Predictability of Computerized Tomography as Compared to Ureteroscopy in Detection of Ureteric Stone in Patients with Indwelling Stents

Abstract

Objective: The current gold standard for the diagnosis of ureteric stones in patients with a stent in situ is ureteroscopy but this study is planned to determine the positive predictive value of computerized tomography (CT) scan among such patients. Methods: This study involved patients who had ureteral stent in situ and were referred for re-evaluation of residual stones after extracorporeal shock wave lithotripsy. These patients underwent CT-scan for detection of ureteric stone. Later on, ureteroscopy was performed and ureteric stone was confirmed on direct visualization. Results: The mean age of the patients was 32.2±8.9 years. Male to female ratio of 1.7:1. CT scan shows a stone in 252 patients (70.2%) out of which 165 (46.0%) were confirmed on ureteroscopy. This yielded a sensitivity of 88.7 %, specificity of 49.7 %, positive predictive value of 65.5%, negative predictive value of 80.4% and diagnostic accuracy of 69.9% of CT for detecting ureteric calculi in patients with ureteric stents (p value < 0.0001). Conclusion: CT scan owing to its limited diagnostic accuracy cannot replace ureteroscopy for detection of ureteric stones in patients with ureteric stents.