UROLITHIASIS IN THOSE PATIENTS WITH MYELODYSPLASIA

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  • 二分脊椎患者の尿路結石

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Abstract

(Objective) To evaluate incidence and treatments of urolithiasis in myelodysplastic patients.<br>Patients and methods: During the past 27 years 303 myelodysplastic patients, 160 men and 143 women, have been treated and 50 of them were operated on with bladder augmentation procedures. Their medical records were retrospectively reviewed.<br>(Results) Urolithiasis occurred 20 times in 15 patients, 11 men and 4 women, where calculi developed 18 times in the bladder and twice in the kidney. Prevalence of urolithiasis was 20% (10/50) in those who had undergone bladder augmentation and 2% (5/253) in those who had not had this surgery, where the difference was statistically significant between the two groups (p<0.01). Overall, 5% of all the patients suffered from stones in the urinary tract. Bladder calculi were endoscopically treated in 11 occasions or were resolved with suprapubic lithotomy in 4 cases. Small stones in the bladder were spontaneously delivered 3 times and extracorporeal shock wave lithotripsy (ESWL) was necessary for a renal calculus in one patient. The last patient having a renal stone has been put under care. Majority of stone compositions consisted of magnesium ammonium phosphate (MAP).<br>(Conclusion) It was found that urolithiasis was 10 times more prevalent in those patients operated on with enterocystoplasty than those without bladder augmentation and that intermittent clean catheterization and regular bladder irrigation were of necessity to prevent urolithiasis for those having enterocystoplasty.

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