- Email: [email protected]
E61 Dissolution of uric acid nephrolithiasis with potassium citrate and potassium bicarbonate
52
THURSDAY 10 SEPTEMBER 2015 / EUROPEAN UROLOGY SUPPLEMENTS 14 (2015) 29–78
values between two groups (p<0.001); there was no significant change with respect to BMI values and biochemical test datas. Conclusions: Our results clearly indicated a close correlation between stone disease and endothelial dysfunction evaluated by FMD technique. These findings may, again be useful in the understanding of ethiopatagenesis of urinary stone disease. We believe that further studies with large scale studies are certainly needed to outline this relationship.
the correction of these factors’ disorders is the priority in methaphylaxis.
E60 The intensity of metabolic disorders in patients with calcium urolithiasis
Introduction and objectives: The most important factor for uric acid stone formation is acid urinary pH that is a prerequisite for uric acid stone formation and growth. Indeed the goal standard of urinary alkalization is to achieve a pH of 6.0-6.5. Administration of alkali should be titrated appropriately by pH paper to record urinary pH until a steady state is achieved. The aim of this study is to evaluate the clinical efficacy of therapy potassium citrate and potassium bicarbonate for dissolution of uric acid stones. Materials and methods: 11 patients (5 females and 6 males, mean age 51+/-9 years) with non obstructive, asymptomatic renal uric acid stones (diameter < or = 15 mm) and normal renal function were considered. Four of them presented residual stones after endourological procedures. Ultrasonography, computed tomography scan was performed to confirm stone presence and burden and plain X-ray to exclude calcified stones. At basal a blood sample was drown for creatinine, uric acid, glucose, sodium and potassium and a 24 h urine sample was collected for uric acid excretion; urine analysis and culture were performed on fresh urine morning. All patients were instructed on the importance of adequate oral alkalization and counseled on self-dosing to maintain their pH between 6.0 and 6.5 using pH paper. Potassium citrate (40 mEq) and potassium bicarbonate (20 mEq) divided in two doses with daily water intake of 1,5 L was given for 3 months. Follow-up evaluation was performed after 1 month and 3 months after from the starting of therapy. The effect of alkaline therapy on stone dissolution was evaluated by ultrasonography and urinary pH measurement. Results: After 1 month of potassium citrate and potassium bicarbonate treatment, complete stone dissolution was found in 3 patients and partial in 6. After 3 months other 5 patients were stone-free, while in 2 stone dissolution was achieved after the prolongation of the therapy for 6 months. In 2 patients ureteroscopy (URS) with lithotripsy was required for symptomatic stones passed in the ureter (Table 1).
Kariev S., Gaybullaev A., Tursunov B., Kasimov S., Gaybullaev O. Institute of Postgraduate Medical Education, Dept. of Urology & Nephrology, Tashkent, Uzbekistan Introduction and objectives: The disorders of metabolic condition have the differences in the different regions. This situation is important not only for the beginning of methaphylaxis. The comparison of such data gives the possibility for the study of the etiology of the disease, what is important for the treatment of the disease too. Purpose: To study the intensity of metabolic disorders in patients with calcium lithogenesis. Materials and methods: The results of the investigation of metabolic factors of 779 patients with calcium urolithiasis were analyzed. All patients live in Tashkent city (Uzbekistan) and in nearby regions. Urinalysis has been performed in a 3040 days after the stone elimination (by the planned or urgent intervention) or after the stopping of renal colic. The type of the lithogenesis has been determined on the base of Ro-spectral analysis of the stone or on the base of type of crystalluria. The criteria of the evaluation of metabolic condition: diuresis for 24 hours, urine pH, the urine excretion of calcium (Ca), oxalates (Ox), uric acid (Ur), magnesium (Mg), citrates (Cit), inorganic phosphorus (Pi) in 24 hours. Results: The diuresis was in average 1.12±0.20 L/24 h (DI 0.651.97) and in 96,66% cases (752 pts) it was less than 1.5 L/24 h. Urine pH was in average 5.49±0.41 (DI 4.40-7.50). In 27.47% cases (214 pts) urine pH was less than 5.8. Daily Ca excretion was in average 6.19±2.41 mmol/24h (DI 1.1522.14), in 73.68% cases (574 pts) it was more than 5.0 mmol/24h. Hypercalciuria has been revealed only in 11.3% cases (88 pts, in average 11.25±3.18 mmol/24h). Daily Ox excretion was in average 1.09±0.95mmol/24h (DI 0.1511.31). In 92.81% cases (723 pts) it was more than 0.5 mmol/24h. Daily Ur excretion was in average 4.47±0.80 mmol/24h (DI 7.63-1.04). Only in 31.71 % cases (247 pts) it was more than 3.6 mmol/24h. Daily Mg excretion was in average 2.27±0.53 mmol/24h (DI 0.704.71). In 69.96 % cases (545 pts) it was less than 3.0 mmol/24h. Daily Cit excretion was in average 1.92±0.35 mmol/24h (DI 0.80 – 3.66). In 96.79% cases (754 pts) it was less than 2.5 mmol/24h, in average 1.89±0.32mmol/24h. Daily Pi excretion was in average 11.01±4.21 mmol/24h (DI 1.74 – 33.23), i.e. there was no high excretion of Pi among the examined patients. Conclusions: Thus, in patients with calcium lithogenesis of Tashkent region hypocitraturia (96.79%) is the most common disorder of metabolic condition. The next disorders are decrease of daily diuresis (96.66%) and hyperoxaluria (92.81%). The increase of Ca and Ur excretion were observe in 73.68% and 31.71% respectively. The decrease of daily excretion of Mg was in 69.96%, the decrease of urine pH was only in 27.47%. Therefore, in our region the leading factors of calcium lithogenesis are the disorders of the balance of Cit, Ox and diuresis. Therefore,
E61 Dissolution of uric acid nephrolithiasis with potassium citrate and potassium bicarbonate Cicerello E., Mangano M., Cova G., Maccatrozzo L. Ospedale Ca’ Foncello, Dept. of Urology, Treviso, Italy
Table 1. Stone dissolution (diameter in mm) before and after potassium citrate and potassium bicarbonate therapy Patient 1 2 3 4 5 6 7 8 9 10 11
Basal
1 Month
3 Months
10 12 8 15 13 11 9 12 15 11 15
8 7 0 15 6 5 0 6 7 11 URS
0 0 7 0 0 URS 0 9
6 Months
0
0
After 1 month and 3 months of treatment urinary pH was significantly increased (from 5.21+/-0.20 to 6.3+/-0.27 and to 6.4+/0.28 respectively, p<0.05). Conclusions: Urinary alkalization is effective for the dissolution of non obstructive uric acid stones. The therapy with potassium citrate and potassium bicarbonate could be preferred because it may avoid the complication of calcium salt precipitation. Furthermore for its action in slow release, urinary pH could be
THURSDAY 10 SEPTEMBER 2015 / EUROPEAN UROLOGY SUPPLEMENTS 14 (2015) 29–78
continuously increased during 24 h preventing stone recurrence in patients at risk. E62 Effect of medical expulsive therapy on the health-related quality of life of patients with ureteral stones: A critical evaluation Eryildirim B., Cahit S., Tuncer M., Sabuncu K., Cetinel A.C., Tarhan F., Sarica K. Dr. Lutfi Kirdar Training and Research Hospital, Dept. of Urology, Istanbul, Turkey Introduction and objectives: To evaluate the possible effects of medical expulsive therapy (MET) on the health-related quality of life (HRQOL) of the patients under watchful-waiting for ureteral stones. Materials and methods: A total 120 patients with ureteral stones were included in this study program. Patients were divided into two subgroups and while patients in Group 1 received medical therapy only for colic pain if needed; patients in Group 2 received MET (Tamsulosin 0.4 mg) in addition to medical therapy. All cases were evaluated weekly during 1-month period and the patients with persistant stones after this period in both groups were evaluated with respect to the analgesic requirement, number of renal colic attacks as well as emergency department (ED) visits along with the QOL scores. Results: Mean values of patient age and stone burden were 37.14±2.46 years and 42.04±2.03mm2 respectively. Evaluation of the cases with residing stones after 4 weeks (28 cases in Group 1 and 27 cases in Group 2) with or without MET revealed following findings; renal colic, total amount of analgesic required and the mean number of ED visits were significantly lower in cases receiving MET. Evaluation of the mean HRQOL in terms of EQ-5Dindex and EQ-5DVAS values in both groups again demonstrated higher mean values in patients undergoing MET (p<0.05). Conclusions: Our findings indicated that MET for ureteral calculi during watcful-waiting period could increase the HRQOL scores by lowering the number of both renal colic attacks and ED visits resulting in decreased analgesic need. E63 Predictive parameters for medical expulsive therapy in ureteral stones: A critical evaluation Cahit S., Eryildirim B., Kafkasli A., Coskun A., Tarhan F., Faydaci G., Sarica K. Dr. Lutfi Kirdar Training and Research Hospital, Dept. of Urology, Istanbul, Turkey Introduction and objectives: To evaluate the predictive value of some certain radiological as well as stone related parameters for medical expulsive therapy (MET) success with an alpha blocker in ureteral stones. Materials and methods: A total 129 patients receiving MET for 5 to 10 mm ureteral stones were evaluated. Patients were divided into two subgroups where MET was successful in 64 cases (49.61 %); and unsuccessful in 65 cases (50.39 %). Prior to management, stone size, location, position in the ureter, degree of hydronehrosis, diameter of ureteral lumen proximal to the stone, ureteral wall thickness along with patient’s demographics including BMI values were evaluated and recorded. The possible predictive values of these parameters for stone expulsion (and stone expulsion time) were evaluated in a comparative manner between two groups. Results: The overall mean patient age and stone size values were 38.02±0.94 years and 40.31±1.13 mm2 respectively. Regarding the predictive values of these parameters for MET-success, while stone size and localization, degree of hydronephrosis, proximal
53
ureteral diameter and ureteral wall thickness were found to be highly predictive for MET-success; patients age, BMI values and stone density had no predictive value on this aspect. Conclusions: Our findings indicated that some stone and anatomical factors may be used to predict the success of MET in an effective manner. With this approach unnecessary use of these drugs that may cause a delay for stone removal will be avoided and the possible adverse effects of obstruction as well as stone related clinical symptoms could be minimized. E64 Impaction of ureteral stones into the ureteral wall: Use of serum CRP levels in correlation with ureteral wall thickness Sarica K.1, Cahit S.1, Sabuncu K.1, Guzel R.2, Cetinel A.C.1, Eryildirim B.1 1Dr. Lutfi Kirdar Training and Research Hospital, Dept. of Urology, Istanbul, Turkey, 2Medistate Hospital, Dept. of Urology, Istanbul, Turkey Introduction and objectives: Management of impacted proximal ureteral stones is still controversial and the degree of stone impaction into the ureteral wall could affect the spontaneous passage as well as outcomes of stone removal procedures. The aim of the study was to determine the possible predictive value of acute phase reactants on the degree of stone impaction in these patients. Materials and methods: A total of 80 patients (47 males and 33 females M/F:1.42, mean age 44.381.67 years) with impacted proximal ureteral stones were evaluated. In addition to the patient demographics, variables analysed included, diameter of proximal ureter, degree of hydronephrosis, stone size and Hounsfield unit, ureteral wall thickness at the impacted stone site. In an attempt to predict the degree of impaction and correlate it with the parameters mentioned above (particularly with ureteral wall thickness) serum CRP levels (C-reactive protein) and sedimentation rate values along with creatinine values were also evaluated in a comparative manner.All factors that could give rise to serum CRP values have been well evaluated and accepted as exclusion criteria. Results: Evaluation of our data showed a close relationship with serum CRP levels and the ureteral wall thickness, degree of hydronephrosis and sedimantation values (Table 1). As the thickness of ureteral wall at the stone site increased the serum value of CRP increased accordingly implicating an increase in degree of stone impaction in patients with particularly proximal ureteral stones. As the impcation is a critical issue to predict the spontaneous passage rates as well as the success of stone removal procedures in such stones; our data did clearly indicate a highly significant relationship between serum CRP levels ureteral wall thickness and degree of hydronephrosis. Table 1. Evaluation of the mean Ureteral Wall Thickness (UWT), proximal ureteral diameter, degree of hydronephrosis and sedimentation in correlation with CRP in both groups.
Overall n=80 Ureteral wall 3.28±0.15 thickness (mm) Proximal ureteral 10.49±0.29 diameter (mm) Degree of 2.16±0.13 hydronephrosis (Grade) Sedimentation 26.19±2.65 (mm/h)
Normal CRP Group n=42
High CRP Group n=38
p
2.93±0.20
3.59±0.23
0.0376
10.13±0.43
10.90±0.38
0.1916
1.881 ± 0.18
2.474 ± 0.17
0.0219
14.36 ± 2.06
39.26 ± 4.20
< 0.0001
Conclusions: Our findings may help us to use these parameters (ureteral wall thickness and serum CRP values) in order to predict the degree of impaction in such stones as well as the final
THURSDAY 10 SEPTEMBER 2015 / EUROPEAN UROLOGY SUPPLEMENTS 14 (2015) 29–78
values between two groups (p<0.001); there was no significant change with respect to BMI values and biochemical test datas. Conclusions: Our results clearly indicated a close correlation between stone disease and endothelial dysfunction evaluated by FMD technique. These findings may, again be useful in the understanding of ethiopatagenesis of urinary stone disease. We believe that further studies with large scale studies are certainly needed to outline this relationship.
the correction of these factors’ disorders is the priority in methaphylaxis.
E60 The intensity of metabolic disorders in patients with calcium urolithiasis
Introduction and objectives: The most important factor for uric acid stone formation is acid urinary pH that is a prerequisite for uric acid stone formation and growth. Indeed the goal standard of urinary alkalization is to achieve a pH of 6.0-6.5. Administration of alkali should be titrated appropriately by pH paper to record urinary pH until a steady state is achieved. The aim of this study is to evaluate the clinical efficacy of therapy potassium citrate and potassium bicarbonate for dissolution of uric acid stones. Materials and methods: 11 patients (5 females and 6 males, mean age 51+/-9 years) with non obstructive, asymptomatic renal uric acid stones (diameter < or = 15 mm) and normal renal function were considered. Four of them presented residual stones after endourological procedures. Ultrasonography, computed tomography scan was performed to confirm stone presence and burden and plain X-ray to exclude calcified stones. At basal a blood sample was drown for creatinine, uric acid, glucose, sodium and potassium and a 24 h urine sample was collected for uric acid excretion; urine analysis and culture were performed on fresh urine morning. All patients were instructed on the importance of adequate oral alkalization and counseled on self-dosing to maintain their pH between 6.0 and 6.5 using pH paper. Potassium citrate (40 mEq) and potassium bicarbonate (20 mEq) divided in two doses with daily water intake of 1,5 L was given for 3 months. Follow-up evaluation was performed after 1 month and 3 months after from the starting of therapy. The effect of alkaline therapy on stone dissolution was evaluated by ultrasonography and urinary pH measurement. Results: After 1 month of potassium citrate and potassium bicarbonate treatment, complete stone dissolution was found in 3 patients and partial in 6. After 3 months other 5 patients were stone-free, while in 2 stone dissolution was achieved after the prolongation of the therapy for 6 months. In 2 patients ureteroscopy (URS) with lithotripsy was required for symptomatic stones passed in the ureter (Table 1).
Kariev S., Gaybullaev A., Tursunov B., Kasimov S., Gaybullaev O. Institute of Postgraduate Medical Education, Dept. of Urology & Nephrology, Tashkent, Uzbekistan Introduction and objectives: The disorders of metabolic condition have the differences in the different regions. This situation is important not only for the beginning of methaphylaxis. The comparison of such data gives the possibility for the study of the etiology of the disease, what is important for the treatment of the disease too. Purpose: To study the intensity of metabolic disorders in patients with calcium lithogenesis. Materials and methods: The results of the investigation of metabolic factors of 779 patients with calcium urolithiasis were analyzed. All patients live in Tashkent city (Uzbekistan) and in nearby regions. Urinalysis has been performed in a 3040 days after the stone elimination (by the planned or urgent intervention) or after the stopping of renal colic. The type of the lithogenesis has been determined on the base of Ro-spectral analysis of the stone or on the base of type of crystalluria. The criteria of the evaluation of metabolic condition: diuresis for 24 hours, urine pH, the urine excretion of calcium (Ca), oxalates (Ox), uric acid (Ur), magnesium (Mg), citrates (Cit), inorganic phosphorus (Pi) in 24 hours. Results: The diuresis was in average 1.12±0.20 L/24 h (DI 0.651.97) and in 96,66% cases (752 pts) it was less than 1.5 L/24 h. Urine pH was in average 5.49±0.41 (DI 4.40-7.50). In 27.47% cases (214 pts) urine pH was less than 5.8. Daily Ca excretion was in average 6.19±2.41 mmol/24h (DI 1.1522.14), in 73.68% cases (574 pts) it was more than 5.0 mmol/24h. Hypercalciuria has been revealed only in 11.3% cases (88 pts, in average 11.25±3.18 mmol/24h). Daily Ox excretion was in average 1.09±0.95mmol/24h (DI 0.1511.31). In 92.81% cases (723 pts) it was more than 0.5 mmol/24h. Daily Ur excretion was in average 4.47±0.80 mmol/24h (DI 7.63-1.04). Only in 31.71 % cases (247 pts) it was more than 3.6 mmol/24h. Daily Mg excretion was in average 2.27±0.53 mmol/24h (DI 0.704.71). In 69.96 % cases (545 pts) it was less than 3.0 mmol/24h. Daily Cit excretion was in average 1.92±0.35 mmol/24h (DI 0.80 – 3.66). In 96.79% cases (754 pts) it was less than 2.5 mmol/24h, in average 1.89±0.32mmol/24h. Daily Pi excretion was in average 11.01±4.21 mmol/24h (DI 1.74 – 33.23), i.e. there was no high excretion of Pi among the examined patients. Conclusions: Thus, in patients with calcium lithogenesis of Tashkent region hypocitraturia (96.79%) is the most common disorder of metabolic condition. The next disorders are decrease of daily diuresis (96.66%) and hyperoxaluria (92.81%). The increase of Ca and Ur excretion were observe in 73.68% and 31.71% respectively. The decrease of daily excretion of Mg was in 69.96%, the decrease of urine pH was only in 27.47%. Therefore, in our region the leading factors of calcium lithogenesis are the disorders of the balance of Cit, Ox and diuresis. Therefore,
E61 Dissolution of uric acid nephrolithiasis with potassium citrate and potassium bicarbonate Cicerello E., Mangano M., Cova G., Maccatrozzo L. Ospedale Ca’ Foncello, Dept. of Urology, Treviso, Italy
Table 1. Stone dissolution (diameter in mm) before and after potassium citrate and potassium bicarbonate therapy Patient 1 2 3 4 5 6 7 8 9 10 11
Basal
1 Month
3 Months
10 12 8 15 13 11 9 12 15 11 15
8 7 0 15 6 5 0 6 7 11 URS
0 0 7 0 0 URS 0 9
6 Months
0
0
After 1 month and 3 months of treatment urinary pH was significantly increased (from 5.21+/-0.20 to 6.3+/-0.27 and to 6.4+/0.28 respectively, p<0.05). Conclusions: Urinary alkalization is effective for the dissolution of non obstructive uric acid stones. The therapy with potassium citrate and potassium bicarbonate could be preferred because it may avoid the complication of calcium salt precipitation. Furthermore for its action in slow release, urinary pH could be
THURSDAY 10 SEPTEMBER 2015 / EUROPEAN UROLOGY SUPPLEMENTS 14 (2015) 29–78
continuously increased during 24 h preventing stone recurrence in patients at risk. E62 Effect of medical expulsive therapy on the health-related quality of life of patients with ureteral stones: A critical evaluation Eryildirim B., Cahit S., Tuncer M., Sabuncu K., Cetinel A.C., Tarhan F., Sarica K. Dr. Lutfi Kirdar Training and Research Hospital, Dept. of Urology, Istanbul, Turkey Introduction and objectives: To evaluate the possible effects of medical expulsive therapy (MET) on the health-related quality of life (HRQOL) of the patients under watchful-waiting for ureteral stones. Materials and methods: A total 120 patients with ureteral stones were included in this study program. Patients were divided into two subgroups and while patients in Group 1 received medical therapy only for colic pain if needed; patients in Group 2 received MET (Tamsulosin 0.4 mg) in addition to medical therapy. All cases were evaluated weekly during 1-month period and the patients with persistant stones after this period in both groups were evaluated with respect to the analgesic requirement, number of renal colic attacks as well as emergency department (ED) visits along with the QOL scores. Results: Mean values of patient age and stone burden were 37.14±2.46 years and 42.04±2.03mm2 respectively. Evaluation of the cases with residing stones after 4 weeks (28 cases in Group 1 and 27 cases in Group 2) with or without MET revealed following findings; renal colic, total amount of analgesic required and the mean number of ED visits were significantly lower in cases receiving MET. Evaluation of the mean HRQOL in terms of EQ-5Dindex and EQ-5DVAS values in both groups again demonstrated higher mean values in patients undergoing MET (p<0.05). Conclusions: Our findings indicated that MET for ureteral calculi during watcful-waiting period could increase the HRQOL scores by lowering the number of both renal colic attacks and ED visits resulting in decreased analgesic need. E63 Predictive parameters for medical expulsive therapy in ureteral stones: A critical evaluation Cahit S., Eryildirim B., Kafkasli A., Coskun A., Tarhan F., Faydaci G., Sarica K. Dr. Lutfi Kirdar Training and Research Hospital, Dept. of Urology, Istanbul, Turkey Introduction and objectives: To evaluate the predictive value of some certain radiological as well as stone related parameters for medical expulsive therapy (MET) success with an alpha blocker in ureteral stones. Materials and methods: A total 129 patients receiving MET for 5 to 10 mm ureteral stones were evaluated. Patients were divided into two subgroups where MET was successful in 64 cases (49.61 %); and unsuccessful in 65 cases (50.39 %). Prior to management, stone size, location, position in the ureter, degree of hydronehrosis, diameter of ureteral lumen proximal to the stone, ureteral wall thickness along with patient’s demographics including BMI values were evaluated and recorded. The possible predictive values of these parameters for stone expulsion (and stone expulsion time) were evaluated in a comparative manner between two groups. Results: The overall mean patient age and stone size values were 38.02±0.94 years and 40.31±1.13 mm2 respectively. Regarding the predictive values of these parameters for MET-success, while stone size and localization, degree of hydronephrosis, proximal
53
ureteral diameter and ureteral wall thickness were found to be highly predictive for MET-success; patients age, BMI values and stone density had no predictive value on this aspect. Conclusions: Our findings indicated that some stone and anatomical factors may be used to predict the success of MET in an effective manner. With this approach unnecessary use of these drugs that may cause a delay for stone removal will be avoided and the possible adverse effects of obstruction as well as stone related clinical symptoms could be minimized. E64 Impaction of ureteral stones into the ureteral wall: Use of serum CRP levels in correlation with ureteral wall thickness Sarica K.1, Cahit S.1, Sabuncu K.1, Guzel R.2, Cetinel A.C.1, Eryildirim B.1 1Dr. Lutfi Kirdar Training and Research Hospital, Dept. of Urology, Istanbul, Turkey, 2Medistate Hospital, Dept. of Urology, Istanbul, Turkey Introduction and objectives: Management of impacted proximal ureteral stones is still controversial and the degree of stone impaction into the ureteral wall could affect the spontaneous passage as well as outcomes of stone removal procedures. The aim of the study was to determine the possible predictive value of acute phase reactants on the degree of stone impaction in these patients. Materials and methods: A total of 80 patients (47 males and 33 females M/F:1.42, mean age 44.381.67 years) with impacted proximal ureteral stones were evaluated. In addition to the patient demographics, variables analysed included, diameter of proximal ureter, degree of hydronephrosis, stone size and Hounsfield unit, ureteral wall thickness at the impacted stone site. In an attempt to predict the degree of impaction and correlate it with the parameters mentioned above (particularly with ureteral wall thickness) serum CRP levels (C-reactive protein) and sedimentation rate values along with creatinine values were also evaluated in a comparative manner.All factors that could give rise to serum CRP values have been well evaluated and accepted as exclusion criteria. Results: Evaluation of our data showed a close relationship with serum CRP levels and the ureteral wall thickness, degree of hydronephrosis and sedimantation values (Table 1). As the thickness of ureteral wall at the stone site increased the serum value of CRP increased accordingly implicating an increase in degree of stone impaction in patients with particularly proximal ureteral stones. As the impcation is a critical issue to predict the spontaneous passage rates as well as the success of stone removal procedures in such stones; our data did clearly indicate a highly significant relationship between serum CRP levels ureteral wall thickness and degree of hydronephrosis. Table 1. Evaluation of the mean Ureteral Wall Thickness (UWT), proximal ureteral diameter, degree of hydronephrosis and sedimentation in correlation with CRP in both groups.
Overall n=80 Ureteral wall 3.28±0.15 thickness (mm) Proximal ureteral 10.49±0.29 diameter (mm) Degree of 2.16±0.13 hydronephrosis (Grade) Sedimentation 26.19±2.65 (mm/h)
Normal CRP Group n=42
High CRP Group n=38
p
2.93±0.20
3.59±0.23
0.0376
10.13±0.43
10.90±0.38
0.1916
1.881 ± 0.18
2.474 ± 0.17
0.0219
14.36 ± 2.06
39.26 ± 4.20
< 0.0001
Conclusions: Our findings may help us to use these parameters (ureteral wall thickness and serum CRP values) in order to predict the degree of impaction in such stones as well as the final