Ureteral Wall Thickness Key Indicator for Stone Impaction

A new study published in The Journal of Urology suggests that noninvasive assessment of ureteral wall thickness indicates the likelihood of ureteral stone impaction, and the readings indicate favorable results.

Unfavorable endourological outcomes are linked to ureteral stone impaction, although there are few accurate predictors of stone impaction. In this study, Nicholas Dean and colleagues sought to determine how well the thickness of the ureteral wall performed as a predictor of ureteral stone impaction and the failure rates of shock wave lithotripsy, spontaneous stone passage, and retrograde guidewire and stent passage.

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) standards were followed in the completion of this investigation. A search was done in April 2022 using PROSPERO, OVID EMBASE, OVID Medline, Proquest Dissertations & Theses Global, Wiley Cochrane Library, and SCOPUS for all adult, human, and English language research examining ureteral wall thickness. Using a random effects approach, a systematic review and meta-analysis was carried out. The MINORS (Methodological Index for Non-randomized Studies) score was used to evaluate the risk of bias.

The key findings of this study were:

34 studies were considered in our qualitative examination, and 14 studies totaling 2,987 patients were pooled for the quantitative analysis.

According to meta-analysis results, a smaller ureteral wall thickness is linked to better subgroup stone outcomes.

In addition to better rates of spontaneous stone transit, effective retrograde guidewire and stent installation, and improved shock wave lithotripsy results, thinner ureteral wall thickness also signals a lack of stone impaction.

There is no established method for measuring the thickness of the ureteral wall in studies.

The necessity for a uniform ureteral wall thickness methodology is confirmed by the variation in measuring techniques, and the clinical value of ureteral wall thickness has not yet been established.

Reference:

Dean, N. S., Millan, B., Uy, M., Albers, P., Campbell, S. M., Krambeck, A. E., & De, S. (2023). Ureteral Wall Thickness Is an Effective Predictor of Ureteral Stone Impaction and Management Outcomes: A Systematic Review and Meta-analysis. In Journal of Urology (Vol. 210, Issue 3, pp. 430–437). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/ju.0000000000003561