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Peer-reviewedCC BYCureus

Audit of Conservative Management of Acute Ureteric Stones and Factors Influencing Treatment Outcome in the Emergency Department

  • Ifeanyichukwu E Ihedoro1
  • Ebuka Egwuatu2
  • Lesedi Leepetswe3
  • Ahmed Abroaf2
  • Andrei Dontu2
  • Kathie Wong2
  • Jaswant Mom4
  • Syed Rizvi2
  • Dumitru Butu2
4 affiliations
  1. 1Urology, Eleos Specialist Hospital, Umuahia, NGA
  2. 2Urology, Cumberland Infirmary, Carlisle, GBR
  3. 3Surgery, Cumberland Infirmary, Carlisle, GBR
  4. 4Urology, West Cumberland Hospital, Carlisle, GBR
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Abstract

Background: Ureteric stones are a common cause of presentation to the emergency department. Management options include conservative therapy, urinary diversion (ureteric stent /nephrostomy), ureteroscopy, or extracorporeal shockwave lithotripsy. Conservative management is known to have a high success rate in appropriately selected patients. This audit evaluates compliance with evidence-based standards in acute ureteric stones management and identifies factors influencing successful conservative treatment.

Methods: This retrospective audit reviewed 143 patients who presented with renal colic to the Emergency Department between January and December 2025 and were offered conservative management. Data collected included patient demographics, laboratory findings, CT parameters, administration of non-steroidal anti-inflammatory drugs (NSAIDS) and tamsulosin, re-presentation rates and treatment outcomes. The audit benchmarked against NICE guidelines. Data analysis was performed using descriptive statistics and appropriate statistical tests (t-test, Fisher’s exact test and Mann-Whitney U test) with significance set at p < 0.05.

Results: A total of 143 patients met the inclusion criteria. The average age of patients was 48 years. This comprised 101 males (70.63%) and 42 females (29.37%). NSAIDS were administered to 103 patients (72%) at presentation, while 49 patients (34.3%) with distal ureteric stones received tamsulosin. The success rate for the conservative therapy was 93.7%. Seventeen patients (11.9%) re-presented to the emergency department with colic. Among all the variables analyzed (C-reactive protein, white blood cell (WBC), creatinine, perinephric stranding, stone position), stone size was the only variable that showed a significant association with the outcome of conservative treatment (p< 0.05).

Conclusion: Our audit findings revealed that NSAIDS and tamsulosin were sub-optimally administered in eligible patients; however, there was a very high rate of successful conservative treatment. Stone size was the only variable that showed significant association with successful conservative treatment.

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Cite

BibTeXRIS
BibTeX
@article{ihedoro2026audit,
  title = {{Audit of Conservative Management of Acute Ureteric Stones and Factors Influencing Treatment Outcome in the Emergency Department}},
  author = {Ifeanyichukwu E Ihedoro and Ebuka Egwuatu and Lesedi Leepetswe and Ahmed Abroaf and Andrei Dontu and Kathie Wong and Jaswant Mom and Syed Rizvi and Dumitru Butu},
  journal = {Cureus},
  year = {2026},
  month = oct,
  doi = {10.7759/cureus.117417},
  url = {https://europepmc.org/article/PMC/PMC13728757},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Audit of Conservative Management of Acute Ureteric Stones and Factors Influencing Treatment Outcome in the Emergency Department
AU  - Ifeanyichukwu E Ihedoro
AU  - Ebuka Egwuatu
AU  - Lesedi Leepetswe
AU  - Ahmed Abroaf
AU  - Andrei Dontu
AU  - Kathie Wong
AU  - Jaswant Mom
AU  - Syed Rizvi
AU  - Dumitru Butu
PY  - 2026
DA  - 2026/10/04
JO  - Cureus
DO  - 10.7759/cureus.117417
UR  - https://europepmc.org/article/PMC/PMC13728757
AB  - Background: Ureteric stones are a common cause of presentation to the emergency department. Management options include conservative therapy, urinary diversion (ureteric stent /nephrostomy), ureteroscopy, or extracorporeal shockwave lithotripsy. Conservative management is known to have a high success rate in appropriately selected patients. This audit evaluates compliance with evidence-based standards in acute ureteric stones management and identifies factors influencing successful conservative treatment.  Methods: This retrospective audit reviewed 143 patients who presented with renal colic to the Emergency Department between January and December 2025 and were offered conservative management. Data collected included patient demographics, laboratory findings, CT parameters, administration of non-steroidal anti-inflammatory drugs (NSAIDS) and tamsulosin, re-presentation rates and treatment outcomes. The audit benchmarked against NICE guidelines. Data analysis was performed using descriptive statistics and appropriate statistical tests (t-test, Fisher’s exact test and Mann-Whitney U test) with significance set at p < 0.05.  Results: A total of 143 patients met the inclusion criteria. The average age of patients was 48 years. This comprised 101 males (70.63%) and 42 females (29.37%). NSAIDS were administered to 103 patients (72%) at presentation, while 49 patients (34.3%) with distal ureteric stones received tamsulosin. The success rate for the conservative therapy was 93.7%. Seventeen patients (11.9%) re-presented to the emergency department with colic. Among all the variables analyzed (C-reactive protein, white blood cell (WBC), creatinine, perinephric stranding, stone position), stone size was the only variable that showed a significant association with the outcome of conservative treatment (p< 0.05).  Conclusion: Our audit findings revealed that NSAIDS and tamsulosin were sub-optimally administered in eligible patients; however, there was a very high rate of successful conservative treatment. Stone size was the only variable that showed significant association with successful conservative treatment.
SN  - 2168-8184
ER  -