A prospective study of cases of urolithiasis with reference to risk factors, surgery and outcomes

Authors

  • Ramalinga Reddy Rachamalla Department of General Surgery, Narayana Medical College, Andhra Pradesh, India
  • Rajasekhar Konduru Department of General Surgery, Narayana Medical College, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20184687

Keywords:

Cystolithotomy, ECSWL, PCNL, Ureteroscopy, Urolithiasis

Abstract

Background: Urinary stone disease or Urolithiasis is on a surge of increase with an incidence of 6.3% among men and 4.1% among women. The site of development of the calculi is variable and dependable on various factors. The aim of study was to identify the various predisposing and causative factors, with clinical presentations and complications and to identify identifying various modalities of treatment.

Methods: A prospective observational study was conducted for a period of one year after ethical committee approval. All the cases of Urolithiasis confirmed by ultra-sonogram was included and socio demographic data, clinical and laboratory investigations were performed on all the cases and the data was entered in Microsoft excel and analyzed. Surgical approach to all the cases were recorded.

Results: 150 cases with 64% males and 36% females were included in the study and mean age was 38.21 years. Pain abdomen was the most common symptom. Calculus was most common on right side with upper pole of the kidney being most common site of calculus in the study. Mean size of calculus in the study was 12.5mm. Statistically significant association was found with Diabetes mellitus, Obesity and low water intake (P value <0.05) in the study. Ureteroscopy (URS) was performed in 36 cases (24%), PCNL in 22 cases (14.67%), ECSWL in 46 (30.67%), cystolithotomy in 34 (22.67%) and urethral extraction in 12 cases (8%).

Conclusions: For renal calculi, PCNL is the best treatment modality as of now, but it is associated with greater post-operative morbidity. For stone less than 1cm size, ECSWL is a good alternative to PCNL, but has poor clearance rate and thus greater need for auxiliary procedure. For ureteral calculi, both ECSWL and ureteroscopy have given good results but ECSWL is better tolerated by the patients.

References

Scales CD, Smith AC, Hanley JM, Saigal CS. Urologic Diseases in America Project. Prevalence of kidney stones in the United States. Eur Urol. 2012;62:160-5.

Strope SA, Wolf JS, Hollenbeck BK. Changes in gender distribution of urinary stone disease. Urol. 2010;75:543-6.

López M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatric nephrology. 2010;25(1):49.

Courbebaisse M, Prot-Bertoye C, Bertocchio JP, Baron S, Maruani G, Briand S. Nephrolithiasis of adult: from mechanisms to preventive medical treatment. The Internal Med J. 2017;38(1):44-52.

Marak A, Shantibala K, Singh TA, Singh RKN, Singh LS. Urolithiasis: Prevalence and related factors in a rural area of Manipur. Int J Med Sci Public Health. 2013;2:956-9.

Hiatt RA, Dales LG, Friedman GD, Hunkeler EM. Frequency of urolithiasis in a prepaid medical care program. Am J Epidemiol. 1982;115:255-65.

Knoll T, Schubert AB, Fahlenkamp D, Leusmann DB, Wendt-Nordahl G, Schubert G. Urolithiasis through the ages: data on more than 200,000 urinary stone analyses. J urol. 2011;185(4):1304-11.

Baker K, Costabile RA. Demographics, stone characteristic and treatment of urinary calculi at the 47th Combat Support Hospital during the first 6 months of Operation Iraqi Freedom. Mil Med. 2007;172:498-503.

Safarinejad MR. Adult urolithiasis in a population-based study in Iran: prevalence, incidence, and associated risk factors. Urol Res. 2007;35:73-82.

Sharma N, Furber A, Lemaster J. Study on urinary bladder stone cases at Okhaldhunga Hospital, Nepal. Nepal Med Coll J. 2004;6:49-52.

David J, Galvin. The contemporary management of renal and ureteric calculi. BJUI 2006;98:1283-8.

Naqvi SA, Khaliq M, Zafar MN, Rizvi SA. Treatment of ureteric stones. Comparison of laser and pneumatic lithotripsy. Br J Urol. 1994;74(6):694-8.

Lieske JC, de la Vega LS, Gettman MT, Slezak JM, Bergstralh EJ, Melton LJ 3rd, Leibson CL. Diabetes mellitus and the risk of urinary tract stones: a population-based case-control study. Am J Kidney Dis. 2006;48:897-904.

Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol. 1996;155(3):839-43.

Takazawa R. Appropriate kidney stone size for ureteroscopic lithotripsy: when to switch to a percutaneous approach. World J Nephrol 2015;4:111. 155:839-43.

Knoll T, Bach T, Humke U, Neisius A, Stein R, Schonthaler M, Wendt-Nordahl G. S2k guidelines on diagnostics, therapy and metaphylaxis of urolithiasis (AWMF 043/025): compendium. Urologe A. 2016;55(7):904-22.

Abarchi H, Hachem A, Erraji M, Belkacem R, Outarahout N, Barahioui M. Pediatric Vesical lithiasis. 70 case reports. Ann Urol. 2003;37(3):1179.

Park H, Park M, Park T. Two-year experience with ureteral stones: extracorporeal shockwave lithotripsy vs. ureteroscopic manipulation. J Endourol. 1998;12(6):501-4.

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Published

2018-11-28

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Original Research Articles