ESPU Congress 2018 - Abstract Book

178 / 238

178 29th CONGRESS OF THE ESPU
11:49–11:52
S24-2 (PP)
SPONTANEOUS PASSAGE OF <=1CM URETERAL STONES
IN CHILDREN: IS THERE A PREDICTING FACTOR?
Ahmet Midhat ELMACI1, Muhammet Irfan DONMEZ2 , Fatih AKIN3 and Metin
GUNDUZ4
1) Dr. Ali Kemal Belviranli Women's Maternity and Children's Hospital, Pediatric Nephrology, Konya, TURKEY - 2) Dr. Ali
Kemal Belviranli Women's Maternity and Children's Hospital, Pediatric Urology, Konya, TURKEY - 3) Necmettin Erbakan
University Meram Medical Faculty, Pediatrics, Konya, TURKEY - 4) Selcuk University Medical Faculty, Pediatric Surgery,
Konya, TURKEY
PURPOSE
To analyze if there were any factors that could predict spontaneous passage of ≤1 cm ureteral
stones in children.
MATERIAL AND METHODS
The files of the patients diagnosed with ureteral stone between 2008–2017 from two different
hospitals were retrospectively reviewed. Detection of ureteral stones were done using ultrasonog-
raphy and computed tomography when needed. Patients were either conservatively or surgically
managed. Conservative treatment included adequate hydration and pain management whereas
surgical treatment included ureterorenoscopic intervention. Patients were referred for surgical
treatment after 15 days of follow-up with no spontaneous passage. Factors such as; age, gender,
type of hematuria (macroscopic/microscopic), presence of dysuria, abdominal/side pain, irritability,
vomiting, stone localization (proximal/mid/distal ureter), laterality, presence of concomitant kidney
stone, degree of hydronephrosis, stone size and stone composition were analyzed.
RESULTS
A total of 70 patients (32 males, 38 females; mean age 5.5±4.4 years) were found to have been
diagnosed with ≤1 cm ureteral stone (mean maximum diameter 6.7±2.3 mm). Diagnosis was made
using ultrasonography in 47 patients and computed tomography in 23 patients. Spontaneous pas-
sage of the ureteral stone was observed in 40 patients. Stone composition of 22 patients were
available (17 calcium oxalate, 4 cystine, 1 uric acid). Stone size was found to be the only factor
that could predict spontaneous passage (5.19±1.59 vs 8.90±1.27, p<0.001). Interestingly, stone
localization was not shown to predict spontaneous passage. Additionally, there were no significant
difference between age groups (0–5 vs 5–15 years, p>0.05).
CONCLUSIONS
In our study, spontaneous passage of ≤1 cm ureteral stones in children could be predicted solely
with stone diameter. Therefore, expectant management strategies should be initially followed in
patients with ureteral stones <7 mm.
11:52–11:58
Discussion