[Comparative analysis of patients with primary episode of urinary stones disease and recurrent urolithiasis after ureteroscopic interventions].

Abstract

Actuality. The incidence of urinary stone disease (USD) of the Russian Federation population has increased by approximately in 34,1% with manifestation at the age of 40 to 50 years. There is a high probability of recurrence with up to 50% experiencing a recurrence within 5 years. Despite the existing advances in the field of metaphylaxis of USD, surgical reinterventions are still performed.

Materials and methods: A total of 300 patients with urolithiasis were performed ureteroscopic interventions at S.S. Yudin City Clinical Hospital between September 2021 and November 2022. Depending on the episode of calculus formation, patients were divided into two groups - 184 (61.3%) patients with a first episode of USD and 116 (38.7%) cases of recurrence urolithiasis. All patients underwent multispiral computed tomography without the introduction of a contrast agent. To assess pain in renal colic, a visual analogue scale, a numeric pain rating scale and a faces pain scale were used.

Results: The median duration of surgery was 30 min in group 1 and 40 min in group 2. Long-term drainage of the urinary tract after removal of the calculus with internal ureteral stent was in 45 (24.5%) individuals of group 1 and in 43 (37.1%) individuals in group 2. Complications were assessed using PULS (Postureteroscopic Lesion Scale), Satava scale and Clavien-Dindo classification. There were no complications in 98,4% cases in patients with a first episode of USD and in 93,1% in patients with recurrence urolithiasis (p=0,03) due to Clavien-Dindo classification, in 97,8% and 87,9 % respectively (p=0,0007) due to Satava scale. The median time period for stent removal in group 1 was 4 days, and for group 2 - 15 days.

Conclusion: Ureteroscopic surgeries for patients with recurrent urolithiasis were associated with an increased risk of complications that require long-term drainage and endoscopic reinterventions and hospitalizations. Low patient compliance leads to development of recurrence urolithiasis.