sdü tıp fak derg Medical Journal of Süleyman Demirel University 2602-2109 Süleyman Demirel Üniversitesi Dentistry Diş Hekimliği Stone composition of urinary tract stones from our region Bölgemizdeki üriner sistem taþlarýnýn taþ içeriði Hoşcan Mustafa Burak Oksay Taylan Tunçkıran Ahmet Özorak Alper Ekinci Mehmet Arıkan Serap 03 30 2012 19 1 17 20 12 29 2010 Copyright © 1994, Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 1994 Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Objective: To evaluate the spectrum of urinary tract stone compositions in patients managed at one center.Methods: A total of 710 urinary calculi, passed spontaneously or after extracorporeal shock-wave lithotripsy as well as collected by endoscopic or open surgical procedures were analyzed by applying chemical and physicochemical methods primarily used for detecting minerals in our laboratory. Results: The distribution of stone compositions were noted as 454 (64.9%) calcium oxalate; 104 (14.6%) calcium phosphate; 99 (13.9%) struvite; 24 (3.3%) uric acid; 21 (2.9%) mixed; 5 (0.7%) cystine; and 3 (0.4%) xantine stones. Conclusion: Calcium stones, calcium oxalate in particular predominate among other types of urinary calculi in our center. Infection stones still have a considerable incidence that stays near to calcium phosphate calculi. This data can be helpful for dietary recommendations and treatment plans in cases without stone type assessment.

Amaç: Bölgemizde tedavi edilen üriner sistem taþ hastalarýnýn taþ kompozisyonunun spektrumunu deðerlendirmek. Metod: Ekstrakorporeal þok dalga litotripsi, endoskopik veya çeþitli açýk cerrahi yöntemleriyle elde edilenler ile hastalarýn kendi düþürdükleri toplam 710 üriner taþ, laboratuarda esas olarak mineralleri saptamak için kullanýlan kimyasal ve fizikokimyasal yöntemler kullanýlarak incelendi.Bulgular: Taþlarýn 454ü (%64.9) kalsiyum okzalat, 104ü kalsiyum fosfat (%14.6), 99u struvite (%13.9), 24ü ürik asit (%3.3), 21i karýþýk (%2.9), 5i (%0.7) sistin, 3ü ksantin (%0.4) idi. Sonuç: Bizim bölgemizde kalsiyum taþlarý, özellikle kalsiyum okzalat diðer taþ tipleri arasýnda daha fazla görülmektedir. Enfeksiyon taþlarý da kalsiyum fosfat taþlarýna yakýn seviyede belirgin bir insidansa sahiptir. Bu veriler taþ analizi deðerlendirmesi yapýlmamýþ hastalarda beslenme önerileri ve tedavi planlarý için yararlý olabilir.

 composition calcium oxalate urinary calculi içerik kalsiyum okzalat üriner taþ Trinchieri A. Epidemiology of urolithiasis. Arch Ital Urol Androl 1996;68:203–249. Ramello A, Vitale C, Marangella M. Epidemiology of nephrolithiasis. J Nephrol 2000;(13 suppl) 3:S45–S50. Bakane BC, Nagtilak SB, Patil B. Urolithiasis: a tribal scenario. Indian J Pediatr 1999;66:863–5. Aurora AL, Taneja OP, Gupta DN, et al. Bladder stone disease of childhood. I. An epidemiological study. Acta Paediatr Scand 1970;59: 177–84. Chandoke PS. Cost effectiveness of different treatment options for staghorn calculi. J Urol 1996;156:1567–71. Chen RN, Streem SB. Extracorporeal shock wave lithotripsy for lower pole calculi: long-term radiographic and clinical outcome. J Urol 1996;156:1572. Prein EL, Frondel C. Studies of urolthiasis. The composition of urinary calculi. J Urol 1947; 57: 980–79. Dajani A, Abu Khadra A, Baghdadi F. Urolithiasis in Jordanian children. A report of 52 cases. Br J Urol 1988;61:482–486. Yagisawa T, Hayashi T, Yoshida A, et al. Metabolic characteristics of the elderly with recurrent calcium oxalate stones. BJU Int 1999;83:924–928. Wootton IDP. Analysis of Calculi. In: Wooton IDP, ed. Microanalysis in Medical Biochemistry. London: Churchill Livingstone; 1974: 285–7. A s p e r R . S t o ne a n a l y s i s . U r o l R e s 1990;18(Suppl):S9-S12. Herring LC. Observations on the analysis of ten thousand urinary calculi. J Urol 1962;88:545-562. Daudon M, Jungers P. Clinical value of crystalluria and quantitative morphoconstitutional analysis of urinary calculi. Nephron Physiol 2004;98(2):31- 36. Otnes B. Crystalline composition of urinary stones in Norwegian patients. Scand J Urol Nephrol 1983;17(1):85-92. Leusmann DB, Blaschke R, Schmandt W. Results of 5,035 stone analyses: a contribution to epidemiology of urinary stone disease. Scand J Urol Nephrol 1990;24(3):205-210. Pietrow PK, Preminger GM. Evaluation and medical management of urinary lithiasis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA. Saunders; 2007:1408-1409. Pak CY, Poindexter JR, Adams-Huet B, et al: Predictive value of kidney stone composition in the detection of metabolic abnormalities. Am J Med 2003;115:26-32. Ansari MS, Gupta NP, Hemal AK, et al. Spectrum of stone composition: structural analysis of 1050 upper urinary tract calculi from northern India. Int J Urol 2005;12(1):12-6. Dretler SP, Polykoff G. Calcium oxalate morphology: fine tuning. J Urol 1996;1329: 828–33. Ison KT, Coptcoat MJ. Stone composition is no guide to strength: changing the direction of research? J Urol 1989;142:833–4. Daudon M, Donsimoni R, Hennequin C, et al. Sex and age related composition of 10,617 urinary calculi by infra red spectroscopy. Urol Res 1995;23:319–26. Rao MVR, Agawan JS, Tania OP. Studies in urolithiasis II: X-ray diffraction analysis of renal calculi from Delhi region. Indian J Med Res 1976;64:102. Ahlawat R, Goel MC, Elhence A. Upper urinary tract analysis using X-ray diffraction: results from tertiary referral center in North India. Natl Med J India 1996;9:10–2. Sharma RN, Shah I, Gupta S, et al. Thermogravimetric analysis of urinary stones. Br J Urol 1989;64:10–13. Kim KM. The stone. Scanning Electr Microsc 1982;4:1635–40. Graff J, Deiderichs W, Schultz H. Long-term follow-up in 1003 extracorporeal shock wave lithotripsy patients. J Urol 1988;140:479–83. Griffith DP. Struvite stone. Kidney Int 1978;13:372–82. Cohen-Solal F, Dabrowsky B, Boulou JC, et al. Automated Fourier transform infrared analysis of urinary stone: technical aspects and examples of procedures applied to carbapatite/weddellite mixture. Appl Spectrosc 2004;58:671–7. Scubert G. Urinary stone analysis. In: Rao NP, Preminger GM, Kavanagh JP, eds. Urinary Tract Stone Disease. London: Springer-Verlag Ltd; 2011: 341-354.