Clinical Observations in 4468 Cases of Patients with Urinary Stones.
- Author:
Sun Ju LEE
1
;
Duk Kyo KIM
;
Sei Kyung RHO
;
Jung Sik HUH
;
Hyung Lae LEE
;
Choong Hyun LEE
;
Sung Goo CHANG
;
Jin Il KIM
Author Information
1. Department of Urology, Kyung Hee University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
urinary stone;
stone analysis;
urinary tract infection
- MeSH:
Adult;
Ammonium Compounds;
Calcium;
Calculi;
Escherichia coli;
Female;
Humans;
Hypercalcemia;
Hypercalciuria;
Hyperparathyroidism, Primary;
Magnesium;
Male;
Pregnancy;
Recurrence;
Sex Ratio;
Ureter;
Uric Acid;
Urinary Bladder Calculi;
Urinary Calculi*;
Urinary Tract Infections
- From:Korean Journal of Urology
1996;37(8):877-887
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
4468 cases of patients with urinary stones between 1985 and 1995 have been clinically evaluated. The sex ratio was about 1.8: 1 (M: F). 1359 urinary stones have been analysed by infra-red spectrophotometer, calcium containing stones were the most common (80%), magnesium ammonium phosphate (MAP) and uric acid stone was 13.6% and 9.9%, respectively. Among the 212 patients (7%) with urinary tract infection (UTI), Escherichia coli was the most frequently isolated in 85 patients (40.1%). Patients with staghorn calculi and bladder stone were associated with MAP stone and UTI significantly more than other type of stone (p<0.05 by chi-square test). Hypercalciuria was found 275 patients (16%) in male, 208 patients (23.2%) in female, respectively. Primary hyperparathyroidism was diagnosed in 15 cases (0.3%), patients with hypercalcemia were 15, hypercalciuria in 10. 298 cases of 4468 cases (6.7%) were recurrent stone. There was no correlation with clinical parameters for stone formation but MAP stone in female significantly associated with recurrent stone. The duration of stone recurrence was 37.8+/-29.1 months (average). Pediatric stone was 40 cases, there was no clinical difference compared with adult stone. The management of stone with pregnancy was conservative in major. In treatment of renal stone, ESWL was 78.7%, pyelolithotomy in 5.0%, nephrolithotomy in 0.6% and combination therapy with ESWL and surgery was 3.2%. In ureter stone, ESWL was 55.2%, ureterolithotomy in 10.0%, ureteroscopic removal in 8.7% and combination therapy with ESWL and surgery or ureteroscopic removal was 5.5%. Even though the advance in disintegration of stone and removal technique have radically altered the approach to urinary stones, but it is desirable that stone analysis should be performed in all patients and the metabolic evaluation in patients with multiple stones or recurrent disease.
