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Urolithiasis: Presentation and Surgical Outcome at a Tertiary Care Hospital in Ethiopia

BACKGROUND: The prevalence of urolithiasis is on a rising trend in tropical and sub-Saharan African countries. The treatment options and data on the surgical outcome are limited in our country. This study was designed to assess the clinical presentation, surgical management and outcome of patients o...

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Autores principales: Mohammed, Seid, Yohannes, Binyam, Tegegne, Alemayehu, Abebe, Kirubel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737624/
https://www.ncbi.nlm.nih.gov/pubmed/33335863
http://dx.doi.org/10.2147/RRU.S284706
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author Mohammed, Seid
Yohannes, Binyam
Tegegne, Alemayehu
Abebe, Kirubel
author_facet Mohammed, Seid
Yohannes, Binyam
Tegegne, Alemayehu
Abebe, Kirubel
author_sort Mohammed, Seid
collection PubMed
description BACKGROUND: The prevalence of urolithiasis is on a rising trend in tropical and sub-Saharan African countries. The treatment options and data on the surgical outcome are limited in our country. This study was designed to assess the clinical presentation, surgical management and outcome of patients operated on for urolithiasis. PATIENTS AND MATERIALS: A retrospective study of all patients admitted and operated for urolithiasis at St. Paul’s hospital millennium medical college (SPHMMC) from July, 2016 to December, 2017 was conducted. Factors associated with surgical outcome were identified with binary logistic regression. RESULTS: Urolithiasis constituted 247 (30.0%) of 824 urologic admissions. Of these, 202 (Male:Female = 2:1) patients were investigated. The mean age was 37.1 ± 14.4 years (range, 10–85 years). The mean duration of illness was 16.7 ± 18.7 months and the commonest presenting symptom was isolated flank pain (97, 48.0%). A majority of the patients (186, 92.1%) had upper tract stones of which 96 (51.6%) were renal stones. More than two-thirds (164, 81.2%) of the patients had complications at presentation, and hydronephrosis (148, 73.3%) was the major one. Half of the patients (104, 51.5%) were treated with endoscopic procedures, 88 (43.6%) with open stone surgery and in 10 (4.9%) patients both were performed. Nephrectomy was done to 15 (7.4%) patients. Intraoperative and postoperative complications were noted in 16 (7.9%) and 26 (12.9%) patients, respectively. These complications were higher in patients with comorbid illness (AOR = 2.44; 95% CI 1.12–5.31; p = 0.024). Complete stone clearance was achieved in more than half of the clients (114, 61.0%). Multiple stones (AOR = 8.33; 95% CI 2.53–27.43; p < 0.0001) and endoscopic procedures (AOR = 4.17; 95% CI 1.57–10.71; p = 0.003) had significant association with incomplete stone clearance. CONCLUSION: Patients’ presentation in this review was not different from studies elsewhere. Endoscopic procedures are emerging in our set up; however, it was significantly associated with incomplete stone clearance. Strategies to improve outcome (stone clearance) need to be implemented accordingly.
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spelling pubmed-77376242020-12-16 Urolithiasis: Presentation and Surgical Outcome at a Tertiary Care Hospital in Ethiopia Mohammed, Seid Yohannes, Binyam Tegegne, Alemayehu Abebe, Kirubel Res Rep Urol Original Research BACKGROUND: The prevalence of urolithiasis is on a rising trend in tropical and sub-Saharan African countries. The treatment options and data on the surgical outcome are limited in our country. This study was designed to assess the clinical presentation, surgical management and outcome of patients operated on for urolithiasis. PATIENTS AND MATERIALS: A retrospective study of all patients admitted and operated for urolithiasis at St. Paul’s hospital millennium medical college (SPHMMC) from July, 2016 to December, 2017 was conducted. Factors associated with surgical outcome were identified with binary logistic regression. RESULTS: Urolithiasis constituted 247 (30.0%) of 824 urologic admissions. Of these, 202 (Male:Female = 2:1) patients were investigated. The mean age was 37.1 ± 14.4 years (range, 10–85 years). The mean duration of illness was 16.7 ± 18.7 months and the commonest presenting symptom was isolated flank pain (97, 48.0%). A majority of the patients (186, 92.1%) had upper tract stones of which 96 (51.6%) were renal stones. More than two-thirds (164, 81.2%) of the patients had complications at presentation, and hydronephrosis (148, 73.3%) was the major one. Half of the patients (104, 51.5%) were treated with endoscopic procedures, 88 (43.6%) with open stone surgery and in 10 (4.9%) patients both were performed. Nephrectomy was done to 15 (7.4%) patients. Intraoperative and postoperative complications were noted in 16 (7.9%) and 26 (12.9%) patients, respectively. These complications were higher in patients with comorbid illness (AOR = 2.44; 95% CI 1.12–5.31; p = 0.024). Complete stone clearance was achieved in more than half of the clients (114, 61.0%). Multiple stones (AOR = 8.33; 95% CI 2.53–27.43; p < 0.0001) and endoscopic procedures (AOR = 4.17; 95% CI 1.57–10.71; p = 0.003) had significant association with incomplete stone clearance. CONCLUSION: Patients’ presentation in this review was not different from studies elsewhere. Endoscopic procedures are emerging in our set up; however, it was significantly associated with incomplete stone clearance. Strategies to improve outcome (stone clearance) need to be implemented accordingly. Dove 2020-12-08 /pmc/articles/PMC7737624/ /pubmed/33335863 http://dx.doi.org/10.2147/RRU.S284706 Text en © 2020 Mohammed et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Mohammed, Seid
Yohannes, Binyam
Tegegne, Alemayehu
Abebe, Kirubel
Urolithiasis: Presentation and Surgical Outcome at a Tertiary Care Hospital in Ethiopia
title Urolithiasis: Presentation and Surgical Outcome at a Tertiary Care Hospital in Ethiopia
title_full Urolithiasis: Presentation and Surgical Outcome at a Tertiary Care Hospital in Ethiopia
title_fullStr Urolithiasis: Presentation and Surgical Outcome at a Tertiary Care Hospital in Ethiopia
title_full_unstemmed Urolithiasis: Presentation and Surgical Outcome at a Tertiary Care Hospital in Ethiopia
title_short Urolithiasis: Presentation and Surgical Outcome at a Tertiary Care Hospital in Ethiopia
title_sort urolithiasis: presentation and surgical outcome at a tertiary care hospital in ethiopia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737624/
https://www.ncbi.nlm.nih.gov/pubmed/33335863
http://dx.doi.org/10.2147/RRU.S284706
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