Symptomatic Urinary Lithiasis: Epidemiology and Management at Urology Department of University Hospital of Cotonou

Abstract

Purpose: To study the epidemiology and treatment modalities of urolithiasis at Urology Department of University Hospital of Cotonou. Materials and Methods: It was a retrospective and descriptive study over a 10 years period ranging from January 1st, 2004 to December 31st, 2013. One hundred and two patients who were hospitalized for symptomatic urolithiasis at the Urology Department of University Hospital of Cotonou were enrolled. Results: Hospital incidence of urolithiasis was 3.7%. Patients mean age was 39.6 years (extremes: 10 years to 73 years). Male to female ratio was 2.2. The main reason for consultation was renal colic for 81 patients (79.4%). Average duration of symptoms at presentation was 5 months (range: 1 day to 10 years). A total of 173 stones were identified with an average size of 12 mm (range: 1 mm to 95 mm). Calyceal stones were seen in 32.9% of cases, renal pelvis stones in 21.4% of cases, ureteral stones in 34.1% and bladder stones in 11.5% of cases. Open surgery was the main treatment for stones that could not be managed medically. 50.8% of patients underwent surgery with extraction of 116 stones. This represented 67.1% of all stones. 9 patients (8.8%) had expelled their stone during urination. The postoperative course was uneventful in 77.5% of cases. Conclusion: Modern treatment options for urolithiasis remain rudimentary in our health facilities. Open surgery is still the main stay of treatment in our countries with limited resources.

<p>Urolithiasis: Presentation and Surgical Outcome at a Tertiary Care Hospital in Ethiopia</p>

“…This holds true in reports from our country and elsewhere. 2,5,9,11,13,16,25,29 In contrast to this, studies from USA, Japan and Nigeria found out that calculi are frequent in the 5th and 6th decade of life. 1,12,32 This variation may be explained by a difference in study subjects and geographic location.…”

“…11,[25][26][27] Furthermore, reports from other countries recognized urolithiasis among the major reasons of urologic surgical admission. 2,3,14 Worldwide, the estimated male to female ratio of urolithiasis ranges from 1.5 to 2.5:1. 7 Comparable with this, our study and others also confirmed urolithiasis as a male predominant disease.…”

“…Urolithiasis is defined as the formation or occurrence of stone(s) at any level of the urinary tract (kidney, ureter, bladder and urethra). [1][2][3][4][5] It is the third most common pathology affecting the urinary tract and it has been described since antiquity. [6][7][8][9][10] The incidence and prevalence of a urinary stone vary with geographic location, race, age, occupation, and sex.…”

“…[17][18][19] Despite the advancement of minimally invasive and noninvasive management of stone disease, which has become the gold standard treatment, open stone surgery remains the technique of choice in most developing countries. 2,3,16,20,21 This reflects the lack of trained professionals and endourologic instruments. 16,[22][23][24] As Ethiopia is a fast-growing, sub-Saharan Africa country, located near to the Afro-Asian stone belt, the burden is expected to be rising and becoming a public health issue.…”

Does chronic hyperglycaemia increase the risk of kidney stone disease? results from a systematic review and meta-analysis

“…The effect is marked in higher income countries, but is attenuated in lower-middle income countries 8 10. This may be attributable to lack of availability of prompt intervention in developing countries, leading to later presentation and invasive treatments including nephrectomy 59–61. Following surgical treatment, management to prevent recurrence is recommended,13 again this may not be available in developing countries.…”