A comparison between asymptomatic and symptomatic ureteral stones

Area of Science:

• Nephrology
• Urology
• Medical Research

Background:

• Ureteral stones can be symptomatic or asymptomatic (silent).
• Silent stones may present unique challenges in diagnosis and management.
• The impact of silent stones on renal function is not fully understood.

Purpose of the Study:

• To investigate the characteristics of asymptomatic ureteral stones.
• To assess the impact of silent stones on renal function.
• To compare renal function outcomes between silent and symptomatic ureteral stones.

Main Methods:

• Retrospective review of 677 patients undergoing ureteroscopic lithotripsy or laparoscopic ureterolithotomy for ureteral stones (2016-2020).
• Patients categorized into asymptomatic (n=43) and symptomatic (n=634) groups.
• Comparison of stone characteristics, hydronephrosis, and estimated glomerular filtration rate (eGFR) pre- and post-treatment.

Main Results:

• Asymptomatic stones were larger (11.4 mm vs. 9.6 mm) and more frequently in the upper ureter with high-grade hydronephrosis (32.8% vs. 12.3%).
• No significant improvement in postoperative eGFR was observed in the asymptomatic group at all follow-up points.
• Symptomatic stone patients showed significant eGFR improvement post-treatment (p < 0.001).

Conclusions:

• Silent ureteral stones can cause irreversible renal function impairment.
• Active treatment strategies are necessary for silent stones to prevent permanent kidney damage.
• Patients hesitant about treatment for asymptomatic stones require counseling regarding potential renal consequences.