Early hospital admission and treatment onset may positively affect spontaneous passage of ureteral stones in patients with renal colic

摘要

Objective To evaluate the impact of early hospital admission and onset of medical expulsive therapy (MET) in spontaneous passage of ureteral stones causing renal colic. Methods We recruited 392 patients referred to the emergency room with symptoms of renal colic. All patients received standard MET of oral tamsulosin 0.4 mg at the time of diagnosis. In group A, patients who received MET in <2 hours from the symptom onset were included, whereas group B consisted of patients treated in >2 hours. The association of MET onset and stone-free rates after 6 weeks of follow-up was evaluated. Early MET onset predictive impact on spontaneous stone passage was evaluated as well. Results The stone-free rate in group A and B patients was 71.2% and 59.7% (P =.018), respectively. A significant association was observed between spontaneous calculus elimination and stone size (P ≤.001), location within the ureter (P =.007), and the interval between pain onset and pharmaceutical management (P =.018). Patients who received a late-onset MET had an increased risk to develop febrile upper urinary tract infection during the follow-up period (P =.040). In the multivariate analysis, size (P ≤.001) and early therapy onset (P =.019) were statistically important predictors for stone-free status after the surveillance period. Conclusion Patients with renal colic who admitted to the emergency department earlier since symptom onset may have increased potential to be stone free during the surveillance period.