Etiology and pathogenesis in the causation of vesical calculus: a prospective study

Abstract

Background: Vesical calculus are the most common manifestation of lower urinary tract stones accounting for approximately 5% of all urinary stone diseases. In pediatric population bladder stones are most commonly due to malnutrition and poor socioeconomic factors. In adults they are most commonly associated with bladder outlet obstruction. In this context we study the different etiological factors and pathogenesis in the causation of vesical calculus.Methods: This is a prospective study that included 40 patients admitted with clinical diagnosis of vesical calculus at KR Hospital, Mysore from June 2016 to May 2017.Results: Maximum patients belong to age group of 51-60 years (30%) and minimum numbers belongs to age group of 1-10, 11-20 and 81-90 years age group. Male to female ration in present study is 5:1. In present study patients with bore well as source of water were highest in number i.e., 22 patients. Maximum number of patients i.e., 22 patients (55%) presented with history of pain abdomen and 15 patients (37.5%) with dysuria. Twenty-four patients (60%) had alkaline urine. Urine albumin was positive in 10 patients (25%), urine sugar was present in 8 patients (20%), pus cells were found in urine of 28 patients (70%) and RBCs were present in 24 patients (60). Klebsiella was the commonest organism isolated from the urine of 22 patients (55%) and E. coli was isolated in 8 patients (20%). Ultrasonography of abdomen and pelvis detected associated other conditions such as hydroureteronephrosis in 8 patients (20%), cystitis in 10 patients (25%) and benign prostatic hyperplasia in 20 patients (50%).Conclusions: Bladder calculi are most common in people of old age group indicating obstruction could be the cause for stone formation. They are rarely formed spontaneously. There must be an inciting event namely bladder outlet obstruction or infection to promote the stone formation.