Ureteral Stone CT Diagnosis: Acute Flank Pain, Hydroureteronephrosis, UVJ Findings, and the Critical Clue of a Passed Ureteric Stone
A Case-Based Radiology Guide to Pathophysiology, Imaging Diagnosis, Differential Diagnosis, Treatment, Prognosis, and the Emerging Role of Artificial Intelligence
Acute flank pain is one of the most common reasons for emergency abdominal imaging. Among the many possible causes, ureteral stone disease remains one of the most important because a small calculus can produce dramatic pain, urinary obstruction, hematuria, and, in selected patients, potentially serious renal or infectious complications.
Yet one of the most important lessons in urinary stone imaging is that the stone seen on CT is not necessarily the stone that is currently causing the obstruction.
A patient may present with severe flank pain and undergo CT demonstrating hydronephrosis, hydroureter, perinephric fat stranding, and a small calculus near the bladder. If the ureter is dilated all the way to the ureterovesical junction (UVJ), while the calculus is already located within the bladder, the correct interpretation may not be “simple bladder stone.” Instead, the entire pattern may represent a recently passed ureteral stone, with residual imaging evidence of a recently relieved obstruction.
This distinction illustrates an essential principle of modern radiology:
Do not interpret the stone alone. Interpret the stone, the urinary tract, the obstruction, and the clinical timeline as one continuous process.
The attached case describes a 54-year-old man presenting to the emergency department with flank pain. CT demonstrated mild enlargement of the right kidney, right perinephric fat stranding, right renal pelvic and ureteral dilatation extending to the UVJ, and a calculus at the bladder base. The case material emphasizes that the bladder calculus may represent a stone that has recently traversed the ureter rather than an incidental primary bladder calculus.
1. The Central Diagnostic Question: Where Did the Stone Go?
The most important radiologic question in this case is not simply:
“Is there a urinary stone?”
The better questions are:
Where is the stone now?
Where was the stone previously?
Is there evidence of current or recent obstruction?
Does the distribution of urinary tract dilatation fit the location of the stone?
Could the calculus have recently migrated from the ureter into the bladder?
The case demonstrates a classic diagnostic sequence:
Acute flank pain
→ right perinephric stranding
→ right renal pelvic dilatation
→ right hydroureter
→ dilatation extending to the UVJ
→ calculus at the bladder base
When these findings are interpreted together, a recently passed ureteral stone becomes a highly plausible explanation.
This is clinically important because urinary stones are dynamic lesions. They migrate. Their position changes over time, while the physiologic consequences of obstruction may persist after the stone has moved.
A CT scan is therefore not simply a photograph of a stone.
It is a map of the stone's journey through the urinary tract.
2. Why Does a Ureteral Stone Cause Severe Flank Pain?
The ureter is a narrow muscular conduit transporting urine from the renal pelvis to the urinary bladder.
When a calculus becomes lodged within the ureter, urine flow becomes restricted. Proximal urinary pressure rises, the renal pelvis and ureter may dilate, and ureteral smooth-muscle activity increases as the urinary tract attempts to propel the stone toward the bladder.
This combination of obstruction, increased pressure, ureteral distension, and vigorous peristaltic activity produces the characteristic syndrome of renal colic.
Pain frequently begins in the flank and may migrate toward the lower abdomen, groin, or genital region depending on the location of the calculus.
Therefore, “flank pain” should not automatically be interpreted as disease of the kidney itself.
The pathology may actually be located several centimeters downstream in the ureter.
This is why tracing the ureter from the renal pelvis to the bladder is one of the most important habits in CT interpretation of suspected stone disease.
3. Pathophysiology of Ureteral Stone Disease
3.1 Urinary obstruction is the key mechanism
The central pathophysiologic event in symptomatic ureterolithiasis is urinary obstruction.
A stone becomes impacted within a narrow segment of the ureter, restricting urine flow. The resulting increase in upstream pressure produces hydronephrosis and hydroureter.
At the same time, inflammatory and vascular changes may occur around the kidney and ureter. On CT, these may manifest as perinephric or periureteral fat stranding.
Importantly, perinephric stranding is not synonymous with infection.
It is a nonspecific sign of local inflammation or urinary tract obstruction and must be interpreted in the context of symptoms, laboratory findings, and the remainder of the CT examination.
If the calculus subsequently moves into the urinary bladder, the obstruction may begin to resolve. However, the collecting system does not necessarily return to normal immediately.
Consequently, an important transitional imaging pattern can occur:
Stone already in the bladder + residual hydroureteronephrosis + recent flank pain.
This is exactly the type of situation in which a radiologist must reconstruct the temporal sequence rather than interpreting each finding independently.
4. Epidemiology and Risk Factors
Urinary stone disease is common worldwide and represents a major cause of emergency department visits, acute abdominal imaging, and urologic intervention.
The lifetime prevalence of kidney stone disease has increased in many populations, with metabolic syndrome, obesity, diabetes, dietary patterns, environmental factors, and inadequate fluid intake contributing to risk. A major review estimates prevalence rates approaching 15% in some populations and emphasizes the substantial risk of recurrence after an initial stone event.
Most urinary calculi contain calcium, particularly calcium oxalate, although uric acid, struvite, cystine, and other less common compositions occur.
The clinically relevant variables are not simply stone composition.
They include:
Stone size
Stone location
Degree of obstruction
Duration of obstruction
Renal function
Presence or absence of infection
Patient symptoms
Probability of spontaneous passage
Anatomic abnormalities
Previous stone history
A small distal ureteral stone may have a high probability of spontaneous passage, whereas a larger proximal stone may be much less likely to pass.
Therefore, stone size and location must always be interpreted together.
Radiologic evidence supports the importance of both dimensions when estimating spontaneous passage probability.
5. Clinical Presentation of Ureteral Stones
The classic presentation is acute renal colic.
Typical symptoms include:
Sudden severe flank pain
Pain radiating toward the lower abdomen or groin
Hematuria
Nausea
Vomiting
Urinary frequency
Urgency
Dysuria
Suprapubic discomfort, particularly with distal ureteral stones
The pain may be intermittent and wave-like because of ureteral peristalsis.
However, clinical presentation varies considerably.
A particularly important diagnostic trap is the patient whose pain suddenly improves.
Improvement may mean that the calculus has moved into the bladder and obstruction is resolving.
But it does not necessarily mean that all radiologic abnormalities have disappeared.
Hydroureter, hydronephrosis, or perinephric inflammatory changes may persist temporarily after stone migration.
Thus:
Clinical improvement ≠ immediate normalization of CT findings.
The imaging and clinical timeline must be interpreted together.
6. Imaging Diagnosis: Why Noncontrast CT Is So Important
For adults presenting with acute flank pain and suspected stone disease, noncontrast CT of the abdomen and pelvis remains a highly important imaging examination.
The 2023 ACR Appropriateness Criteria rate CT abdomen and pelvis without intravenous contrast as “Usually Appropriate” for initial imaging in adults with acute flank pain and suspected stone disease.
CT can demonstrate:
Stone location
Stone size
Hydronephrosis
Hydroureter
Perinephric stranding
Periureteral inflammatory change
Alternative causes of abdominal pain
Complications of obstruction
The landmark prospective comparative effectiveness study by Smith-Bindman et al. demonstrated that an initial ultrasonography-based strategy can reduce radiation exposure while maintaining similar short-term adverse-event outcomes, but CT remains highly valuable when definitive stone localization or alternative diagnosis is required.
7. The Correct CT Reading Strategy: Follow the Entire Ureter
When evaluating suspected ureterolithiasis, do not stop after identifying the kidneys.
Use a systematic pathway:
Kidney
→ renal pelvis
→ proximal ureter
→ mid ureter
→ distal ureter
→ UVJ
→ urinary bladder
The ureter should be followed continuously whenever possible.
The most important questions are:
Question 1: Is there hydronephrosis?
Look for dilation of the renal pelvis and calyces.
Question 2: Is the ureter dilated?
Hydroureter indicates downstream obstruction or recent obstruction.
Question 3: Where is the transition point?
A sudden change in ureteral caliber may indicate the previous site of obstruction.
Question 4: Is a calculus visible?
Search carefully along the entire ureter.
Question 5: Is the calculus already inside the bladder?
A small bladder-base calculus may be the key to understanding the entire case.
Question 6: Is there perinephric stranding?
This may support recent or ongoing obstruction but is not specific for infection.
The AUA imaging technology assessment similarly emphasizes the importance of appropriate imaging in suspected ureteral calculous disease and the role of CT in defining stone burden and urinary tract anatomy.
8. Figure 1 — Axial CT: The Upstream Consequences of Obstruction
Figure 1. Axial abdominal CT demonstrating mild right renal enlargement, right perinephric fat stranding, and dilatation of the right renal pelvis and ureter.
Radiologic interpretation:
The combination of right renal enlargement, perinephric fat stranding, and upper urinary tract dilatation indicates recent or ongoing right-sided urinary obstruction. In the clinical setting of acute flank pain, obstructive ureteral stone disease is a major consideration. The individual finding of perinephric stranding is nonspecific and should not be interpreted as pyelonephritis without appropriate clinical and laboratory correlation.
Key imaging lesson
Perinephric stranding + hydronephrosis + hydroureter = think obstruction before making an isolated diagnosis of infection.
9. Figure 2 — Axial CT: The Stone Has Already Reached the Bladder
Figure 2. Axial CT demonstrating dilatation of the right ureter extending toward the UVJ and a small calculus at the bladder base.
Radiologic interpretation:
The bladder-base calculus should not automatically be labeled a primary bladder stone. When the ureter remains dilated to the UVJ and the patient has a history of acute flank pain, the calculus may represent a recently passed ureteral stone. The residual hydroureter can therefore be viewed as a physiologic footprint of the preceding obstruction.
This is the most important image in the case.
10. The “Passed Ureteral Stone” Sign: A Temporal Diagnosis
A passed ureteral stone is fundamentally a temporal diagnosis.
The radiologist is reconstructing what probably happened before the CT examination.
A plausible sequence is:
This sequence elegantly explains why a patient can have severe flank pain and hydroureter while the actual stone is no longer within the ureter.
That is the central diagnostic lesson of this case.
11. Differential Diagnosis
A dilated ureter does not automatically mean an obstructing stone is currently present.
Important differential diagnoses include:
11.1 Recently passed ureteral stone
This is the leading explanation for the case pattern.
The combination of acute flank pain, hydroureter extending toward the UVJ, and a bladder-base calculus strongly supports recent distal stone migration.
11.2 UVJ obstruction
A stone at the UVJ can cause upstream hydroureter and hydronephrosis.
11.3 Ureteral stricture
A focal narrowing may cause persistent upstream dilatation without a visible stone.
11.4 Urothelial tumor
Ureteral wall thickening, enhancing soft tissue, or a discrete mass should raise concern for urothelial malignancy, particularly in an appropriate clinical context.
11.5 Acute pyelonephritis
Perinephric inflammatory changes can occur, but infection usually requires clinical correlation, including fever, leukocytosis, urinalysis, and other evidence of infection.
Importantly, infection plus obstruction is a medical emergency.
11.6 Renal or ureteral trauma
Trauma should be considered when there is an appropriate history.
11.7 Vascular pathology
Renal vascular disorders can cause flank pain but generally do not explain the complete pattern of hydroureteronephrosis.
The attached case specifically emphasizes that ureteral tumor, ureteral stricture, acute pyelonephritis, renal trauma, and renal venous thrombosis may enter the differential depending on the imaging and clinical setting.
12. The Most Important Diagnostic Trap
One of the most dangerous cognitive errors is:
“There is a stone in the bladder, therefore this is simply a bladder stone.”
That conclusion may be wrong.
The bladder stone may actually be the final visible stage of a ureteral stone episode.
The radiologist should therefore ask:
Why is the ureter dilated?
If the ureter remains dilated to the UVJ, and there is no current ureteral calculus, a recently passed calculus becomes an important explanation.
The combination to remember is:
Acute flank pain + hydroureter + UVJ-level dilatation + bladder-base calculus
This pattern should immediately trigger consideration of a recently passed ureteral stone.
13. Diagnosis: A Practical Clinical-Radiologic Framework
The diagnosis should integrate four domains:
A. Symptoms
Acute flank pain, radiation toward the groin, hematuria, nausea, and urinary symptoms.
B. Urinary tract anatomy
Hydronephrosis and hydroureter indicate upstream urinary tract consequences.
C. Stone location
The current location of the calculus must be identified.
D. Timeline
The current location of the stone must be reconciled with the degree and distribution of urinary tract dilatation.
This is why the best CT report should not simply say:
“Bladder calculus with right hydroureteronephrosis.”
A more clinically meaningful interpretation would be:
“Right hydroureteronephrosis with perinephric stranding and a small calculus at the bladder base. Given the acute flank pain and ureteral dilatation extending to the UVJ, the findings are compatible with a recently passed right ureteral calculus, with residual obstructive changes.”
This communicates the diagnostic story rather than merely listing abnormalities.
14. Treatment: Observation, Medical Expulsive Therapy, or Intervention?
Treatment depends on:
Stone size
Stone location
Probability of spontaneous passage
Pain control
Degree of obstruction
Renal function
Infection
Patient preference
Anatomy
Previous stone history
The current EAU guideline supports observation in appropriately selected patients without complications and notes that spontaneous passage is more likely for smaller distal stones. The guideline reports substantially higher spontaneous passage rates for distal stones and particularly high passage probability for distal stones smaller than 5 mm.
Conservative management
For an uncomplicated stone with a reasonable probability of spontaneous passage, management may include:
Analgesia
Appropriate hydration
Observation
Clinical follow-up
Repeat imaging when clinically indicated
NSAIDs are an important component of acute renal colic management when not contraindicated.
Medical expulsive therapy
Alpha-blockers may be considered in selected patients, particularly those with distal ureteral stones in the approximately 5–10 mm range.
The EAU currently gives a strong recommendation for alpha-blockers as one treatment option for distal ureteral stones measuring 5–10 mm in appropriately selected patients, while acknowledging that this is an off-label use.
Evidence comparing agents such as silodosin and tamsulosin suggests that both can be useful in selected patients, with some analyses suggesting greater expulsion efficacy with silodosin.
However, medical expulsive therapy should not delay definitive management when complications develop.
15. When Is Active Stone Removal Necessary?
Active treatment should be considered when there is:
Persistent obstruction
Refractory pain
Low probability of spontaneous passage
Deterioration in renal function
Bilateral obstruction
Obstruction in a solitary functioning kidney
Infection associated with obstruction
The EAU specifically lists persistent pain, persistent obstruction, renal insufficiency, and low probability of spontaneous passage among the indications for stone removal.
Treatment options include:
Ureteroscopy
Ureteroscopy allows direct visualization and removal or fragmentation of the calculus.
Shock-wave lithotripsy
Extracorporeal shock-wave lithotripsy can fragment appropriately selected stones without endoscopic access.
Other interventions
In selected complex cases, antegrade approaches, percutaneous techniques, or surgical approaches may be required.
The choice depends on stone size, location, density, anatomy, body habitus, renal function, and patient-specific factors.
16. The Emergency Situation: Infected Obstructed Kidney
One principle should never be forgotten:
An infected obstructed urinary system is an emergency.
Fever, chills, systemic inflammatory response, sepsis, worsening renal function, or other evidence of infection in the setting of urinary obstruction should prompt urgent clinical management.
The EAU recommends urgent decompression of the collecting system in patients with sepsis associated with obstructing stones, using ureteral stenting or percutaneous drainage, with definitive stone treatment delayed until the infection has been controlled.
This is not a situation in which the clinician should simply wait for spontaneous stone passage.
The priority is:
Drain first → treat infection → remove the stone after stabilization.
17. Prognosis
The prognosis of uncomplicated ureteral stone disease is generally favorable when the stone passes and obstruction resolves.
However, persistent obstruction can compromise renal function.
Therefore, “small stone” should never be interpreted as synonymous with “low risk.”
A small stone can become clinically dangerous if it produces:
Persistent obstruction
Infection
Renal dysfunction
Bilateral obstruction
Obstruction in a solitary kidney
Refractory pain
In the present case, the calculus appears to have reached the bladder, suggesting that the obstructive process may be resolving. Nevertheless, residual hydroureter and perinephric changes may persist temporarily.
18. Artificial Intelligence and the Future of Ureteral Stone Diagnosis
Artificial intelligence is rapidly entering urinary stone imaging.
The most immediate application is automated stone detection on CT.
AI algorithms can potentially:
Detect small calculi
Highlight suspicious regions
Quantify stone burden
Measure stone dimensions
Segment stones
Assist in stone composition prediction
Estimate treatment response
Support surgical planning
Reduce missed-stone rates
Prioritize urgent examinations
A 2024 systematic review specifically evaluated AI for urinary stone detection and found growing evidence that machine-learning and deep-learning approaches can detect and measure urinary stones, while also emphasizing the heterogeneity of datasets, methodologies, and validation standards.
The key point is that AI should not be viewed as a replacement for radiologists.
Instead, the most clinically useful model is likely to be:
AI detection → radiologist verification → clinical integration → urologic decision-making.
19. From Stone Detection to Clinical Intelligence
The next generation of AI will likely move beyond simple “stone/no stone” classification.
A clinically meaningful AI system should potentially answer:
Is there a stone?
Where is it?
How large is it?
What is its density?
Is there hydronephrosis?
Is there hydroureter?
Is there perinephric stranding?
Is there evidence of infection?
Has the stone already passed?
What is the probability of spontaneous passage?
Is intervention likely to be required?
This represents a transition from computer-aided detection to computer-assisted clinical reasoning.
Emerging research is also exploring multimodal approaches that combine CT findings with electronic health-record data and transformer-based architectures for stone classification. These technologies remain investigational and require rigorous external validation before routine clinical deployment.
At the 2026 AUA Annual Meeting, the scientific program also demonstrated how rapidly the field is expanding into AI-assisted endourology, robotic ureteroscopy, postoperative risk prediction, and real-time surgical decision support.
20. AI Cannot Yet Replace Temporal Radiologic Reasoning
This case demonstrates an important limitation of purely detection-oriented AI.
An algorithm may correctly identify:
“Small calculus in urinary bladder.”
But the clinically important diagnosis is:
“Recently passed ureteral stone with residual obstructive changes.”
That diagnosis requires understanding the relationship between:
Symptoms
Stone location
Hydroureter
Hydronephrosis
UVJ anatomy
Perinephric stranding
The probable temporal sequence
Therefore, future AI systems should not merely detect objects.
They should understand relationships and trajectories.
The goal is not simply:
“Find the stone.”
The goal is:
“Explain what happened to the patient.”
21. A Radiologist's Four-Question Checklist
When reading CT for suspected ureteral stone disease, ask:
1. WHERE IS THE STONE?
Kidney?
Proximal ureter?
Mid ureter?
Distal ureter?
UVJ?
Bladder?
2. IS THERE OBSTRUCTION?
Look for:
Hydronephrosis
Hydroureter
Perinephric stranding
Periureteral edema
3. WHAT CAUSED THE OBSTRUCTION?
Stone?
Stricture?
Tumor?
External compression?
Other pathology?
4. HAS THE STONE MOVED?
If the stone is now in the bladder but the ipsilateral ureter remains dilated, consider a recently passed ureteral stone.
This four-question approach is more reliable than simply searching for a hyperdense focus.
22. Why This Case Matters Beyond Urolithiasis
Modern radiology is sometimes described as the interpretation of images.
That description is incomplete.
Radiology is the interpretation of patients through images.
PACS, digital imaging, artificial intelligence, structured reporting, and increasingly sophisticated image-processing technologies have transformed radiology. They have dramatically improved access to imaging and the speed of communication.
But technology also creates a potential danger.
If the radiologist becomes merely an image classifier, important clinical context may be lost.
This case illustrates why radiologists must remain clinicians.
A small calculus in the bladder is not simply a small bright object.
It may be the final clue in a story that began hours earlier with ureteral obstruction and renal colic.
The radiologist's task is to reconstruct that story.
The attached case material emphasizes this broader clinical role: the radiologist should connect symptoms with CT findings, interpret stone location together with ureteral dilatation, recognize the possibility of stone migration, and communicate clinically meaningful conclusions rather than merely identifying an isolated imaging abnormality.
Quiz
Question 1
A 54-year-old man presents with acute right flank pain. CT demonstrates mild right renal enlargement, perinephric stranding, right hydronephrosis, and hydroureter extending to the UVJ. A small calculus is seen at the bladder base.
What is the most likely diagnosis?
A. Acute pyelonephritis
B. Renal vein thrombosis
C. Renal cell carcinoma
D. Recently passed right ureteral stone
E. Primary bladder calculus
Correct Answer: D. Recently passed right ureteral stone
Explanation
The combination of acute flank pain, upstream urinary tract dilatation, hydroureter extending to the UVJ, and a bladder-base calculus strongly suggests that the stone recently migrated through the distal ureter into the bladder. The residual hydroureter and perinephric changes represent evidence of recent obstruction.
Question 2
What is the most appropriate CT-reading strategy when ureteral stone disease is suspected?
A. Evaluate only the kidneys
B. Stop evaluating the ureter if a bladder stone is identified
C. Follow the entire ureter from the renal pelvis through the UVJ into the bladder
D. Measure only the largest stone
E. Ignore perinephric fat
Correct Answer: C. Follow the entire ureter from the renal pelvis through the UVJ into the bladder
Explanation
Ureteral stones migrate. The location of the stone at the time of imaging may not be the location responsible for the preceding obstruction. Therefore, the entire urinary tract must be evaluated.
Question 3
Which factor is most important when determining the clinical significance and treatment strategy for ureteral stone disease?
A. Stone color
B. Number of stones alone
C. Stone location and size together with obstruction, renal function, and infection
D. Bladder volume alone
E. Improvement in pain alone
Correct Answer: C. Stone location and size together with obstruction, renal function, and infection
Explanation
Treatment is not determined by stone size alone. Persistent obstruction, infection, renal dysfunction, solitary kidney, bilateral obstruction, and refractory pain can substantially change management.
Clinical Pearls
Pearl 1
A bladder-base calculus may be a recently passed ureteral stone.
Pearl 2
Residual hydroureter can persist after stone migration.
Pearl 3
Perinephric stranding is not synonymous with pyelonephritis.
Pearl 4
Always trace the ureter from the renal pelvis to the bladder.
Pearl 5
Stone size alone does not determine clinical risk.
Pearl 6
Obstruction plus infection requires urgent attention.
Pearl 7
AI can detect stones, but understanding the temporal story remains a major clinical reasoning task.
Conclusion
Acute flank pain caused by ureteral stone disease is one of the classic clinical problems in emergency radiology, but the most subtle cases are not necessarily those in which the stone is difficult to see.
Sometimes the stone is easy to see.
The challenge is understanding what the stone means.
In this case, the key findings are:
**Right renal enlargement
perinephric stranding
hydronephrosis
hydroureter
dilatation to the UVJ
bladder-base calculus
acute flank pain**
Taken individually, these findings can be confusing.
Taken together, they tell a coherent story.
The most likely explanation is that a right ureteral stone recently passed through the UVJ and entered the bladder, while residual urinary tract dilatation and inflammatory changes remain visible.
This case therefore provides an important lesson for every radiologist:
Do not merely find the stone. Find the story behind the stone.
CT is not simply a method for detecting urinary calculi.
It provides a three-dimensional record of obstruction, migration, tissue response, and recovery.
The future of stone imaging will combine this human clinical reasoning with artificial intelligence. AI may increasingly identify stones, quantify them, segment them, predict passage, assess treatment response, and support endourologic procedures.
But the ultimate objective should remain unchanged:
to connect the image with the patient.
A small calculus at the bladder base may appear insignificant.
In the right clinical context, it can be the final piece of evidence explaining an entire episode of renal colic.
That is why the most valuable radiologic diagnosis is not always the one that identifies the largest abnormality.
It is the one that explains the patient's story.
Recommended Reading
[1] S. R. Khan, M. S. Pearle, W. G. Robertson, G. Gambaro, B. K. Canales, S. Doizi, O. Traxer, and H.-G. Tiselius, “Kidney stones,” Nature Reviews Disease Primers, vol. 2, Art. no. 16008, 2016. DOI: 10.1038/nrdp.2016.8. DOI: 10.1038/nrdp.2016.8
[2] R. Smith-Bindman et al., “Ultrasonography versus computed tomography for suspected nephrolithiasis,” New England Journal of Medicine, vol. 371, no. 12, pp. 1100–1110, 2014. DOI: 10.1056/NEJMoa1404446. DOI: 10.1056/NEJMoa1404446
[3] Expert Panel on Urological Imaging, R. T. Gupta et al., “ACR Appropriateness Criteria® Acute Onset Flank Pain—Suspicion of Stone Disease (Urolithiasis),” Journal of the American College of Radiology, vol. 20, no. 11S, pp. S315–S328, 2023. DOI: 10.1016/j.jacr.2023.08.020. DOI: 10.1016/j.jacr.2023.08.020
[4] M. S. Pearle et al., “Medical management of kidney stones: AUA guideline,” Journal of Urology, vol. 192, no. 2, pp. 316–324, 2014. DOI: 10.1016/j.juro.2014.05.006. DOI: 10.1016/j.juro.2014.05.006
[5] D. G. Assimos et al., “Surgical management of stones: American Urological Association/Endourological Society guideline, Part I,” Journal of Urology, vol. 196, no. 4, pp. 1153–1160, 2016. DOI: 10.1016/j.juro.2016.05.090. DOI: 10.1016/j.juro.2016.05.090
[6] D. G. Assimos et al., “Surgical management of stones: American Urological Association/Endourological Society guideline, Part II,” Journal of Urology, vol. 196, no. 4, pp. 1161–1169, 2016. DOI: 10.1016/j.juro.2016.05.091. DOI: 10.1016/j.juro.2016.05.091
[7] J. Jendeberg et al., “Size matters: The width and location of a ureteral stone accurately predict the chance of spontaneous passage,” European Radiology, vol. 27, pp. 4775–4785, 2017. DOI: 10.1007/s00330-017-4852-6. DOI: 10.1007/s00330-017-4852-6
[8] J. J. T. C. Coursey et al., “Clinical effectiveness protocols for imaging in the management of ureteral calculous disease: AUA Technology Assessment,” Journal of Urology, vol. 189, no. 4, pp. 1203–1213, 2013. DOI: 10.1016/j.juro.2012.10.031. DOI: 10.1016/j.juro.2012.10.031
[9] H. D. Jung et al., “Silodosin versus tamsulosin for medical expulsive therapy of ureteral stones: An updated systematic review and meta-analysis of randomized controlled trials,” Medicina, vol. 58, no. 12, Art. no. 1794, 2022. DOI: 10.3390/medicina58121794. DOI: 10.3390/medicina58121794
[10] F. Panthier et al., “Can artificial intelligence accurately detect urinary stones? A systematic review,” Journal of Endourology, vol. 38, no. 8, pp. 725–740, 2024. DOI: 10.1089/end.2023.0717. DOI: 10.1089/end.2023.0717
[11] R.-Z. Tao, Z.-Q. Qin, F.-D. Liu, and J.-L. Lv, “Efficacy and safety of tamsulosin in the medical expulsion therapy for distal ureteral calculi: A systematic review and meta-analysis of placebo-controlled trials,” Urology Journal, vol. 16, no. 3, pp. 224–231, 2019. DOI: 10.22037/uj.v0i0.4758. DOI: 10.22037/uj.v0i0.4758
[12] V. K. Sigurjonsdottir et al., “Impact of nephrolithiasis on kidney function,” BMC Nephrology, vol. 16, Art. no. 149, 2015. DOI: 10.1186/s12882-015-0126-1. DOI: 10.1186/s12882-015-0126-1
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