Factors and Cut-Off Predicting Stone Passage under Medical Expulsive Therapy (MET)

Background: Ureteral stones are the most common leading cause of acute flank pain. This study aimed to identify sociodemographic and clinical variables predicting spontaneous ureteral stone passage and determine the optimal size cut-off for predicting such passage. Method: We conducted a retrospective evaluation of patients presenting with acute renal colic at a urology outpatient clinic. Patients with ureteral stones ≤ 10 mm and no surgical intervention post-initial diagnosis, who attended follow-up visits, were included. Exclusion criteria comprised stone size > 1 cm, fever due to obstructive pyelonephritis, acute kidney injury, single kidney status, or bilateral ureteral obstruction. Results: Of 124 included patients, the spontaneous stone passage rate was 57.3%, with a mean passage time of 11.1 (SD 6.25) days. Bivariate analysis revealed that factors predicting spontaneous passage were stone size (p Conclusions: Stone size < 7 mm, UVJ or distal ureter location, emerged as key predictors of stone passage in nephrolithiasis, and stone size below 6.85 mm is a reasonable cut off to initiate MET rather than 10 mm.

Is Ultrasound the Urologist’s Stethoscope in the Outpatient Clinic?

Ultrasound is a non-invasive diagnostic imaging modality that has become the urologist’s stethoscope in the outpatient clinic for diagnosis and monitoring of various urological pathologies. Objectives: Check if office ultrasound is beneficial in the outpatient clinic, helpful in the management, affected by the economic crisis, and determine in which condition it is sufficient. Materials and Methods: Between 2012 and 2022, one thousand files were prospectively collected randomly. Many objectives were chosen to evaluate the impact of the economic crisis on the use of ultrasound, identify the clinical conditions where ultrasound is beneficial, determine the conditions where ultrasound was sufficient, and determine if ultrasound findings were helpful for management. Results: The economic crisis did not impact the use of ultrasound, when the chief complaint was flank pain, 56.7% had positive findings. In 54%, ultrasound was helpful to avoid the need for further imaging, and in 93.5%, ultrasound was helpful in the management of patients. When the chief complaint was LUTS, 25.6% had positive findings while 82.9% did not require further imaging, in 78.6%, ultrasound was helpful in the management. In the case of hematuria, 60.7% had positive findings, 20% did not need further imaging, and 81% of ultrasounds were helpful in the management. When patients present with urgency 31% had positive findings, 93.7% did not require more imaging and 76% of ultrasounds were helpful in management. In the case of dysuria as the chief complaint, 35.8% had positive findings, 77.7% did not need more imaging, and helpful in the management of 62.8%. Conclusion: Ultrasound is a valuable cost-effective tool in the outpatient clinic urology clinic for diagnosing and monitoring. It is safe, painless, and can be repeated easily which makes it the precious Urologist’s stethoscope.