Search

Introduction: In ureterolithiasis, the prediction of spontaneous passage poses a challenge for urologists. Moreover, there is controversy surrounding the preferred management approach, whether medical or surgical, as each approach has its disadvantages. Procalcitonin and other inflammatory markers were studied for predicting stone passage spontaneously, but their significance remains controversial. This study aims to assess the association between these markers, especially procalcitonin, and spontaneous ureteral stone passage., Materials and Methods: In this multicenter prospective cohort study from March 2022 to October 2023, consecutive patients with a single unilateral distal ureteric stone less than 10 mm were enrolled. Exclusion criteria were specified. Patients underwent medical expulsive therapy (MET) and were monitored for stone passage. The significance level was set at p < 0.05., Results: Out of 94 patients enrolled, 72.3% were male and 27.7% were female, with a mean age of 38.84± 10.41 years. Stone sizes varied, with the most common range being 4 mm- 5.9 mm. Participants were categorized based on spontaneous stone passage as spontaneous stone passage (SSP) and non-SSP. No significant differences were observed in most demographic and laboratory variables. However, serum procalcitonin and C-reactive protein showed significant differences between the SSP and non-SSP groups., Conclusions: Although several inflammatory markers were studied to predict the spontaneous passage of the ureteral stone, the current study concluded that only elevated procalcitonin, C-reactive protein, and large stone diameter decrease the chance of spontaneous ureteral stone passage.

Urolithiasis is a common disease that affects approximately one-fifth of the global population. This systematic review explores the predictive role of inflammatory markers for the spontaneous passage of ureteral stones. The literature was systematically searched via Google Scholar, PubMed/MEDLINE, the Cochrane Library, Science Direct, CINAHL, Web of Science, and EMBASE databases to identify papers published until 2023. Overall, 26 articles were identified, of which 10 were excluded. The remaining 16 papers reported 2,695 patients (1,723 males and 972 females), with 1,654 (61.37%) experiencing spontaneous stone passage (SSP) and 1,041 (38.63%) not experiencing it (non-SSP). Stones located in the upper part of the ureter were less likely to pass spontaneously (152/959, 15.94% in the SSP group vs. 180/546, 32.48% in the non-SSP group; p < 0.001). Mid-ureteral stones were present in 180/959 (18.75%) of the SSP group compared to 84/546 (14.52%) of the non-SSP group (p = 0.0974). Lower ureteral stones were more likely to pass spontaneously, with 627/959 (63.31%) in the SSP group compared to 282/546 (49.36%) in the non-SSP group (p < 0.001). No significant correlation was found between most inflammatory markers and SSP (p > 0.05). However, procalcitonin levels were lower in the SSP group compared to the non-SSP group (132.7 ± 28.1 vs. 207 ± 145.1, respectively) (p < 0.001). This systematic review has revealed that except procalcitonin, most inflammatory markers do not offer significant predictive capability for ureteral SSP., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)