[Clinical and epidemiological studies on urolithiasis in Ilan]

Clinical and epidemiological studies were performed on 1,184 cases of urolithiasis treated in the Department of Urology, Poh Ai Hospital. The incidence of urolithiasis was 147/100,000 population in 1991. The highest incidence was found in patients in their 50s. The male to female ratio was 2.9:1. There were 895 cases with single stones, and 289 cases with multiple stones. The ratio of upper to lower urinary tract stones was 13.6:1. Among the hospitalized patients, 673 cases (56.8%) underwent surgical treatment and 511 cases (43.2%) received conservative treatment with spontaneous stone passage. Among 1071 cases of upper urinary tract calculi, 567 cases (52.9%) underwent surgical treatment: 236 cases (41.6%) were treated by endoscopic surgery, 176 cases (31.0%) were treated by open-surgery and 131 cases (23.1%) by extracorporeal shock wave lithotripsy. Among 79 cases of lower urinary tract calculi, 75 cases (94.9%) were treated surgically: 68 cases (90.7%) by transurethral endoscopic surgery and 7 cases (9.3%) by cystolithotomy. According to analysis of 365 stones, the most frequent type was calcium-containing stones (92.3%). Pyuria was noted in 250 out of 1,086 (23.0%) cases. Bacteriuria was noted in 202 out of 914 (22.1%) cases. Concerning organisms isolated from the urine, Staphylococcus epidermidis was found most frequently (55/202). Stone patients increased in number during the summer season (July and August). Systematic questionnaires completed by the patients with urolithiasis, lead us to the following conclusions: 1) 50.7% (216/438) of patients gave a past history of urolithiasis, and 2) family histories showed that males whose siblings had urolithiasis were at the highest risk of uolithiasis, followed by those whose fathers had a history of urolithiasis.