The impact of metabolic risk management on recurrence of urinary stones

Abstract

Introduction: Urinary stone disease is a common urologic problem and recurrence in stone formation is a very familiar issue to urologists. Although recurrence in stone formation has been linked to metabolic abnormalities, it can be accessible by metabolic risk analysis studies. Methods: Herein, we present our experience in metabolic risk management on recurrence of urinary stones for 10 years in Akdeniz University School of Medicine department of Urology. We retrospectively analyzed Akdeniz University Urinary Stone Database between dates of January 2000 and December 2010. We found over 3500 patients who were managed by SWL (shock wave lithotripsy) or PCNL (percutaneus nephrolithotripsy) or URS (Ureterorenoscopic lithotripsy) or open surgery. Results: 525 patients’ metabolic risk analysis was ordered due to recurrent urinary stone disease. Only 134 (25.5 %) current metabolic analysis were returned. Mean patient age was 32.2 years (range: 19-82 years). Patients were 103 male and 31 female. Stone analysis results were CaOx monohydrate in 48 (35.8 %), CaOx dihydrate in 8 (5.9 %), CaOx mono and dihydrate in 70 (52.2 %), uric acid in 3, CaOx monohydrate and uric acid in 2, cystine in 2, and struvite in 1 patient, respectively. The metabolic risk analysis showed some abnormality in 54 (40.2 %) patients. Conclusion: Although compliance to metabolic risk analysis studies is low among recurrent urinary stone formers, some significant metabolic abnormalities could be detected in those who are effectively screened. Recurrence of urinary stones in patients who are started on appropriate metabolic management can be prevented.

Keywords

• Metabolic analysis
• PCNL
• Stone management
• SWL
• URS.