The Small Acute Ureteral Stone Protocol: Clinical Outcomes and Relapse Patterns.

Area of Science:

• Nephrology
• Urology

Background:

• Nephrolithiasis impacts 10% of North Americans, causing significant healthcare burdens.
• Effective management of small ureteral stones (≤5 mm) is crucial for resource optimization.

Purpose of the Study:

• To evaluate the effectiveness of a novel virtual Small Acute Ureteral Stone (SAUS) protocol.
• To assess the SAUS protocol's impact on resource utilization and patient care for ureteral stones ≤5 mm.

Main Methods:

• Retrospective review of 209 patients in the SAUS protocol (June 2018-May 2019).
• Protocol involved virtual follow-up with renal bladder ultrasound and nurse case manager assessments.
• Median follow-up duration of 5.4 years, collecting data on stone passage, interventions, and long-term outcomes.

Main Results:

• The SAUS protocol redirected 53% of patients from urgent visits, with 98% avoiding urologic intervention.
• Radiographical stone passage confirmed in 77% of patients; 74% were symptom-free.
• Only 13% required intervention for the initial stone; 67% did not re-present within 5 years post-discharge.

Conclusions:

• The SAUS protocol effectively manages small ureteral stones virtually, reducing clinic visits and interventions.
• This virtual management strategy shows potential for reducing healthcare costs and improving urolithiasis patient care.
• The protocol's success suggests applicability in similar clinical settings for efficient stone management.