Treatment of upper urinary tract calculi at the University Hospital of Conakry: retrospective analysis of 54 cases

ABSTRACT

To study the diagnostic and therapeutic aspects of upper urinary tract calculi at a hospital in Guinea taking into consideration the local working conditions. This retrospective study included 52 patients with a total of 54 urinary tract calculi treated between January 1, 1994 and December 31, 2003. The parameters studied included the presenting symptoms, the findings on clinical and laboratory investigations and the methods of treatment. The patients' mean age was 37.5 [range 13 - 76] years with a preponderance of the age group of 21 - 30 years, representing 26.9% [n = 14] of the cases. The male-to-female ratio was 103. The socio-economic groups most affected by upper urinary tract calculi were farmers and housewives. Pain was the most frequent presenting symptom seen in 92.3% of the patients. The average time between onset of symptoms and presentation was 35 months. Urine microscopy and culture revealed infection in 46 patients [88.5%]; organisms were isolated in 42 cases [80.8%], the majority were Proteus mirabilis, E. coli and Streptococci in 45.2%, 33.3% and 21.4% of the cases, respectively. Intravenous urography [IVU] helped in the diagnosis in 81.5% cases [n = 44]. Treatment consisted of surgery in 96.2% [n=50] of the patients, while 3.8% [n=2] were treated conservatively. After a mean follow-up of 34 months, the results are satisfactory with a pain- and stone-free rate of 82.7% [n=43]. The diagnosis of upper urinary tract calculi is easy. However, we have noted a considerable delay in treatment due to the lack of equipment in our technical environment leading to considerable morbidity and prolonged hospitalization of the patients