Urinary stones in subjects with a permanent ileostomy

Area of Science:

• Urology
• Gastroenterology
• Nephrology

Background:

• Urinary stone (urolithiasis) prevalence is a concern in patients with permanent ileostomies.
• Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, often necessitates ileostomy surgery.
• Factors contributing to urolithiasis in ileostomists require further investigation.

Purpose of the Study:

• To determine the prevalence of urinary stones in patients with permanent ileostomies.
• To identify potential risk factors for urolithiasis in this patient group.
• To compare stone prevalence and risk factors between ileostomists with ulcerative colitis and Crohn's disease.

Main Methods:

• Intravenous urography was used to diagnose urinary stones in ileostomists.
• A control group of healthy subjects was matched for age and sex.
• Urinary parameters (volume, sodium, magnesium, pH) and serum uric acid levels were analyzed.

Main Results:

• Urinary stones were found in 10.3% of ileostomists with ulcerative colitis, with a higher prevalence (17.4%) in males.
• No urinary stones were detected in ileostomists with Crohn's disease.
• Ileostomists commonly exhibited reduced urinary volume, low urinary sodium and magnesium, low urinary pH, and were more prone to hyperuricemia compared to controls.

Conclusions:

• Ileostomists, especially those with a history of ulcerative colitis, have an increased risk of developing urinary stones.
• Hyperuricemia is strongly associated with the presence of urinary stones in ileostomists.
• Metabolic derangements such as low urinary volume and altered electrolyte concentrations may contribute to urolithiasis in this population.