Patients preference in the management of urinary stone disease

ABSTRACT

To assess patients' preference in choosing modality of treatment for the urinary stone disease. 100 consecutive patients with urinary stone disease were interviewed through self designed questionnaire. Following parameters were evaluated presentation, biochemical and radiological investigations, previous treatment, patient's preference in choosing modality of treatment [hakeem, homeopathy, allopathy and spiritual treatment], duration of treatment and cost. Ultimate management of patients was also assessed. Mean age of the patients were 38.43 years. There were 61 males and 39 females. Mean duration of illness was 4.3 years. Mean stone size was 3.83 cm. Seventy six patients had kidney stones, four patients were with ureteric stones, eleven patients had bladder stones and twelve patients had bilateral renal stones. Seven patients were in renal failure due to stones. First priority was hakeem/ quacks in 45%, allopathic in 39%, homeopathic in 17% and spiritual treatment in 03% patients. Mean cost of treatment of different modalities was as follows Allopathic Rs 4,530/-, Homeopathic Rs 2,747/-, Hakeem Rs 2,427- and Spiritual Rs 907/-. Fifty five patients underwent pyelolithotomy, 10 patients percutaneous nephrolithitomy [PNL], eleven patients Nephrectomy, 4 patients ureteroscopic removal of stone [URS], 11 patients Vesicolithotmy/Litholapaxy and 4 patients extracorporeal shock wave lithotripsy [ESWL]. Mean post-op stay was 10.5 days. In spite of recent advances in medical science, allopathy is not the first choice for vast majority of the patients in the management of urinary calculi. Our population is still under the influence of hakeems, quacks and homeopaths. Reasons are illiteracy, poverty, fear of surgery and negative propaganda through media. Patients with small stones requiring ESWL end up with major surgical procedures, like pyelolithotmies and nephrectomies. Some of them develop renal failure because of inappropriate management