A 5-Year Review of the Presentation and Management of Urolithiasis in a Nigerian Teaching Hospital

Abstract

Introduction: Urolithiasis has afflicted humans since centuries dating back to 4000BC, with the disease prevalence differing in various parts of the world. Contrary to earlier studies that depicted urinary stone disease as rare in Nigeria, recent reports have shown an increasing incidence. We aim to document the pattern and management of urinary tract calculi seen at the Lagos State University Teaching Hospital, Ikeja, Nigeria. Patients and Methods: We retrospectively reviewed the cases of urolithiasis managed at Lagos State University Teaching Hospital, Ikeja, Nigeria between January 2012 and December 2016. Variables analyzed were patients' age, gender, presenting symptoms, investigations and modalities of treatment. Results: The clinical records of a total of seventy-six patients treated for urinary stone disease within the 5-year study period were available for review. The ages of the patients ranged from 2 years to 84 years with a mean age of 49.13 ± 16.27 years. The male to female ratio was 1.8:1. While the urinary bladder was the commonest site of the stone amongst our patients (n=37, 48.7%), 4 (5.3%) were found at multiple sites. All the patients had abdominal ultrasound and 57.9% had, in addition, a computerized tomography (CT) urography. Majority, (53.9%) were treated by open surgery. There was no statistically significant impact of gender on disease presentation (P=0.167) or treatment (P=0.8381). However the patients who had surgical treatment were significantly older than those who were treated conservatively (P=0.033). Conclusion: Urolithiasis in our region has become more common, mimicking the increasing prevalence reported in the West. Most of the cases of urinary tract stones are still successfully managed by open surgery and thus open stone surgery should be considered as a valid alternative to endourologic management techniques in resource poor regions lacking endoscopic facilities.