title: Is fluid ingestion really necessary during ultrasonography for detecting ureteral stones? A prospective randomized study.
abstract: OBJECTIVE
  Ultrasonographic evaluation of ureteral stones is usually performed after fluid ingestion for filling the bladder to visualize the ureterovesical junction better. We hypothesized that water ingestion may decrease the imaging quality of ultrasonography for detecting ureter stones. In our prospective randomized study, the accuracy of ultrasonography for detecting ureteral stones performed with or without fluid intake were evaluated.
  
  
  METHODS
  The study population comprised 150 consecutive patients thought to have ureteral stones who underwent ultrasonography. Patients were divided into 2 groups. Group A patients ingested 500 mL of water to distend the bladder before ultrasonographic examination. Group B patients were restricted from drinking any water at least 4 hours before the procedure.
  
  
  RESULTS
  Ultrasonography showed 35 (67.30%) of 52 stones in group A and 68 (93.15%) of 73 stones in group B. The difference of detection rates between the 2 groups was statistically significant (P < .001). The greatest improvement in detection rates was noted in the middle ureter stones. The evaluated sensitivity and specificity rates for group A were 67% and 82%, respectively, and those for group B were 93% and 94%. When the 2 methods were compared, total accuracy of ultrasonography increased from 71% in group A to 93% in group B.
  
  
  CONCLUSIONS
  This prospective randomized study showed that the diagnostic accuracy of ultrasonography for detection of middle ureteral stones increased significantly when performed without any water ingestion before the procedure. We recommend that patients thought to have ureteral stones should be first examined without any fluid ingestion.
authors.affiliation: Ankara Universitesi Tip Fakültesi, Ibni Sina Hastanesi Uroloji Anabilim Dali, 06450 Samanpazari, Ankara, Turkey. erizozden@yahoo.com
authors.forename: Eriz
authors.initials: E
authors.lastname: Ozden
authors.forename: Cagatay
authors.initials: C
authors.lastname: Gögüs
authors.forename: Kadir
authors.initials: K
authors.lastname: Türkölmez
authors.forename: Cemil
authors.initials: C
authors.lastname: Yagci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D004326:Drinking; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D014514:Ureteral Calculi / Q000000981:diagnostic imaging*; D014867:Water
chemical_list: D003287:Contrast Media; D014867:Water