Hammad F T, Kaya M, Kazim E
Department of Urology, Dubai Hospital, Dubai, United Arab Emirates.
Urology. 2006 Jun;67(6):1154-8. doi: 10.1016/j.urology.2005.12.038.
Recent improvements in socioeconomic conditions have changed the clinical picture of urinary stones, including bladder calculi. With the ongoing changes in these predisposing factors, it is possible that the clinical picture of bladder calculi will show additional changes. Nevertheless, few contemporary series of bladder calculi in published English reports have addressed these issues.
We retrospectively reviewed the records of 328 patients who underwent surgical therapy for bladder calculi at our institution from January 1995 to June 2005.
Acute urinary retention was the most common presenting symptom (n = 221, 67%). Patients who presented with urinary retention were younger (37 versus 48 years, P <0.001), had a greater incidence of recent renal colic (40% versus 19%, P <0.01), and had a lower incidence of bladder outlet obstruction (14% versus 37%, P <0.001) compared with the nonretention group. However, previous stone passage did not influence the probability of presenting with urinary retention. Small bladder stones were associated with a greater likelihood of presenting with urinary retention. The retention group had greater incidence of stones less than 1 cm in diameter compared with the nonretention group (72% versus 39%, P <0.001). Finally, calcium oxalate was found in 78% of patients with bladder calculi.
Acute urinary retention was the main mode of presentation in patients with bladder calculi. Younger age, a history of recent renal colic, and smaller stones appeared to increase the likelihood for patients to present with urinary retention.
社会经济状况的近期改善已改变了包括膀胱结石在内的尿路结石的临床特征。随着这些诱发因素的持续变化，膀胱结石的临床特征可能会出现更多变化。然而，已发表的英文报告中很少有当代膀胱结石系列研究涉及这些问题。
我们回顾性分析了1995年1月至2005年6月间在我院接受膀胱结石手术治疗的328例患者的病历。
急性尿潴留是最常见的首发症状（n = 221，67%）。与无尿潴留组相比，出现尿潴留的患者更年轻（37岁对48岁，P <0.001），近期肾绞痛发生率更高（40%对19%，P <0.01），膀胱出口梗阻发生率更低（14%对37%，P <0.001）。然而，既往结石排出情况并不影响出现尿潴留的可能性。小膀胱结石与出现尿潴留的可能性更大相关。与无尿潴留组相比，尿潴留组直径小于1 cm的结石发生率更高（72%对39%，P <0.001）。最后，在78%的膀胱结石患者中发现了草酸钙。
急性尿潴留是膀胱结石患者的主要表现形式。年龄较小、近期有肾绞痛病史和结石较小似乎会增加患者出现尿潴留的可能性。
