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Predictive Factors for Ureteral Stone Passage in Children
William Robert DeFoor1, Joonsue Lee1, Campbell Grant2
1Division of Pediatric Urology, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA.
Journal of Endourology
|June 2, 2025
Summary
Pediatric ureteral stones smaller than 3.5 mm in transverse diameter are more likely to pass spontaneously. This finding suggests CT scans should report stone dimensions to predict spontaneous passage in children.
Area of Science:
- Pediatric Urology
- Nephrolithiasis Research
- Medical Imaging Analysis
Background:
- Ureteral stones are a common pediatric urologic issue.
- Predicting spontaneous stone passage is crucial for treatment decisions.
Purpose of the Study:
- To investigate the association between ureteral stone dimensions (transverse vs. longitudinal) and spontaneous passage rates in children.
- To identify key predictors of spontaneous stone passage in pediatric patients.
Main Methods:
- Retrospective cohort study of pediatric patients with ureteral calculi diagnosed by CT.
- Independent radiologist review of CT images to measure stone dimensions.
- Logistic regression analysis to determine predictors of spontaneous stone passage.
Main Results:
- Transverse and longitudinal stone dimensions were associated with spontaneous passage on univariable analysis.
- Transverse stone diameter (OR=2.5) and history of nephrolithiasis (OR=4.3) were independent predictors.
- A transverse diameter of 3.5 mm optimally predicted spontaneous stone passage (AUC=0.82).
Conclusions:
- Pediatric ureteral stones with a transverse dimension < 3.5 mm have a higher likelihood of spontaneous passage.
- CT reporting of ureteral stone transverse dimensions is recommended for predicting passage.
- This aids in guiding management strategies for pediatric nephrolithiasis.
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