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Journal of Clinical Urology 11(1S)
SSP and were included in the multivariable analysis. The
unadjusted odds ratio for the association of MET use with
SSP from univariable analysis was 1.250 (95%CI, 1.041,
1.501). However, following a multivariable mixed effects
logistic regression model, there was no association of
MET use with SSP in any subgroup irrespective of stone
size (OR 1.085, 95%CI 0.978, 1.205) or stone position [see
Table 1].
Conclusions: In acute ureteric colic patients who are
suitable for initial conservative management, MET has no
benefit in spontaneous stone passage, regardless of stone
size or position.
P4-4: Table 1
Table: Mixed Effects Multivariable Model with outcome SSP
Variable
Odds ratio estimate (95%
confidence interval)
Age (years)
Gender: Male
MET administered: YES
Stone location: Middle ureter
Stone location: Upper ureter
MET Administered: Stone
position: Middle ureter
MET Administered: Stone
position: Upper ureter
Stone size (mm)
MET Administered * Stone
size (mm) - interaction term
1.006 (1.000, 1.012)
0.869 (0.712, 1.061)
0.861 (0.521, 1.424)
0.806 (0.546, 1.189)
0.435 (0.332, 0.569)
0.808 (0.458, 1.424)
Random Effect Variance
1.086 (0.716, 1.645)
0.714 (0.666, 0.767)
1.085 (0.978, 1.205)
Estimate (95%
confidence interval)
0.268 (0.160, 0.449)
P4-5 Proximal-to-distal ureteric ratio
(PDUR): a novel predictor of spontaneous
ureteric stone passage
Sandoval Barba H1, Scallan N1, Chithiramohan A1,
Subramonian K1
1Queen Elizabeth Hospital, Birmingham, United Kingdom
Introduction & Objectives: Currently, stone size and
location are the main predictors of spontaneous ureteric
stone passage (SUSP). We studied different stone dimensions and ureteric factors including a novel ratio reflecting
the degree of obstruction.
Materials & Methods: Consecutive patients with solitary ureteric stones were recruited and divided into two
groups based on whether they needed intervention after
6 weeks' observation. We registered stone axial (AD) and
longitudinal (LD) diameters, stone location and volume,
grade of hydronephrosis (HN) and proximal-to-distal ureteric ratio (PDUR) using ureteric diameters above (PUD)
and below (DUD) stones. Pelviureteric and vesicoureteric
junction calculi were excluded. Logistic regression analysis
and ROC curves were performed.
Results: Eighty-four patients were included of whom 53
(63%) had SUSP. AD, LD, stone volume and PDUR were
significant in the univariable analysis, but only AD and
PDUR in the multivariable analysis (table 1). The AUC for
PDUR and AD were 0.7 (p=0.001, CI 0.59-0.81) and 0.76
(p<0.0001, CI 0.64-0.87), respectively (figures). Diagnostic
accuracy of PDUR and AD are given in Table 2.
Conclusion: PDUR is a novel factor for predicting SUSP
independently. Different cut-off levels of PDUR and AD
could be used to predict SUSP with different sensitivity
and specificity. A prospective powered study should confirm these pilot results.
P4-5: Table 1. Data summary.
Variables
SUSP group
Intervention
group
Median (range)
AD (mm)
LD (mm)
Stone location
Stone volume (cm3)
HN
PUD (mm)
DUD (mm)
PDUR
3 (1-7)
9 (3-17)
0.09 (0.02-1.04)
6 (3-15)
5 (2-9)
1.4 (0.75-2.66)
Univariable
Multivariable
p, CI
5 (2-13)
12 (3-24)
0.19 (0.02-1.4)
8.5 (5-20)
5 (3-12)
1.7 (1-3.3)
<0.001
0.002
0.74
0.003
0.13
0.001
0.017, 0.3-0.89
0.56, 0.85-1.34
0.94, 0.03-23.25
0.019, 0.08-0.8
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