Silent ureteral stones: impact on kidney function--can treatment of silent ureteral stones preserve kidney function?

Urology. 2012 Feb;79(2):304-8. doi: 10.1016/j.urology.2011.07.1436. Epub 2011 Nov 4.


Objective: To report our experience with silent ureteral stones and expose their true influence on renal function.

Methods: We analyzed 506 patients who had undergone ureterolithotripsy from January 2005 to May 2010. Silent ureteral stones were calculi found in the absence of any specific or subjective ureteral stone-related symptoms. Of the 506 patients, 27 (5.3%) met these criteria (global cohort). All patients were assessed postoperatively with dimercaptosuccinic acid scintigraphy (DMSA). A difference in relative kidney function of >10% was considered abnormal. Pre- and postoperative comparative DMSA analyses were electively obtained for 9 patients (kidney function cohort). A t test was used to assess the numeric variables, and the chi-square test or Fisher's exact test was used for categorical variables. Two-tailed P<.05 was considered statistically significant.

Results: Stones were diagnosed by radiologic abdominal evaluation for nonurologic diseases in 40% and after previous nephrolithiasis treatment in 33%. The primary therapy was ureterolithotripsy in 88%. The mean follow-up time was 23 months. The overall ureteral stone-free rate after 1 and 2 procedures was 96% and 100%, respectively. In the global cohort, the mean pre- and postoperative serum creatinine levels were similar (P=.39), and the mean postoperative function on DMSA was 31%. In the kidney function cohort, no difference was found between the pre- and postoperative DMSA findings (22%±12.1% vs 20%±11.8%; P=.83) and serum creatinine (0.8±0.13 mg/dL vs 1.0±0.21 mg/dL; P=.45).

Conclusion: Silent ureteral stones are associated with decreased kidney function present at the diagnosis. Hydronephrosis tends to diminish after stone removal, and kidney function remains unaltered.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Asymptomatic Diseases*
  • Child
  • Comorbidity
  • Creatinine / blood
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Hydronephrosis / etiology
  • Hydronephrosis / prevention & control
  • Kidney / physiopathology*
  • Lithotripsy
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Recurrence
  • Renal Insufficiency / prevention & control*
  • Retrospective Studies
  • Ureteral Calculi / diagnostic imaging
  • Ureteral Calculi / physiopathology*
  • Ureteral Calculi / therapy
  • Young Adult


  • Creatinine