METHODS: A retrospective review of prospectively collected patients included adults (> 18yo) with [Formula: see text] 2 ipsilateral ureteral stones without prior treatment for their current stone burden. A historical comparison group was used as a control population. Univariate logistic regression analyses and descriptive statistics were performed with SPSS® 20.0 (p < 0.05).
RESULTS: Seventy-nine MSSUS patients were compared to 101 SUS patients. MSSUS patients had 2.21 [Formula: see text] 0.66 ureteric stones and had significantly smaller lead stones (MSSUS 6.4 mm vs SUS 7.2 mm, p = 0.03). MSSUS patients were more likely to have had prior stones (66 vs 42%) and 5.9 times more likely to have had prior stone procedures. Conservative management was successful in 30% MSSUS vs 19% SUS (p = 0.073), and there were no differences in resolution time (p = 0.44). For patients proceeding to intervention, (MSSUS n = 52, SUS n = 78), ureteroscopy was performed on 58% MSSUS vs 51% SUS patients (p = 0.302), and shockwave lithotripsy in 10% MSSUS vs 26% SUS (p = 0.01). MSSUS were more likely to spontaneously pass a stone prior to planned intervention (OR = 41.1; 95% CI = 12.0-140.7; p = 0.0001).
CONCLUSIONS: MSSUS patients are more likely recurrent stone formers with extensive stone histories and current stone burdens. Conservative management appears as successful between groups, with no difference in resolution time. When employed, ureteroscopy outcomes do not different between cohorts.
方法:对前瞻性收集的患者进行回顾性回顾,其中包括成人(>18yo)患有[公式:见正文]2同侧输尿管结石,但未事先治疗其目前的结石负担。历史比较组用作对照人群。使用SPSS®20.0进行单变量逻辑回归分析和描述性统计(p<0.05)。
结果:将79例MSSUS患者与101例SUS患者进行了比较。MSSUS患者有2.21[公式:见正文]0.66输尿管结石和明显较小的铅结石(MSSUS6.4mmvsSUS7.2mm,p=0.03)。MSSUS患者更可能有先前的结石(66vs42%),并且有先前的结石手术的可能性更高5.9倍。保守管理在30%MSSUS和19%SUS中成功(p=0.073),分辨率时间没有差异(p=0.44)。对于进行干预的患者,(MSSUSn=52,SUSn=78),58%的MSSUS与51%的SUS患者进行了输尿管镜检查(p=0.302),10%MSSUS和26%SUS中的冲击波碎石(p=0.01)。MSSUS在计划干预前更有可能自发通过结石(OR=41.1;95%CI=12.0-140.7;p=0.0001)。
结论:MSSUS患者更可能是复发性结石患者,具有广泛的结石病史和当前的结石负担。保守管理在群体之间似乎很成功,分辨率时间没有差异。当被雇用时,输尿管镜检查结果在队列之间没有差异.