The problem of renal lithiasis in an orthopedic hospital

ABSTRACT

As will be noticed, cases 5 and 8 although presenting the typical symptoms of renal colic, did not show any stone either by X-ray or cystoscopy; but the urine was positive for red cells. It is possible that the stone or stones were radio-transparent or had escaped the notice of the patient. In the consideration of the etiologic factors concerning the frequency of the formation of renal calculus in bedridden patients, several factors are believed to come into play 1. Posture predisposes to stasis, so that some of the urine is retained in the renal calyces. It is well known that stasis favors the formation of stone2. Toxemia. In our cases toxemia arising from chronic suppuration might give rise to some calcium plaques of Randall which might well serve as the nidus of a stone in the renal papilla3. Disturbance in the calcium and phosphorus metabolism without hyperparathyroidism. The orthopedic surgeon in quite aware of the increased demineralization of bones following injury and immobilization. This is shown by X-ray studies of the affected limbs, as well as studies of the calcium and phosphorus content of the urine which is usually increased4. A fourth factor is the inadequate nursing service. The lack of personnel to help bedridden patients change their positions was badly felt. Some of the patients had to forego drinking a sufficient amount of water because there was no one to supply them with it. The withholding of urination on account of insufficient help was also a strong factorThe factor of infection in the urinary tract probably was not an important factor in our cases. (Discussion)