title: Early hospital admission and treatment onset may positively affect spontaneous passage of ureteral stones in patients with renal colic.
abstract: OBJECTIVE
  To evaluate the impact of early hospital admission and onset of medical expulsive therapy (MET) in spontaneous passage of ureteral stones causing renal colic.
  
  
  METHODS
  We recruited 392 patients referred to the emergency room with symptoms of renal colic. All patients received standard MET of oral tamsulosin 0.4 mg at the time of diagnosis. In group A, patients who received MET in <2 hours from the symptom onset were included, whereas group B consisted of patients treated in >2 hours. The association of MET onset and stone-free rates after 6 weeks of follow-up was evaluated. Early MET onset predictive impact on spontaneous stone passage was evaluated as well.
  
  
  RESULTS
  The stone-free rate in group A and B patients was 71.2% and 59.7% (P=.018), respectively. A significant association was observed between spontaneous calculus elimination and stone size (P≤.001), location within the ureter (P=.007), and the interval between pain onset and pharmaceutical management (P=.018). Patients who received a late-onset MET had an increased risk to develop febrile upper urinary tract infection during the follow-up period (P=.040). In the multivariate analysis, size (P≤.001) and early therapy onset (P=.019) were statistically important predictors for stone-free status after the surveillance period.
  
  
  CONCLUSIONS
  Patients with renal colic who admitted to the emergency department earlier since symptom onset may have increased potential to be stone free during the surveillance period.
authors.affiliation: Urology Department, Hadassah University Hospital, Jerusalem, Israel. Electronic address: sfoungaristosst@gmail.com.
authors.forename: Stavros
authors.initials: S
authors.lastname: Sfoungaristos
authors.affiliation: Urology Department, Patras University Hospital, Patras, Greece.
authors.forename: Adamantios
authors.initials: A
authors.lastname: Kavouras
authors.affiliation: Urology Department, Patras University Hospital, Patras, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kanatas
authors.affiliation: Urology Department, Hadassah University Hospital, Jerusalem, Israel.
authors.forename: Mordechai
authors.initials: M
authors.lastname: Duvdevani
authors.affiliation: Urology Department, Patras University Hospital, Patras, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Perimenis
mesh_terms: D000328:Adult; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission; D012075:Remission, Spontaneous; D056844:Renal Colic / Q000209:etiology*; D012189:Retrospective Studies; D014514:Ureteral Calculi / Q000150:complications*