The tendencies in diagnostics of urolithiasis and comparison of different radiologic methods in evaluation of renal stones

This study analyses clinical and radiologic imaging data of patients who had urinary tract stones diagnosed.A retrospective analysis of case histories of patients treated for urolithiasis at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics during years 2013-2014 was carried out. We analyzed and compared demographic distribution, symptoms that led to urolithiasis to being suspected, complications, most common microorganisms causing infections and radiologic findings, which included stone size, stone location, comparison of stone measurements in different modalities and postoperative data. The results: morbidity was similar between genders, however men were prone to urolithiasis at earlier age. The peak of morbidity for women was 60-79 years, for men it was at 50-69 years of age. Most common symptoms when urinary obstruction was suspected were flank pain(85,63%) and fever (28,75%). A positive Pasternacki's sign was present for 62,15% of patients. Stones were located in left urinary tract in 50,37% of cases, in 32,46% cases they were located in right urinary tract and in 17,16% of cases urolithiasis was bilateral. Most commonly the stones were found in middle or lower calices, renal pelvis and lower part of ureter. The chemical composition of stones was as follows: 84,78% had Calcium oxalates, 28,26% - Calcium hydrophosphates, 28.26% - Magnesium ammonium phosphate, 28.26% - uric acid, 13,04% - carbonates, 2,17% - cystine. The most common complications were hydronephrosis (79,11%) and pyelonephritis (27,55%), the most common cause of infection being escherichia coli (46,77%). CT, urograms and ultrasound had sensitivities of 100%, 82% and 54% respectively. Compared to postoperative measurements, stone sizes determined by urography had better correllation than those of ultrasound. No statistically significant relation between stone size determined by radiologic measurements and method of treatment or complications was found