Abstract
INTRODUCTION: Urolithiasis is a prevalent clinical condition associated with considerable morbidity. Distal ureteric stones are frequently managed with medical expulsive therapy (MET); however, predicting spontaneous stone passage remains a clinical challenge. Inflammatory markers such as platelet-lymphocyte ratio (PLR) and mean platelet volume (MPV) may serve as useful indicators for assessing the likelihood of MET success. This study aims to evaluate the predictive value of PLR and MPV in determining the success of MET for distal ureteral stones. MATERIALS AND METHODS: This prospective observational study enrolled 121 patients with single distal ureteric stones (5-10 mm). All patients received tamsulosin 0.4 mg/day for two weeks. PLR and MPV were measured at baseline, one week, and two weeks. Spontaneous passage was confirmed by imaging at two weeks. Differences between stone passers (n=100) and non-passers (n=21) were analyzed. Logistic regression identified independent predictors of stone passage, and receiver operating characteristic (ROC) analysis determined diagnostic performance and optimal cut-offs. RESULTS: Stone passers had significantly higher MPV and lower PLR compared to non-passers at all time points (p<0.001). ROC analysis showed good predictive performance for PLR (AUC=0.84, cut-off 20.5) and MPV (AUC=0.87, cut-off 7.5 fL). Logistic regression identified stone size >7 mm (OR 0.42, p=0.03), PLR ≤ 20.5 (OR 3.62, p<0.001), and MPV >7.5 fL (OR 4.28, p<0.001) as independent predictors of spontaneous stone passage. CONCLUSION: PLR and MPV are significant, easily measurable hematological markers that can predict spontaneous passage of distal ureteric stones, aiding clinical decision-making and potentially reducing unnecessary interventions.