Research Article
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Are There Any Predictive Findings for Surgical Intervention Need in Urinary System Stones?

Year 2019, Volume: 16 Issue: 1, 93 - 96, 22.03.2019

Abstract

Background:Renal colic is a frequently encountered urologic emergency condition,
that often develops due to kidney stone disease, manifests itself with severe
pain, which prompt patients to admit emergency departments where it is usually
diagnosed and treated. Most of the patients report a history of urinary stone
disease or renal colic. In the present study, we aimed to investigate the
factors that can predict the diagnosis and the need for intervention in those
patients admitted with renal colic.

Methods:

Patients who were admitted to the
emergency department and urology outpatient clinic of our hospital between May
2016 and June 2018 with the complaints of unilateral or bilateral side pain,
abdominal pain, inguinal pain were reviewed retrospectively and patients who
were suspected of renal colic were examined and included in the study. Physical
examination findings, family history, history and pain scores of the patients
were reviewed. Complete urinalysis was done and computed tomography (CT) was
performed on patients suspected of having stones. Patients diagnosed with stone
disease by CT were divided into two groups according to the criteria of having
any need for intervention or not.  Group
I consisted of those patients who required surgical intervention due to stone
while Group II consisted of the patients without stones or with stones that
need no intervention other than medical treatment.



Results:A total of 516 patients were included in the study. The mean age was found as 41,17 ± 20,8 years in group 1 and 36,08
± 18,8 years in group 2. The
male/female ratio was 112/60 in group 1 and 200/144 in group 2. As the result
of the study, the presence of microscopic hematuria, familial history of stone,
history of stone and history of stone operation were found to be predictive
factors in determining the need for intervention due to urinary stone disease,
in multiple analysis.

Conclusions: The presence of familial history of stones, the presence of microscopic
hematuria in complete urinalysis and the presence of a stone history may be
used for predicting the need for interventions due to stones in those patients
admitted to the emergency departments or outpatient clinics.

References

  • 1- Ahmad NA, Ather MH, Rees J: Unenhanced helical computed tomography in the evaluation of acute flank pain. Int J Urol 2003;10:287.
  • 2- Portis A, Sundaram C. Diagnosis and Initial Management of Kidney Stones. Am Fam Physican 2001;63:1329-38.
  • 3- Müslümanoğlu AY, Tepeler A. Renal kolik tanı ve tedavisi. Marmara medikal journal 2008; 21(2):187-192.
  • 4- Shokeir AA. Renal colic: pathophysiology, diagnosis and treatment. Eur Urol 2001;39: 241-249.
  • 5- Eskelinen M, Ikonen J, Lipponen P: Usefulness of history-taking, physical examination and diagnostic scoring in acute renal colic. Eur Urol, 1998; 34:467.
  • 6- Walsh PC, Retik AB, Vaughan ED Jr, Wein AJ(Editors). Campbell's Urology. In: Menon M, Resnick MI. Urinary lithiasis: etiology, diagnosis, and medical management. 8th Edition, Philadelphia, Saunders, 2002:3227-92.
  • 7- Duran L, Acar E, Çelenk Y, Karaca A, Yavuz Y. Evaluation of Patients Presenting with Renal Colic in Emergency Department. Kocatepe Medical Journal 2014;15(3):274-8.
  • 8- Türk H, Ün S. Predictive factors for stone disease in patients with renal colic. Archivio Italiano di Urologia e Andrologia 2017; 89:2.
  • 9- Temeltas G, Asan Ç, Müezzinoğlu T, Büyüksu C. An evaluation of the efficacy of lornoxicam in acute renal colic treatment. İnönü Üniversitesi Tıp Fakültesi Dergisi 2008;15(1):1-3.
  • 10- Akıncı H. Karabük devlet hastanesine basvuran ürolojik acil olguların analizi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2009;35(1):17-20.
  • 11- Aktas C, Yencilek E, Ay D, et al. Comparison of computerized spiral tomography with ultrasonography for detection of ureteral calculi. Türkiye Acil Tıp Dergisi 2010;10(1):12-4.
  • 12- Yiğit Ö, Isık S. Seasonal distribution of renal colic visits to emergency department. Türkiye Acil Tıp Dergisi 2008;8(3):110-3.
  • 13- Federle M, Fishman E, Jeffrey B, Anne V. Pocket radiolologist- abdominal. 2nd ed. Salt Lake City: Amirsys-W.B.Saunders, 2003; 305-7.
  • 14- Serinken M, Karcıoğlu Ö, Türkçüer Ġ, Özkan HĠ, Keysan MK, Bukiran A. Analysis of clinical and demographic characteristics of patients presenting with renal colic in the emergency department. BMC Research Notes 2008; 1:79.
  • 15- Marcia L. Edmonds, MD, MSc; Justin W. Yan, MD; Robert J. Sedran, MD, MSc; Shelley L.McLeod, MSc; Karl D. Theakston, MD, MSc. The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients. CJEM 2010; 12(3).
  • 16- Pearle MS, Calhoun EA, Curhan GC. Urologic Diseases of America Project. Urologic diseases in America project: urolithiasis. J Urol 2005; 173: 848-57.
  • 17- Scales CD Jr, Curtis LH, Norris RD, Springhart WP, Sur RL, Schulman KA, et al. Changing gender prevalence of stone disease. J Urol 2007;177: 979-82.

Üriner Sistem Taşı İçin Girişim Gereksinimini Öngören Faktörler Var Mıdır?

Year 2019, Volume: 16 Issue: 1, 93 - 96, 22.03.2019

Abstract


Amaç: Renal kolik, sıklıkla böbrek taş hastalığına bağlı olarak gelişen, acil
servislerde tanı ve tedavisi yapılan, şiddetli ağrı ile kendini gösteren, sık
karşılaşılan ürolojik acil bir durumdur. Hastaların birçoğunda üriner sistem
taş hastalığı veya renal kolik geçirme öyküsü vardır. Bu çalışmamızda, renal
kolik ile başvuran hastaların tanısı ve patolojiye yönelik girişim
gereksinimini predikte eden faktörleri incelemeyi amaçladık.

Materyal ve metod: Mayıs 2016 ile Haziran 2018 tarihleri arasında acil servise ve üroloji
polikliniğine tek ya da iki taraflı yan ağrısı, karın ağrısı, kasık ağrısı
şikayeti ile başvuran ve renal kolik olduğu şüphelenilen hastalar retrospektif
olarak incelenerek çalışmaya dahil edildi. Hastaların fizik muayene bulguları,
aile öyküsü, özgeçmişi ve ağrı skorları sorgulandı. Tam idrar tetkiki ve taş
şüphesi olan hastalara bilgisayarlı tomografi çekildi. Taş hastalığı olup
olmadığı BT ile ortaya konan hastalar girişim gereksinimi olup olmamasına göre
iki gruba ayrıldı. Grup I, taş nedeniyle girişim gerektiren hastalardan, Grup
II, taşı olmayan veya taşı olup medikal tedavi dışında girişim gerektirmeyen
hastalardan oluşmakta idi.

Bulgular: Çalışmaya 516 hasta dahil edildi. Grup 1 de yaş ortalaması 41,17±20,8, grup 2 de yaş
ortalaması
36,08±18,8 olarak tespit
edildi. Grup 1 de erkek/kadın oranı 112/60, grup 2 de 200/144 olarak bulundu.
Bu bulguların sonucuna göre mikroskopik hematüri varlığı, ailede taş öyküsü
varlığı, özgeçmişte taş öyküsü ve taş operasyon öyküsü varlığı  çoklu analizde üriner sistem taş hastalığına
bağlı girişim gereksinimini tespit etmede prediktif faktörler olduğu görüldü.

Sonuç:

Acil
servise veya polikliniğe yan ağrısı ile başvuran hastalarda ailede taş
öyküsünün olması, tam idrar analizinde mikroskopik hematüri varlığı ve taş
öyküsünün varlığı taş hastalığına bağlı girişim gereksinimini öngörmede
kullanılabilir.




References

  • 1- Ahmad NA, Ather MH, Rees J: Unenhanced helical computed tomography in the evaluation of acute flank pain. Int J Urol 2003;10:287.
  • 2- Portis A, Sundaram C. Diagnosis and Initial Management of Kidney Stones. Am Fam Physican 2001;63:1329-38.
  • 3- Müslümanoğlu AY, Tepeler A. Renal kolik tanı ve tedavisi. Marmara medikal journal 2008; 21(2):187-192.
  • 4- Shokeir AA. Renal colic: pathophysiology, diagnosis and treatment. Eur Urol 2001;39: 241-249.
  • 5- Eskelinen M, Ikonen J, Lipponen P: Usefulness of history-taking, physical examination and diagnostic scoring in acute renal colic. Eur Urol, 1998; 34:467.
  • 6- Walsh PC, Retik AB, Vaughan ED Jr, Wein AJ(Editors). Campbell's Urology. In: Menon M, Resnick MI. Urinary lithiasis: etiology, diagnosis, and medical management. 8th Edition, Philadelphia, Saunders, 2002:3227-92.
  • 7- Duran L, Acar E, Çelenk Y, Karaca A, Yavuz Y. Evaluation of Patients Presenting with Renal Colic in Emergency Department. Kocatepe Medical Journal 2014;15(3):274-8.
  • 8- Türk H, Ün S. Predictive factors for stone disease in patients with renal colic. Archivio Italiano di Urologia e Andrologia 2017; 89:2.
  • 9- Temeltas G, Asan Ç, Müezzinoğlu T, Büyüksu C. An evaluation of the efficacy of lornoxicam in acute renal colic treatment. İnönü Üniversitesi Tıp Fakültesi Dergisi 2008;15(1):1-3.
  • 10- Akıncı H. Karabük devlet hastanesine basvuran ürolojik acil olguların analizi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2009;35(1):17-20.
  • 11- Aktas C, Yencilek E, Ay D, et al. Comparison of computerized spiral tomography with ultrasonography for detection of ureteral calculi. Türkiye Acil Tıp Dergisi 2010;10(1):12-4.
  • 12- Yiğit Ö, Isık S. Seasonal distribution of renal colic visits to emergency department. Türkiye Acil Tıp Dergisi 2008;8(3):110-3.
  • 13- Federle M, Fishman E, Jeffrey B, Anne V. Pocket radiolologist- abdominal. 2nd ed. Salt Lake City: Amirsys-W.B.Saunders, 2003; 305-7.
  • 14- Serinken M, Karcıoğlu Ö, Türkçüer Ġ, Özkan HĠ, Keysan MK, Bukiran A. Analysis of clinical and demographic characteristics of patients presenting with renal colic in the emergency department. BMC Research Notes 2008; 1:79.
  • 15- Marcia L. Edmonds, MD, MSc; Justin W. Yan, MD; Robert J. Sedran, MD, MSc; Shelley L.McLeod, MSc; Karl D. Theakston, MD, MSc. The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients. CJEM 2010; 12(3).
  • 16- Pearle MS, Calhoun EA, Curhan GC. Urologic Diseases of America Project. Urologic diseases in America project: urolithiasis. J Urol 2005; 173: 848-57.
  • 17- Scales CD Jr, Curtis LH, Norris RD, Springhart WP, Sur RL, Schulman KA, et al. Changing gender prevalence of stone disease. J Urol 2007;177: 979-82.
There are 17 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Erkan Arslan 0000-0002-3262-2512

Eyyüp Sabri Pelit 0000-0002-3262-2512

Publication Date March 22, 2019
Submission Date December 24, 2018
Acceptance Date January 31, 2019
Published in Issue Year 2019 Volume: 16 Issue: 1

Cite

Vancouver Arslan E, Pelit ES. Are There Any Predictive Findings for Surgical Intervention Need in Urinary System Stones?. Harran Üniversitesi Tıp Fakültesi Dergisi. 2019;16(1):93-6.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty