, ureteroscopy or percutaneous nephrolithotripsy were excluded from study. Statistical analysis was performed using Student's t test and Pearson's correlation coefficient. Results: At the time of emergency department presentation for colic ureteral stone position was the ureteropelvic junction in 10.6% cases, between the ureteropelvic junction and the iliac vessels in 23.4%, where the ureter crosses anterior to the iliac vessels in 1.1%, between the iliac vessels and the ureterovesical junction in 4.3% and at the ureterovesical junction in 60.6%. Proximal calculi had a greater axial diameter than distal calculi (mean 6.1 vs 4.0 mm) and a greater coronal diameter than distal calculi (6.8 vs 4.1 mm, each p <0.001). Axial and coronal diameters moderately correlated with stone position (r = −0.47 and −0.55, respectively, each p <0.001). Conclusions: Proximal ureteral stones were larger in axial and coronal diameter than distal ureteral stones. At emergency department presentation for colic most stones were at the ureterovesical junction and in the proximal ureter between the ureteropelvic junction and the iliac vessels. 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Google Scholar Department of Urology, School of Medicine, University of California-San Francisco, San Francisco, California© 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byHall M, Thiel J, Dunmire B, Samson P, Kessler R, Sunaryo P, Sweet R, Metzler I, Chang H, Gunn M, Dighe M, Anderson L, Popchoi C, Managuli R, Cunitz B, Burke B, Ding L, Gutierrez B, Liu Z, Sorensen M, Wessells H, Bailey M and Harper J (2022) First Series Using Ultrasonic Propulsion and Burst Wave Lithotripsy to Treat Ureteral StonesJournal of Urology, VOL. 208, NO. 5, (1075-1082), Online publication date: 1-Nov-2022.Related articlesJournal of Urology18 May 2009A Simple Objective Method to Assess the Radiopacity of Urinary Calculi and its Use to Predict Extracorporeal Shock Wave Lithotripsy Outcomes Volume 182Issue 1July 2009Page: 165-168 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordsemergenciescolicureterureteral calculiMetrics Author Information Brian H. Eisner Financial interest and/or other relationship with Boston Scientific. More articles by this author Adam Reese More articles by this author Sonali Sheth More articles by this author Marshall L. Stoller More articles by this author Expand All Advertisement PDF downloadLoading ...