A Review of 171 Consecutive Patients with Urinary Lithiasis

Abstract

During a 3 yr interval 171 patients with urinary tract calculi were seen and studied: 98 had kidney, 52 had ureteral and 21 had bladder calculi. In 54 of the 98 patients with kidney stones (55%) abnormal elevations of the blood and/or urine Ca, uric acid or creatinine were noted. Of these 98 patients 54 (55%) were treated with observation only, 42 (43%) were treated surgically (with an operative mortality of 2.4%) and in 2 the renal stones passed spontaneously. Of the patients 62% with renal calculi had a history of stones. Apparently asymptomatic renal stones located in a calix or calices, and not associated with infection, are best managed nonoperatively. The average age of the 52 patients presented with ureteral calculi was 12 yr younger than that of patients presented with renal calculi (36 vs. 48 yr). In 46% of these cases the ureteral calculi ultimately passed spontaneously. Conservative therapy of ureteral calculi with long-term expectant observation (weeks and even months) often is indicated in the unobstructed and uninfected patient. Of the patients with ureteral calculi 29% had a history of stones.