A Study of Relationship between Spontaneous Passage Rates of Ureteral Stones Less than 10 mm and Serum C-Reactive Protein Levels and Neutrophil Percentages

Abstract Background: Ureteric stones is relatively a common condition in urological practice to which several treatment options are available for ureteric stones, these include con-servative management and medical expulsive therapy, endo-scopic removal, extracorporeal shock wave lithotripsy, percu-taneous, laparoscopic and open surgical approaches. Stone size and location in ureter are well-studied predictors for spontaneous passage of ureteric stones, but more predictors are needed to be evaluated to make patients, in which medical expulsive therapy is probably beneficial, more accurately chosen. Aim of Study: In this study we aim to evaluate serum CRP levels and neutrophil percentage as predictors for spontaneous passage of lower ureteric stones less than 10mm, both are used as indicators of inflammatory changes in ureter that may oppose stone passage. Patients and Methods: A total of 52 patients who were diagnosed with distal ureteric stones less than 10mm in the duration from October 2021 to March 2022 were tested for CRP level and neutrophil percentage at time of presentation and followed-up for 4weeks for stone passage. Results: Of the 52 patients, 34 patients (65.38%) passed their stones while 18 patients (34.61%) needed ureteroscopy. The mean of serum CRP was statistically lower in patients who passed their stones (3.91±1.53SD compared to 8.28±  4.89SD in patients whose stones didn't pass with p-value 0.000), similarly neutrophil percentage was statistically lower in this group (63.89±9.68 compared to 73.22±11.34 with p-value 0.003). However, in multivariate regression analysis CRP levels only show statistically significant with stone size and not neutrophil percentage (p-values were 0.007, 0.004 and 0.25 respectively). Conclusion: CRP level can be used with stone size and location in ureter as a predictor for spontaneous passage of ureteric stones, but neutrophil percentage may need more studies to evaluate its value.