尿路結石症 - その治療の変遷 - 薬物を用いた尿路結石の再発予防について - PNLおよびESWL症例の術後再発予防を中心に -

Abstract

Questionnaires about stone recurrence after treatment with percutaneous nephrolithotripsy (PNL) or extracorporeal shock wave lithotripsy (ESWL) were sent to 11 hospitals in the central section of Japan. We received 255 replies on PNL cases and 157 replies on ESWL cases. These patients were evaluated for the recurrence of renal stones and the enlargement of residual stone fragments. The effect of the medical management for the prevention of recurrent stone disease on postoperative recurrence rate was also evaluated. The average follow-up period of patients treated with PNL was 21.6 months, and 18.5 months for patients treated with ESWL. In patients who underwent PNL, 25 of 162 patients (15.4%) who were treated completely without any residual stones have suffered from new stones. The residual stone or fragments enlarged in 14 of the 93 patients (15.1%) who had residual stones or fragments after the treatment. The recurrence rate was significantly higher for the recurrent stone former than the single stone former. The recurrence rate for the patients who had multiple stones, staghorn calculi and metabolic disorders such as hypercalciuria also had a high incidence. Patients who received medical treatment for the prevention of stone recurrence had a lower recurrence rate than the group not treated. Especially among the patients with hypercalciuria, the recurrence rate of stone disease in the treatment group was significantly lower than that in the group not treated.(ABSTRACT TRUNCATED AT 250 WORDS)