Ureteral Stone Location At Emergency Room Presentation With Colic

Main Category: Urology / Nephrology
Article Date: 10 Sep 2009 - 4:00 PDT

email to a friend   printer friendly   opinions  

UroToday.com - Contrary to traditional dictum, ureteral stones most commonly obstruct and present emergently at the ureterovesical junction (61%) and the proximal ureter between the UPJ and iliac vessels (23%). The remaining 16% of the ureteral stones causing renal colic are located at the UPJ (11%), between the iliac vessels and the ureterovesical junction (4.3%), and where the ureter crosses the iliac vessels (1.1%).

This was determined by the UC San Francisco group in a retrospective review of 94 consecutive patients presenting to the ED with unilateral ureteral calculus.

Not surprisingly, as previously observed, proximal ureteral calculi were greater in axial (6 vs. 4 mm) and coronal (7 vs. 4 mm) diameters compared to the distal ureteral stones, respectively.

These findings support the expectation that stones <5 mm in size will likely pass spontaneously from the upper collecting system. However, when assessing the patient in the ED with renal colic, attention to imaging studies should be directed to the UVJ and the proximal ureter as 84% of stones will be at these two locations.

Eisner BH, Reese A, Sheth S, Stoller ML
J Urol. 2009 Jul;182(1):165-8
10.1016/j.juro.2009.02.131

Written by UroToday.com Contributing Editor Elspeth M. McDougall, MD, FRCSC, MHPE

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: www.urotoday.com

Copyright © 2009 - UroToday

• Additional
• References
• Citations