Celik Serdar, Akdeniz Firat, Yildirim Muge Afsar, Bozkurt Ozan, Bulut Merve Gursoy, Hacihasanoglu Mehmet Levent, Demir Omer
Department of Urology, Gaziemir Nevvar Salih Isgoren Hospital, Izmir, Turkey.
Department of Urology, Gaziemir Nevvar Salih Isgoren Hospital, Izmir, Turkey.
Kaohsiung J Med Sci. 2017 Jun;33(6):290-294. doi: 10.1016/j.kjms.2017.04.001. Epub 2017 May 3.
Aim of the study is to investigate the relationship between non-contrast computed tomography (NCCT) findings and stone expulsion rate with medical expulsive therapy (MET) using silodosin for ureteral stones in male adults. Between January 2014 and June 2015, we retrospectively reviewed the patient charts with uncomplicated ureteral stones on NCCT images, who were treated with silodosin for MET. Stone diameter, volume and hounsfield units (HU) measured by NCCT and treatment findings were noted at the end of treatment. Patients were divided into three groups according to the localization as distal, mid and proximal ureteral stones. NCCT and treatment findings were compared between MET success and failure groups in different localizations. Stone expulsion rate was 81.3% for 134 distal, 45.5% for 22 mid and 27.7% for 47 proximal stones. Stone diameter, volume, and HU were significantly lower for success groups with distal and proximal stones (p < 0.05). In ROC analysis the cut-off values for stone volume and HU were detected as 48.7 mm and 598 HU for success group with proximal stones. Stone expulsion rate was found to be 24 times more (OR = 24; p = 0.001) in patients with <598 HU and 14 times more (OR = 14; p = 0.002) in patients with <48.7 mm proximal stones. Lower stone diameter, volume and HU were significant predictors of success with silodosin for MET for ureteral stones. Patients with <598 HU and/or <48.7 mm proximal stones may be prescribed silodosin for MET.
本研究的目的是调查男性成人输尿管结石患者在使用西洛多辛进行药物排石治疗（MET）时，非增强计算机断层扫描（NCCT）结果与结石排出率之间的关系。在2014年1月至2015年6月期间，我们回顾性分析了NCCT图像显示为单纯输尿管结石且接受西洛多辛进行MET治疗的患者病历。记录治疗结束时通过NCCT测量的结石直径、体积和亨氏单位（HU）以及治疗结果。根据结石位置将患者分为三组，即输尿管远端结石组、中段结石组和近端结石组。比较不同位置MET成功组和失败组的NCCT及治疗结果。134例远端结石患者的结石排出率为81.3%，22例中段结石患者为45.5%，47例近端结石患者为27.7%。远端和近端结石成功组的结石直径、体积和HU显著更低（p<0.05）。在ROC分析中，近端结石成功组的结石体积和HU的截断值分别检测为48.7mm和598HU。HU<598的患者结石排出率高出24倍（OR=24；p=0.001），近端结石<48.7mm的患者结石排出率高出14倍（OR=14；p=0.002）。结石直径、体积和HU较低是西洛多辛治疗输尿管结石MET成功的重要预测因素。HU<598和/或近端结石<48.7mm的患者可使用西洛多辛进行MET治疗。
