E-ISSN : 2757-7163
Materials and Methods: Patients who underwent SWL for proximal ureteral stones were included in the study. Demographic and clinical characteristics, including age, body mass index (BMI), serum creatinine, white blood cell count, hemoglobin, and platelet count, were recorded. Stone characteristics and anatomic factors were determined using parameters obtained from non-contrast lower upper abdomen computed tomography scans: stone density (HU), stone diameter, renal pelvis urine density (HU), perirenal stranding, stone-skin distance, and ureteral wall thickness. Patients who underwent emergency URS were grouped. Logistic regression analysis was used to identify risk factors predicting the need for urgent URS in patients.
Results: Among the study population, 232 patients (83.8%) did not require urgent URS (Group 1), while urgent intervention was necessary in 45 patients (16.2%) (Group 2). Patients in the urgent URS group demonstrated a significantly higher body mass index (26 [24-27] vs. 25 [24-26] kg/m², p = 0.002). Non-contrast CT findings revealed that renal pelvis urine density and stone–skin distance were markedly greater in the URS group (13 [9-36] vs. 8 [6-11] HU, p < 0.001 and 12 [6- 16] vs. 9 [7-13] cm, p < 0.001, respectively). Stone density was also higher among patients requiring URS (862 [784-1014] vs. 786 [665-956] HU, p = 0.002). In multivariable analysis, BMI (OR 1.245, 95% CI 1.025–1.512, p = 0.028), stone density (OR 1.003, 95% CI 1.001–1.004, p = 0.002), renal pelvis urine density (OR 1.032, 95% CI 1.009–1.055, p = 0.006), and stone–skin distance (OR 1.654, 95% CI 0.986–1.846, p = 0.004) remained as independent predictors.
Conclusion: BMI, stone density, renal pelvic urine density, and stone–skin distance parameters may serve as useful guidance when considering SWL for patients with proximal ureteral stones. Prospective studies with larger samples are needed to support the findings.
