過去10年間における尿路結石入院患者の臨床的検討

Abstract

The 348 patients with urolithiasis admitted to our department between 1978 and 1987 were studied clinically. Male patients were predominant over females with the male-to-female ratio being 2 to 1. Of 404 uroliths, 389 (96.3%) were upper urinary tract stones, and 15 (3.7%) were lower urinary tract stones. Two hundred and sixty patients (74.7%) had a solitary stone, and 71 patients (20.4%) multiple stones. There were fewer patients with recurrent stones (42 patients, 12.1%) than non-recurrent stone formers. Methods of stone removal were variable including open and endourologic surgeries. The most frequent type of removal of stone was catheter extraction (92 patients, 39.8%). Percutaneous nephrolithotripsy (PNL) and transurethral ureterolithotripsy (TUL) were done on 6 (2.6%) and 5 (2.2%) patients, respectively. Extracorporeal shock wave lithotripsy (ESWL) was not done at this hospital during this period. Spontaneous passage of stone was seen in 70 patients: stones in 38 passed after catheterization. Rate of spontaneous passage of stone in untreated group was 33.5%. Calcium-containing urinary stone was the most frequent type of stone according to analysis of 56 stones with the infrared spectrometry. In conclusion, 1) etiology of urinary tract stone in all recurrent stone formers and in all patients with multiple stones must be pursued, and 2) all stones either removed or passed must be subjected to infrared spectrometry. ESWL, TUL and PNL are expected to be the main modes of stone removal instead of open surgery and conventional catheter extractions in the near future.