A Clinical Observation on Ureterolithiasis

Kim, Soung Sik; Min, Byung Kap

Abstract

A clinical study was made on 126 cases of ureterolithiasis during the 5 years period from January, 1976 to December, 1980. The following results were obtained. 1. The incidence of the patients with ureterolithiasis was 8.8% of the total inpatients. 2. There were 92 men and 34 women, a ratio of 2.7:1. The ages of the patients ranged from 18 to 72 years. showing the highest incidence in 21 to 50 years (74.6%). 3. The most frequent location of the ureteral calculi when first seen was the lower third of the ureter in 53.7% of the patients. The ureteral calculi were approximately equally frequent on the left and right sides and bilateral ureteral calculi were found in 4.8%. 4. The most common size of the ureteral calculi was 0.7-1.0 cm in the longitudinal diameter in 43 cases (34.1%). 5. The clinical symptoms of ureterolithiasis were flank pain in 94.4%, hematuria in 14.3%, referred pain in 9.5%, nausea and vomiting in 7.9%, frequency in 7.1% and fever with chillness in 7.1%. 6. Microscopic hematuria was found in 68.9%, pyuria in 27.1% and crystalluria in 15.6%. 7. Increased levels of BUN, creatinine, calcium and uric acid in serum were found in 18.4%, 8.3%, 1.2% and 10.3%, respectively. And leukocytosis was found in 25.5%. 8. Excretory urogram revealed mild hydronephrosis in 28.7%, moderate hydronephrosis in 21.8%, marked hydronephrosis in 10.3%. non-visualization in 11.5%, delayed visualization in 13.8% and nephrogram only in 6.9%. 9. Definite past history of urinary calculi was found in 14 cases (11.1%) and average duration of recurrence was 5.5 years. 10. Treatment consisted of surgical intervention in 71.4%, expectant therapy in 17.6%, instrumental manipulation in 2.4% and spontaneous passage in 8.7%. 11. Postoperative complications occurred in 6 cases (6.7%), i.e., a remnant stone with ureterocutaneous urinary leakage in 2 cases, wound infection in 2 cases, ureterocutaneous urinary leakage in 1 case. unimproved uremia in 1 case. 12. The chemical analysis of 42 ureteral calculi showed the mixed type of calcium oxalate and calcium phosphate in 10 cases (23.8%), calcium oxalate in 7 cases (16.7%),calcium phosphate in 6 cases (14.3%), the mixed type of calcium oxalate and calcium phosphate and magnesium phosphate in 6 cases (14.3%), the mixed type of calcium oxalate and calcium phosphate and uric acid in 3 cases (7.1 %). The major components of ureteral calculi were calcium phosphate and calcium oxalate.