Can ureteral wall thickness (UWT) be used as a potential parameter for decision-making in uncomplicated distal ureteral stones 5-10 mm in size? A prospective study

Objective To evaluate the correlation between ureteral wall thickness (UWT) and stone passage (SP) and its cut-off value in distal uncomplicated ureteral stones. Patients and methods In the prospective study from January 2019 to January 2020 at a tertiary care hospital, we reviewed 212 patients aged above 18 years with single, symptomatic, radiopaque, and distal ureteric stone sized 5-10 mm, who were treated with MET (Silodosin 8 mg once daily) until SP or a maximum of 4 weeks. There were 2 groups: responders and non-responders. Demographic data of the patients and all stone radiological parameters including stone size, laterality, density, UWT, the diameter of the ureter proximal to the stone (PUD), and the degree of hydronephrosis were recorded and compared between the 2 groups. Results There were 126 (59.4%) in the responder group and 86 (40.6%) in the non-responder group. On univariate analysis, gender, stone density, stone size, PUD, UWT, and the degree of hydronephrosis were significant factors for stone passage. However, using multivariate analysis, only UWT and the degree of hydronephrosis were significant. ROC analysis showed that 3.75 mm is the cut-off value for UWT, with 86% and 87.3% sensitivity and specificity, respectively. Conclusions UWT and hydronephrosis can be used as potential predictors for SP and can help with decision-making in patients with uncomplicated 5-10 mm lower ureteric stones.