京大泌尿器科教室における過去40年間の尿路結石症の統計的観察

Abstract

1. Object : We have made the statist i c al observation from 1915 to 1954 on urolithiasis in 1748 cases. 138 cases out of them , we found caluculus i n more than two parts of urinary tract . When we recognize the above cases as separate one, they increase to 1890 cases in total . Relapes of urolithiasis are considered as 65 out of 1748 cases (3 .7%). 2. Frequency of Urolithiasis : Firstly when w e classify urolithiasis from the location of caluculus renal caluculus correspond to 468 cases (24.8%), ureteral caluculus do 427 cases (22.6%), vesical caluculus 905 cases (47.9%), urethral caluculus 70 cases (3 .7%), and prostatic caluculus 20 cases (1.0%). Secondly according to periodical observation of, 40 years proposition of urinary stone shows the periodical difference , generally speaking for. the first stage, we encountered many cases of lower urinary stone specially , of late it is tending to be upper urinary stone. According to yearly observation on all kinds of urolithiasis during 40 years , i t gad increased remarkably until year 1939 and since then it tended to decrease heavily by the influence of the Second World War . Again from the year 1949 began to increase and finally marked the highest point even known in 1954 , however, the save is not so remarkable as before in comparison with number of out-patient and cystoscopied ones . 3. Difference in Age : The most of patient are ranging in from age of 21 to 30 which mark 432 cases (24 .7%) and the next is the people of the age 31 to 40 which correspond to 359 cases (20.5%), young and grown up patient have upper urinary caluculus in most case . Old and childish patient do the lower one . 4. Difference in Sex : There are 1553 cases (88.8%) for man are of age 21 to 30 and over age of 30, it decrease suddenly. In cases of 196 women (11.2%), urolithiasis will reach to the highest point in their age of 31 to 40. The percentage from the position of caluculus namely man to woman is renal caluculus 3.5:1, ureteral caluculus 6.8:1, vesical caluculus 15 : 1, urethral caluculus in male 70 cases and 0 in female. 5. Difference in Proffesion Salary eaner belon g to this disease in most cases followed by farmer. If we compase, brain worker with so-colled laborer, the former are frequently to be the patient. This fact is quite difference from the former statistics. 6. Difference in Residence : T he people in Kyoto become this disease as many than as the other, followed by the people in Kinki district. 7. In Reference to Uppel; 'Urinary Disease : Ratio for renal caluculus to ureteral caluculus 1.1: 1, the patient get calucultis on their left side of body, in most cases and we would indicate 7.1% for those on both side. Caluculus mostly placed on the lower part within urinary tract and the next is upper parts and middle parts. Proportion of men to women for caluculus on upper urinary tract is as 82.5 : 17.5. This case is common in both male and female sex of age 21 to 30 in most cases. The patient will be suffered from heavy pains, hematuria, fever, and passage of stone. There are various medical treatment for this kind of patient. Operation : 244 cases, conservative treatment : 3 cases, atural passage of stone : 178 cases. 8. V e s ical Caluculus This condition can be seen often among the people of age 51 to 60. The most patient are suffered from miction pains, dysuria, hematuria in order. Lithotrity is the most prevalling treatment. 9. Urethral Caluculus : People of age 21 to 30 belon g to this category in most cases, condition is dysuria as first place miction pains as on second. Treatment is conservatively , mostly. 10. Prostatic Caluculus Cases of ag e more than 41 is situated on the first class in this lesion. The patient are liable to appeal dysuria and half of them have operation. 11. Previous Histo r y and Co-exist Condition : Many of the cases of caluculus on upper urinary tract have sufferd from pulmonary tuberculosis and hydronephrosis, and of vesical stone from cystitis and prostatic hypertrophy. 12. Investigation for Cause of Disease : 1) Object : 60 persons suffered from urolithiasis. 2) 10 persons of them have the patient of tuberculosis and 6 persons urolithiasis in their family . 3) Relation of using medicines is 4 cases for PAS and 1 case for sulfa-drug . 4) 9 cases are for long in bed rest. 5) 7 cases are due to disease of bone and joint . 6) 11 cases are for much drinking milk and 1 case is for heavy perspiration worker . 13. Remote Result of Treatment for Urolithiasis : 1) Object : Reply by mail which we obtained from the 270 peoples. 2) Out of 248 cases which found caluculus on one part only, we observed 16 cases as a relapse one, further relapse is 5 cases for 21 ureterolithotomy and 1 case for 4 pyelolithotomy. 3) Special remote result for the patient recieved lithotomy. After considerable years past since the operation of lithotomy , we have made urologic precise examination from which we realized 5 cases as exact relapse of the same out of 13 cases. (Professor Inada, one of the authe r s , have already reported on the main points of the present text as one of the task for the 43rd Japanese Urological Association in April in 1955)