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 Table of Contents  
ORIGINAL ARTICLE
Year : 2014  |  Volume : 9  |  Issue : 3  |  Page : 113-116

Evaluation of calcium oxalate stones size using kidney, ureters and bladder, fluoroscopy and post lithotripsy procedures


1 Department of Diagnostic Radiologic Technology, College of Medical Radiologic Science, Sudan University of Science and Technology, Khartoum, Sudan
2 Department of Diagnostic Radiologic Technology, College of Medical Radiologic Science, Sudan University of Science and Technology, Khartoum; Department of Diagnostic Radiologic Technology, College of Medical Applied Sciences, Taibah University, Tayba, Medina, Saudi Arabia
3 Department of Diagnostic Radiologic Technology, College of Medical Applied Sciences, Taibah University, Tayba, Medina; Faculty of Radiological Sciences and Medical Imaging, Alzaeim Alazhari University, Khartoum, Sudan
4 Department of Diagnostic Radiologic Technology, College of Medical Radiologic Science, Sudan University of Science and Technology, Khartoum; Department of Diagnostic Radiologic Technology, College of Medical Applied Sciences, Taibah University, Tayba, Medina, Sudan

Date of Web Publication22-Jan-2015

Correspondence Address:
Mohammed Yousef
Department of Diagnostic Radiologic Technology, Taibah University College of Medical Radiologic Science, P.O. Box 1908, Khartoum
Saudi Arabia
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DOI: 10.4103/1858-5000.149833

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  Abstract 

Objectives: This study aimed to measure renal stone using different modality (kidney, ureters and bladder [K.U.B], fluoroscopy and intravenous urography [I.V.U]), to compare these three methods of measurements and to detect the variation of stones size after each lithotripsy shock for the same type of stones. Materials and Methods: A total of 26 patients males (19) and females (7) their age ranged between 18 and 70 years with renal stones, I.V.U, K.U.B were done for all cases. In Al Nelain Medical Centre, The size of renal stone was measured in K.U.B and I.V.U by using the Ruler exposure. Staghorn stones which were >4 cm needed >4 times of exposure to. Results: The findings were found to be that stone <1 cm can be measured but does not disintegrated by lithotripsy and most of the stones that were >1 cm were properly measured when using the fluoroscopy and were treated effectively after 2 nd time of the shock waves. Conclusion: This study concluded that the surface area, site, number of stones after extracorporeal shock wave lithotripsy (ESWL) could be detected using K.U.B, I.V.U and fluoroscopy, and could help in prospective selection of patients who will respond well to ESWL.

Keywords: Fluoroscopy, lithotripsy, oxalate, renal stone


How to cite this article:
Ayad CE, Yousef M, Gamaraldin M, Omer FA, Abdalla NM, Babiker SH, Alhassan AF, Hessain NA, Habeeb MH, AbdAlmalik O. Evaluation of calcium oxalate stones size using kidney, ureters and bladder, fluoroscopy and post lithotripsy procedures. Sudan Med Monit 2014;9:113-6

How to cite this URL:
Ayad CE, Yousef M, Gamaraldin M, Omer FA, Abdalla NM, Babiker SH, Alhassan AF, Hessain NA, Habeeb MH, AbdAlmalik O. Evaluation of calcium oxalate stones size using kidney, ureters and bladder, fluoroscopy and post lithotripsy procedures. Sudan Med Monit [serial online] 2014 [cited 2018 Feb 16];9:113-6. Available from: http://www.sudanmedicalmonitor.org/text.asp?2014/9/3/113/149833


  Introduction Top


Urolithiasis is a problem that has confronted clinicians since the time of Hippocrates, and many family physicians have extensive experience in its clinical management. The prevalence of urolithiasis is approximately 2-3% in the general population, and the estimated lifetime risk of developing a kidney stone is about 12% for white males. [1] Approximately, 50% of patients with previous urinary calculi have a recurrence within 10 years. [2]

In the United States, the prevalence of kidney stones has risen over the past 30 years. [3] Eleven percent of men and 5.6% of women, will have a stone by 70 years of age; the risk is about 3 times higher in Caucasians than African Americans. About 80% of stones are composed of calcium oxalate with variable amounts of calcium phosphate. Diagnosis of a calcium stone requires analysis after passage or removal of the stone. After the first stone, the risk of recurrence is 40% by 5 years, and 75% by 20 years. Among recurrent calcium stone formers (e.g. those in the placebo arms of randomized controlled trials of interventions), 43-80% formed new stones within 3 years. [4],[5],[6],[7],[8],[9],[10],[11] Hospitalizations, surgery, and lost work time due to stones cost over $5 billion yearly in the United States. [12] Stone formation is associated with increased rates of chronic kidney disease and hypertension, [13],[14] which are not completely explained by obesity, a risk factor for each of these conditions. [15] Although many inherited and systemic diseases are associated with calcium kidney stones. [16]

Extracorporeal shock wave lithotripsy, which was first conducted in Germany during 1980, is a noninvasive treatment of renal stone disintegration by shock waves, with a high success rate and approximately 90%. [1] The mechanism dependent on the destruction the stone in small pieces to become easy to bass outside the body by the ureter in renal stone or by common bile duct in gall stone. [17]

Before the procedure of lithotripsy, the patient must do intravenous urography (I.V.U) or kidney, ureters and bladder (K.U.B) or ultrasound for kidney to measure stone size and localize the stone.

This study aimed to measure renal stone using K.U.B and fluoroscopy to compare between the three methods for measurement and to detect the variation of size after each shock for the same type of the stone and correlate for each reading the age of the study population was categorized in six groups as shown in [Figure 1].
Figure 1: A frequency of cases according to age (from researcher source)

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  Materials and methods Top


Equipments

Fluoroscopy machine: C-arm, and two Conventional machine: Major types of machines made by Toshiba Company- maximum MA is 500, maximum KV is 150-minimum MA is 50-minimum.

Methods

A total of 26 patients males (19) and females (7) their age ranged between 18 and 70 years with renal stones, I.V.U, K.U.B were done for all cases [Table 1]. In Al Nelain Medical Centre.
Table 1: Patients sex, age and the size using different radiological examination (K.U.B, I.V.U and fluoroscopy) among the study population


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Measurement procedure

The size of renal stone was measured in K.U.B and I.V.U by using a ruler.


  Results Top


The study population composed of 19 males and 7 females who complicated renal stones (calcium oxalate). Statistical tests were used to analyze the data which presented in tables and figures. The confidence interval selected value (P-value) was 5%, values less than 5% were considered to be significant.


  Discussion Top


This research aim to measure renal stone using (K.U.B, I.V.U and fluoroscopy), to compare between the three methods for measurement and to detect the variation of size after each shock for the same type of the stone and correlate for each reading. A group of 26 patients were selected with different sex and ages between 18 and 70 years old, complained of renal stones that were analyzed as calcium oxalate type. The radiological investigations which were done to measure the size of renal stones were K.U.B with which the sizes of stones detected measuring (1.2-4 cm), I.V.U which is similar to K.U.B and fluoroscopy which is different from K.U.B and I.V.U and the of stones size detected between (1.8 and 6 cm). The relationship between frequency of occurrence of renal stones and different ages of patients which was shown in [Table 2], as being as follows: (10-20 years) its frequency was 2, (20-30 years) its frequency was also 2, (30-40 years) its frequency was 4, (40-50 years) its frequency was also 4, (50-60 years) its frequency was 8, (60-70 years) its frequency was 6. The occurrence of renal stones is common in the ages between 50 and 60 years for different patient's sex. The ability of formation of renal stones is more common in males (19 patients) than females (7 patients) as [Table 3] showed. In [Table 2] shows ten patients with different size of stones (4.9-2.6 cm), ages (25-65 cm) and sex (7 males and 3 females). These patients have done different numbers of procedures, the number of cases which need one procedure was one case, two procedures were five cases, three procedures were zero, four procedures were four cases (the stag horn stone which is approximately 4 cm was observed to be decrease about 1 cm after each procedure).
Table 2: The relation between size of stones and number of ESWL procedures among the study population


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Table 3: The mean and SD and significant value of the selected sample among the study population


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  Conclusion Top


The measurement of the renal stone using K.U.B, I.V.U and fluoroscopy and to use the fluoroscopy as excellent detection modality to measure the stone size, for further studies ultra sound can be used to measure the stone size.

 
  References Top

1.
Menon M, Parulkar BC, Drach GW. Urinary lithiasis: Etiology, diagnosis and medical management. In: Walsh PC, editors. Campbell's Urology. 7 th ed. Philadelphia: Saunders; 1998. p. 2661-733.  Back to cited text no. 1
    
2.
Uribarri J, Oh MS, Carroll HJ. The first kidney stone. Ann Intern Med 1989;111:1006-9.  Back to cited text no. 2
    
3.
Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC. Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int 2003;63:1817-23.  Back to cited text no. 3
    
4.
Borghi L, Meschi T, Guerra A, Novarini A. Randomized prospective study of a nonthiazide diuretic, indapamide, in preventing calcium stone recurrences. J Cardiovasc Pharmacol 1993;22 Suppl 6:S78-86.  Back to cited text no. 4
    
5.
Ettinger B, Pak CY, Citron JT, Thomas C, Adams-Huet B, Vangessel A. Potassium-magnesium citrate is an effective prophylaxis against recurrent calcium oxalate nephrolithiasis. J Urol 1997;158:2069-73.  Back to cited text no. 5
    
6.
Ettinger B, Citron JT, Livermore B, Dolman LI. Chlorthalidone reduces calcium oxalate calculous recurrence but magnesium hydroxide does not. J Urol 1988;139:679-84.  Back to cited text no. 6
    
7.
Ettinger B, Tang A, Citron JT, Livermore B, Williams T. Randomized trial of allopurinol in the prevention of calcium oxalate calculi. N Engl J Med 1986;315:1386-9.  Back to cited text no. 7
    
8.
Laerum E, Larsen S. Thiazide prophylaxis of urolithiasis. A double-blind study in general practice. Acta Med Scand 1984;215:383-9.  Back to cited text no. 8
    
9.
Barcelo P, Wuhl O, Servitge E, Rousaud A, Pak CY. Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J Urol 1993;150:1761-4.  Back to cited text no. 9
    
10.
Hofbauer J, Höbarth K, Szabo N, Marberger M. Alkali citrate prophylaxis in idiopathic recurrent calcium oxalate urolithiasis - A prospective randomized study. Br J Urol 1994;73:362-5.  Back to cited text no. 10
    
11.
Fernández-Rodríguez A, Arrabal-Martín M, García-Ruiz MJ, Arrabal-Polo MA, Pichardo-Pichardo S, Zuluaga-Gómez A. The role of thiazides in the prophylaxis of recurrent calcium lithiasis. Actas Urol Esp 2006;30:305-9.  Back to cited text no. 11
    
12.
Saigal CS, Joyce G, Timilsina AR, Urologic Diseases in America Project. Direct and indirect costs of nephrolithiasis in an employed population: Opportunity for disease management? Kidney Int 2005;68:1808-14.  Back to cited text no. 12
    
13.
Rule AD, Bergstralh EJ, Melton LJ 3 rd , Li X, Weaver AL, Lieske JC. Kidney stones and the risk for chronic kidney disease. Clin J Am Soc Nephrol 2009;4:804-11.  Back to cited text no. 13
    
14.
Madore F, Stampfer MJ, Rimm EB, Curhan GC. Nephrolithiasis and risk of hypertension. Am J Hypertens 1998;11:46-53.  Back to cited text no. 14
    
15.
Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA 2005;293:455-62.  Back to cited text no. 15
    
16.
Coe FL, Evan A, Worcester E. Kidney stone disease. J Clin Invest 2005;115:2598-608.  Back to cited text no. 16
    
17.
Fiebach H, Kern E, Thomas A, Ziegelstein C. Urinary Stones. Principles of Ambulatory Medicine. 7 th ed. Philadelphia: Lippincott Williams and Wilkins; 2007. p. 754-66.  Back to cited text no. 17
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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Introduction
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