Changes in Urinary Stone Composition in the Tunisian Population: A Retrospective Study of 1,301 Cases

BACKGROUND: Studies that evaluate the effect of age on stone composition are scarce. The aim of this study was to highlight the changes in epidemiological characteristics (stone composition and location) of urolithiasis according to patients' age. METHODS: We studied 1,301 urolithiasis patients with age ranging from 6 months to 92 yr (781 males and 520 females). Stone analysis was performed using a stereomicroscope and infrared spectroscopy to determine the morphological type and molecular composition of each stone. RESULTS: The annual average incidence of new stone formation was 31.7 per 100,000 persons. In 71.8% of cases, calculi were located in the upper urinary tract. Compared to other age groups, children and old men were more affected by bladder stones. Calcium oxalate monohydrate was the most frequent stone component, even though its frequency decreased with age (59.5% in young adults and 43.7% in the elderly, P<0.05) in favor of an increase in uric acid stones (11.5% in young adults and 36.4% in the elderly, P<0.05). Struvite stones were rare (3.8%) and more frequent in children than in adults. CONCLUSIONS: The analysis of these data showed that urinary stones in Tunisian patients are tending to evolve in the same direction as the stones in patients from industrialized countries.