Ureteric colic: drugs do not expel stones

  • Shah TT & al.
  • BJU Int
  • 18 Apr 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Medical expulsive therapy (MET) does not increase the likelihood of spontaneous stone passage (SSP) in patients with acute ureteric colic.
  • White blood cell count (WBC), neutrophil count, and C-reactive protein (CRP) levels do not help predict SSP.

Why this matters

  • Clinicians should rely on stone size and position to determine the need for active stone treatment.

Study design

  • Researchers studied patients with acute ureteric colic and single ureteric stones who were discharged with conservative management (N=2518; median age, 47 years; median stone size, 4 mm).
  • They used multivariable mixed effects logistic regression to examine associations with SSP.
  • Funding: British Association of Urological Surgeons; British Journal of Urology International; Urology Foundation; Ferring Pharmaceuticals; Rosetree’s Trust; Action Bladder Cancer UK.

Key results

  • Overall SSP rate: 74% (1874/2518).
  • None of the following predicted SSP (aOR; 95% CI):
    • MET: 1.11 (0.76-1.61; P<.6>
    • WBC: 0.97 (0.91-1.04; P=.39).
    • Neutrophils: 1.06 (0.99-1.13; P=.11).
    • CRP: 1.00 (0.99-1.00; P=.17).
  • SSP was more likely for smaller stones and those farther down the ureter.

Limitations

  • The study was observational and retrospective.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit