Patient Profile and Treatment Selection in Urolithiasis in Tertiary Hospital: A Retrospective Analysis

Abstract

Introduction. Urolithiasis remains a prevalent urological disorder, often leading to significant morbidity, burden and a high rate of recurrence . Multiple factors, including age, sex, stone location, imaging characteristics, urinalysis parameters, and urine culture findings, could play  crucial  roles in guiding therapeutic decisions. This study aims to analyze the relationships between urine pH, urine culture results, stone location and the selection of surgical interventions and stone compositions in patients diagnosed with urinary stones at Dr. Saiful Anwar General Hospital, Malang.

Methods. This retrospective study utilized medical records of patients diagnosed with urolithiasis in Dr. Saiful Anwar General Hospital between 2018 and 2024. The collected data included age, sex, stone location (renal, ureteral, vesical), stone image in NCCT, urinalysis parameters (pH, erythrocyte), urine culture results, stone composition, and surgical intervention. Descriptive analysis was conducted to characterize patient demographics and clinical profiles, while further statistical evaluation was performed to assess relationship between factors that determined stone composition and treatment selection using Chi Square or Fischer’s Exact Test.

Results. A total of 343 patients with urolithiasis met the inclusion criteria, among them, 71.1% were male with mean age of 52.75 ± 17.18 years, and 88.95% presented hematuria.   The most common stone composition was mixed calcium and  MAP (33.8%), most frequently presenting at multiple locations (45.1%). 311 patients had endourological procedures, PCNL (61.5%) as the management of choice. However, open surgery has been done in 22 (6.41%) patients with open surgery, most of whom have various locations of urolithiasis (59.0%). The results showed a significant relationship between stone location and treatment options (p < 0.001). In addition, there was a significant relationship between pH, urine culture and stone composition (p = 0.018; 0.034).

Conclusion. This study highlights that stone locations serve as valuable indicators in determining treatment strategies for urolithiasis patients. In addition, pH and urine culture serve as valuable indicators in determining stone composition. Further analysis is warranted to explore causal relationships between these factors and refine predictive models for personalized stone management.

Keywords: stone composition, treatment, urinary stone disease, urolithiasis