Ureteral Stones: Spontaneous Passage or Urologic Intervention?

Patients with acute ureteral stones can be managed either by a trial of spontaneous passage or by early urologic intervention (usually ureteroscopy with basketing or lithotripsy). In this observational study from nine Canadian emergency departments, researchers examined outcomes with the two strategies in 3000 consecutive patients with acute ureteral colic; 38% underwent planned early urologic intervention, and 62% had trials of spontaneous passage.

In the spontaneous-passage group, treatment failure (need for urologic intervention) occurred in 10%, 35%, and 59% of patients whose stone size was <5 mm, 5.0 to 6.9 mm, and ≥7 mm, respectively. Within each size category, the probability of treatment failure was lower than the above-stated averag…