Open Access

ARTICLE

Spontaneous passage of ureteral stones in patients with indwelling ureteral stents

Lee Baumgarten, Anuj Desai, Scott Shipman, Daniel D. Eun, Michel A. Pontari, Jack H. Mydlo, Adam C. Reese

Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
Address correspondence to Dr. Adam C. Reese, Department of Urology, Temple University School of Medicine, 3401 N. Broad St., Suite 330, Zone C, Philadelphia, PA19140 USA

Canadian Journal of Urology 2017, 24(5), 9024-9029.

Abstract

Introduction: To determine rates of spontaneous ureteral stone passage in patients with indwelling ureteral stents, and to identify factors associated with the spontaneous passage of stones while a ureteral stent is in place.
Materials and methods: From our institutional database, we identified patients who underwent ureteroscopic procedures for stone disease between January 1, 2013 and March 1, 2015. We compared the rates of spontaneous stone passage between patients who had previously undergone ureteral stent placement and those who had not. In patients with indwelling stents, multivariate logistic regression was performed to identify factors associated with spontaneous stone passage.
Results: A total of 194 patients met inclusion criteria. Spontaneous stone passage rates were similar in the stented (17/119, 14%) and non-stented (15/75, 20%) groups(p=0.30). In bivariate analysis of stented patients, smaller stone size (p < 0.001) and distal stone location (p=0.01) were signifcantly associated with spontaneous stone passage. Multivariate logistic regression analysis of stented patients showed that only small stone size was signifcantly associated with the likelihood of stone passage (p = 0.01), whereas stent duration, stone location, and stone laterality were not.
Conclusions: A small, but clinically significant percentage of ureteral stones pass spontaneously with a ureteral stent in place. Small stone size is associated with an increased likelihood of spontaneous passage in patients with indwelling stents. These fndings may help to identify patients who can potentially avoid additional surgical procedures for defnitive stone removal after ureteral stent placement.

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