Calculi In Patients Research Articles

Two pelvises, one stone: A different approach for management of calculi in a duplex renal collecting system

Duplex renal collecting systems are a common congenital abnormality. Management of renal calculi in patients with this abnormality is complex. We describe a patient with a duplex collecting system presenting with a renal calculus. Initial flexible ureteroscopy failed to reach the collecting system containing the stone due to inability to visualize an additional ureteric orifice. The patient then underwent percutaneous puncture of the stone containing moiety, followed by antegrade stent insertion. This allowed for guidewire-assisted passage of a ureteroscope into the duplex collecting system, where the calculi were identified and fragmented.

The scale for the evaluation of the renal parenchymal injury degree in patients with nephrolithiasis

Background. The absence of scale that allows us to assess the degree of renal parenchymal injury by renal calculi and traumatic impact of the surgical methods of treatment has made this research relevant. The purpose of the study was to improve the efficiency of renal parenchymal injury diagnosis and to optimize the surgical management of urolithiasis. Material and methods. For the period from 2014 to 2017, 158 patients with nephrolithiasis were examined. The level of cystatin C in the blood serum of patients with nephrolithiasis was determined by the enzyme immunoassay method in the preoperative period and in the first 48 hours after surgery. The test system BioVendor (Germany) was used. Patients were divided into five groups. Group I was formed of 31 patients, who underwent micropercutaneous nephrolithotripsy. The second group included 31 individuals, who underwent ultra-mini-percutaneous nephrolithotripsy. Group III consisted of 35 patients treated with standard percutaneous nephrolithotripsy. Group IV included 30 persons with staghorn calculi, in this group the combination of a single standard access with multiple ultra-mini-percutaneous access was used. Thirty one patients in group V underwent nephrolithotripsy using multiple standard accesses. Group VI (control) included 32 apparently healthy volunteers with normal serum cystatin C level. To determine the adequacy of the proposed scale of the degree of renal parenchyma injury distribution, Receiver Operating Characteristic curve analysis was applied. Statistical studies were performed using the Statistica 6.0 package. Results. A serum marker of renal parenchymal injury degree — cystatin C in patients with nephrolithiasis is proposed. Based on its assessment, it was proved that in patients with calculi up to 2 cm in diameter, micropercutaneous nephrolithotripsy and ultra-minipercutaneous nephrolithotripsy have a statistically identical degree of renal parenchymal injury. The above noted degree of renal injury was lesser in comparison to standard percutaneous access. In patients with staghorn calculi, according to the serum cystatin C level, percutaneous nephrolithotripsy with multiple standard accesses is the most traumatic endoscopic surgical intervention. The coefficient of renal parenchymal injury was developed, which is determined by the ratio of the difference in serum cystatin C levels (before and after the surgery) to the serum level of this biomarker before surgery. A scale of its use has been created that makes it possible to establish three degree of renal parenchymal injury: mild — with a coefficient of ≤ 0.15; average — from 0.15 to 0.35 and severe — more than 0.35. This scale allows us to assess the traumatic effect of renal calculi in patients with urolithiasis, the efficacy of applied surgical technique and the success of conservative therapy. Conclusions. Based on evaluation of the renal parenchymal injury biomarker (cystatin C) in patients with nephrolithiasis with calculi up to 2 cm in diameter, it was proved that micropercutaneous nephrolithotripsy and ultra-minipercutaneous nephrolithotripsy have statistically equal degree of renal parenchymal injury but lesser than with a standard technique. Regardless the diameter of the calculus, nephrolithotripsy using one standard access or combined application of one standard and multiple ultra-minipercutaneous accesses, according to the serum cystatin C levels, have the same traumatic impact on the renal parenchyma (p > 0.05). In patients with staghorn nephrolithiasis, according to the levels of cystatin C, percutaneous nephrolithotripsy using multiple standard access is the most traumatic endoscopic intervention. A scale for predicting the extent of renal parenchymal injury has been developed for various clinical forms of urolithiasis and methods of nephrolithotripsy.

The Application of Suctioning Flexible Ureteroscopy With Intelligent Pressure Control in Treating Upper Urinary Tract Calculi on Patients With a Solitary Kidney

To investigate the usage of intelligently pressure-controlled flexible ureteroscopy (URS) in managing upper urinary tract calculi in patients with a solitary kidney. Forty patients with a solitary kidney and upper urinary tract calculus were included in this study. All the patients underwent suctioning URS with intelligent control of renal pelvic pressure by connecting pressure-measuring suctioning ureteral access sheath to an irrigation and suctioning platform. Treatment outcome and perioperative data were collected. The mean operative time was 25.2 ± 14.5 minutes. The mean hospital stay was 4.7 ± 1.4 days. The stone-free rate at 4 weeks after surgery was 87.5%, and it was 92.5% at 12 weeks after surgery. Two patients (5%) experienced complications of fever postoperatively. There were no complications of elevated serum creatinine, severe bleeding, sepsis, stone street, ureteral mucosa stripping, and ureteral stenosis. It is safe and efficient to use the intelligently pressure-controlled flexible URS in treating upper urinary tract calculi for patients with a solitary kidney with advantages of high lithotripsy efficacy and low complication rate.

Risk factors for bladder calculi in patients with benign prostatic hyperplasia.

We aim to find the risk factors that influence the formation of bladder calculi in patients with benign prostate hyperplasia (BPH) and to reduce the surgical intervention related to bladder calculi.Between January 2015 and October 2016, 332 patients with BPH underwent surgical therapy were retrospectively evaluated. Patients with BPH were categorized into 2 groups: 94 patients with bladder calculi in group 1 and 238 patients without bladder calculi in group 2. Medical history, age, body mass index (BMI), total prostate specific antigen, total prostate volume (TPV), International Prostate Symptom Score (IPSS), intravesical prostatic protrusion (IPP), urodynamic parameters, and urine culture were compared between groups.There was no significant difference in the age, BMI, peak flow rate, and total IPSS between groups. TPV, total prostate specific antigen, and duration of BPH were significantly lower in group 1 than those in group 2. In addition, IPP was significantly higher in group 1 than group 2 (P < .001). Besides, after exclusion of patients with urinary retention and indwelling catheter, group 1 associated with a significantly higher preoperative positive rate of urine culture than that of group 2 (P = .046). Multivariate analysis indicated that IPP was a significant independent risk factor for the presence of bladder calculi.The incidence of bladder calculi in patients with BPH was proved to be closely associated with preoperative positive urine culture and longer IPP in our study. Furthermore, the IPP was presented to be an independent risk factor for the formation of bladder calculi. And early antibacterial therapy of urinary tract infection (UTI) may help to prevent the presence of bladder calculi in patients with BPH.

Prospective Study on Association of Prostatic Calcifications with Clinical Symptoms and Results of Treatment in Men with type III prostatitis

The purpose is to investigate the clinical significance of prostatic calculi in patients with chronic prostatitis and to discuss the possible treatment.The data from 277 young males with CP/CPPS were analyzed prospectively. Symptom severity was measured using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostatic Symptoms Score (IPSS). Sexual function was assessed by the International Index of Erectile Function (IIEF-5) questionnaire. After four weeks of therapy, the NIH-CPSI, IPSS, and IIEF-5 tests were repeated. The variables were compared between patients with and without prostatic calcifications using the Students t-test or chi-square test. No significant differences were found between CP/CPPS patients with and without prostatic calcifications regarding age, body mass index, prostate volume, CPSI, IPSS and IIEF-5. Men with calcifications endured symptoms significantly longer (37.9 ± 25.2 versus 19.0 ± 16.4 months, P < 0.01), and had significantly higher white blood cell counts per high power field in expressed prostatic secretions (7.7 ± 12.8 versus 3.9 ± 4.7; P < 0.01), than patients without prostatic calcifications, who responded better to medication compared with patients with prostatic calcifications. In conclusion, patients with calcifications were more likely to have category IIIA disease and they required a longer medication period.

Effects of the Distance between Renal Calculi and Skin and the Body Mass Index on the Success of ESWL among Renal Calculi Patients

Effects of the Distance between Renal Calculi and Skin and the Body Mass Index on the Success of ESWL among Renal Calculi Patients

Association between vitamin D, parathyroid hormone and inflammatory markers in urolithiasis patients

Introduction: Hypercalciuria plays an important role in the pathogenesis of renal calculi. The role of vitamin D, parathyroid hormone (PTH), inflammatory markers highly sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in the development of renal calculi has not well defined. Objectives: To assess the serum levels of vitamin D, PTH, hs-CRP and IL-6, urinary and serum calcium and phosphorus levels in patients with renal calculi and to compare these parameters with healthy controls Patients and methods: It was a cross-sectional study. About 41 confirmed renal calculi patients and 41 age and sex matched controls were recruited. Patients with malignancies, hyperparathyroidism, chronic disease, and patients taking vitamin D supplementations were excluded. Serum levels of 25(OH) vitamin D, i-PTH, hs-CRP, IL-6, calcium and phosphorous, 24 hours urine levels of calcium and phosphorus were estimated Results: There was a statistical significant difference in the serum levels of 25(OH) vitamin D (12.26 vs 19.61 ng/mL), i-PTH (75.5 vs. 33.5 pg/mL), hsCRP (5117.05 vs. 1721.87 ng/mL), IL-6 (13.49 vs. 1.47 pg/mL) calcium (11.5 vs. 9.4 mg/dL) and urinary calcium (370.5 vs. 342 mg/d) and phosphorous levels (1172 vs. 1432 mg/d) between the cases and the control. There was negative correlation between the levels of i-PTH and vitamin D (r = - 0.765) and positive correlation between i-PTH and hsCRP, IL-6, Serum calcium and urine calcium (r = 0.353, 0.340, 0.522, 0.501 respectively) Conclusion: There was vitamin D inadequacy and increased levels of PTH, IL-6 and C-reactive protein, calcium in patients with renal calculi when compared with healthy controls.

Safety and Efficacy of Percutaneous Nephrolithotomy in Patients with Severe Skeletal Deformities.

Treatment of renal calculi in patients with severe skeletal deformities can be challenging. We present our experience in order to provide an assessment of technical difficulties, associated complications, and outcomes of percutaneous nephrolithotomy (PCNL) as a treatment option in this special patient group. Our study included eight patients treated with PCNL for renal stones. All had severe skeletal deformities including six with severe kyphoscoliosis, one with osteogenesis imperfecta, and another withrickets. After pre-operative evaluation the procedure was performed under fluoroscopic and/or ultrasonic guidance. In all but one case, PCNL was performed with the patient in the prone position. Silicone rolls and soft padded bolsters were used to obtain the best positioning for the procedure. Clearance rates and complications were assessed. Complete stone-free rate was achieved in six patients (75%) after first-PCNL. The two patients with residual stones underwent a second-look PCNL, after which one was completely cleared. The overall completestone-free rate after second PCNL was 87%. Only minor complications were seen in two patients (25%). We found PCNL to be safe and effective for managing kidney stones in patients with severe skeletal deformities.

Choledocholithiasis: An update on current evidence and practice

IntroductionGallstone disease and its complications place a substantial burden on healthcare services, with common bile duct calculi having the potential to cause significant morbidity and mortality, particularly following the occurrence of ascending cholangitis or pancreatitis. Due to these potential risks it is important, when present, to accurately identify common bile duct calculi in patients with gallstone disease. There are a number of investigations available to aid clinicians in the identification of choledocholithiasis. The aim of this review is to evaluate the current evidence and the up-to-date practice within western populations.MethodsA literature review was performed using the Medline database.ConclusionThe reliability of trans-abdominal ultrasound scans and liver function tests in accurately identifying common bile duct calculi were found to be poor. Risk stratification using algorithms incorporating both tests, together with clinical factors, were also found to be inadequate for accurately predicting choledocholithiasis. Based on initial screening further assessment in intermediate and high-risk groups is suggested to avoid unnecessary invasive investigations and therapeutic procedures, which themselves are associated with a significant rate of complications.

Diagnostic Accuracy of Magnetic Resonance Cholangio- Pancreatography in Choledocholithiasis

Objectives: To estimate the diagnostic accuracy of MRCP in the detection of bile duct calculi in patients with obstructive jaundice using ERCP as gold standard. Study Design: This is a cross sectional study. The study was conducted at Department of Diagnostic Radiology and Imaging Civil Hospital Karachi, from 01-08-2013 to 31-12-2014. Materials & Methods: This study comprises 249 cases of clinically observed obstructive jaundice which were referred by hospital consultants or by general practitioner to the Radiology Department for Magnetic Resonance Cholangio-Pancreatography (MRCP). Inclusion criteria were Patients of either gender between 26- 70 years of age with obstructive jaundice, raised direct bilirubin levels of 3 mg/dl and above, raised alkaline phosphatase levels and abdominal ultrasound showed suspicion of stone in dilated or non-dilated common bile duct. Previously Diagnosed cases of Choledocholithiasis, patients of chronic liver disease and those for which MRI is contraindicated such as those with surgical clips, braces were excluded from the study. Standard MRI technique carried out for evaluation of bile duct calculi in obstructive jaundice patients. Its features were carefully evaluated in terms of presence and absence of calculus / calculi, dilatation of CBD and pancreatic duct and presence of intrahepatic cholestasis by the consultant radiologist. Data entered and Statistical analyses were carried out by using SPSS version 17. Sensitivity, specificity, diagnostic accuracy positive and negative predictable values were calculated. Mean and frequency distribution for ages and gender was calculated respectively. Results: Mean age of the patients was 45.54 ±11.352 years. Gender distribution shows, 42 patients (17%) were male while remaining 207 patients (83%) were female. True positive cases for stones were 145 (58%) and false positive cases were 80 (32%). Positive predictive value was 91.77%, negative predictive value 87.91% with sensitivity 92.95%, specificity 86.02% and Diagnostic accuracy were found to be 90.36%. Conclusion: It is conclude that Magnetic Resonance Cholangio-Pancreatography (MRCP) is a safe, precise, relatively fast, with no ionizing radiation and non-invasive imaging modality for the assessment of common bile duct stones in patients of obstructive jaundice. The result of this study recommends that MR Imaging showed high Sensitivity and positive predictive values in the detection of bile duct calculi.

Comparison of prone vs. supine\xa0unenhanced CT imaging in patients with clinically suspected ureterolithiasis

PurposeTo retrospectively evaluate whether prone CT scanning is superior to supine scanning for correct localization of distal urinary calculi in patients with acute flank pain.MethodsConsecutively performed unenhanced CT scans in patients with acute flank pain were retrospectively analyzed in 150 patients in supine and another 150 patients in prone position. Images were reviewed by two radiologists on consensus. Findings in both groups were compared using two-sided Fisher Exact tests and Wilcoxon–Mann–Whitney test.ResultsUrinary calculi were found in 67% of patients in each group. In the supine scanning group, there were 16 cases, in which the location of the stone was equivocal being either located intramurally at the ureterovesical junction (UVJ) or having already passed into the bladder. In contrast, in the prone imaging group all distal stones could be allocated accurately, either to the intramural UVJ or the urinary bladder (37 intramural UVJ stones and six bladder stones in prone scanning group vs. 21 intramural UVJ stones and one bladder stone when scanned supine).ConclusionProne scanning is superior to supine CT scanning for acute flank pain to accurately distinguish intramural UVJ stones from stones that have already passed into the bladder, a distinction which influences patient management.

Prospective prediction of the major component of urinary stone composition with dual-source dual-energy CT in vivo

To prospectively evaluate the diagnostic accuracy of dual-source dual-energy computed tomography (DSDECT) for predicting the major component and determining the composition of urinary calculi in patients with urolithiasis, using postoperative invitro Fourier transform infrared spectroscopy (FT-IR) analysis as the reference standard. Patients with known urolithiasis underwent preoperative DSDECT evaluation, and subsequently, underwent surgical removal of the stones. All patients were examined using the dual-energy renal stone protocol. Material-specific chromatic images were made using dedicated post-processing software. The final determination of stone composition was made using FT-IR postoperatively. Diagnostic parameters of DSDECT for predicting the major component and detecting the presence of four composition types were calculated. A total of 81 urinary calculi were included in this study. Forty-three were pure stones and 38 were mixed stones according to FT-IR. DSDECT correctly identified the major component of all pure stones and 36 mixed stones. The major component of two mixed stones with uric acid as the major component was falsely interpreted as calcium oxalate. The overall accuracy of DSDECT for predicting the major component of stones was 97.5% (79/81). The accuracy of DSDECT for detecting the presence of four types of composition, uric acid, cysteine, hydroxyapatite, and calcium oxalate, was 97.5% (79/81), 93.8% (76/81), 80.2% (65/81), and 93.8% (76/81), respectively. DSDECT could accurately predict the major component of urinary calculi and detect uric acid, cysteine, and calcium oxalate with a satisfactory accuracy.

Flexible ureteroscopy for lower calyceal stones in a horseshoe kidney – Is it the new treatment of choice?

IntroductionThe efficacy of retrograde intrarenal surgery (RIRS) for the treatment of disorders in a horseshoe kidney has not been sufficiently studied so far. We report on our experience with this method for the treatment of lower-pole calculi in patients with a horse-shoe kidney. Patients and methodsThe files of 9 patients who underwent RIRS for lower calyceal stones in horseshoe kidneys between April 2012 and December 2014 were retrospectively analyzed. The stone-free status, postoperative complications, operative time and duration of hospitalization were assessed. ResultsIn total, 12 renal units with lower calyceal stones were treated, as 3 patients had stones in both kidneys. In 8 renal units complete stone clearance could be achieved in one sitting (67.7%), while in 3 renal units 2 sittings were necessary in order to achieve stone clearance. One patient with a stone sized 18mm still had residual stones after two sittings and, therefore, underwent percutaneous nephrolithotomy (PCNL) for stone clearance. No major complications (Clavien–Dindo grades III–V) were encountered. ConclusionRIRS for the treatment of stone disease in horseshoe kidneys has been shown to be a relatively safe and effective procedure. However, due to the anatomical abnormality, a second look may be needed to render the patient completely stone-free.

Mini-nephroscope combined with pressure suction: an effective tool in MPCNL for intrarenal stones in patients with urinary tract infections.

We report our experience with a mini-nephroscope connected to pressure suction as a modified minimally invasive percutaneous nephrolithotomy (MPCNL) technique to manage intrarenal stones in patients with a urinary tract infection (UTI). We used a mini-nephroscope connected to pressure suction to aspirate infected urine and reduce intrapelvic pressure. From January 2010 to June 2014, we treated 683 patients with intrarenal stones and UTI with this modified MPCNL technique in our department (Group A). Patients with an intrarenal stone and without UTI treated by this modified MPCNL (Group B, N=422) and patients with an intrarenal stone and UTI but treated by traditional MCPNL without pressure suction (Group C, N=95) were collected as control groups. In group A, 635 of the 683 patients (93%) had a positive urine culture preoperatively and the other 48 patients (7%) were diagnosed with pyonephrosis intraoperatively. The mean stone bulk was 843±151.4mm(2) and mean operative time was 71.0±11.5min. The mean stone bulk and operative time were similar to those of group B and group C. However, the ratesofinfectiouscomplications for groups A (6.4%) and B (4.9%) were similar, but higher in group C (28.4%). In group A, only 38 patients had fever and 6 patients developed sepsis. None of the patients showed progression to multiple organ dysfunction syndrome or died in all of patients. Our results demonstrated that this modified MPCNL technique is safe, feasible, and efficient for managing intrarenal calculi in patients with an UTI.

Clinical Effectiveness of Prospectively Reported Sonographic Twinkling Artifact for the Diagnosis of Renal Calculus in Patients Without Known Urolithiasis.

The purpose of this study was to determine the clinical effectiveness of prospectively reported sonographic twinkling artifact for the diagnosis of renal calculus in patients without known urolithiasis. All ultrasound reports finalized in one health system from June 15, 2011, to June 14, 2014, that contained the words "twinkle" or "twinkling" in reference to suspected renal calculus were identified. Patients with known urolithiasis or lack of a suitable reference standard (unenhanced abdominal CT with ≤ 2.5-mm slice thickness performed ≤ 30 days after ultrasound) were excluded. The sensitivity, specificity, and positive likelihood ratio of sonographic twinkling artifact for the diagnosis of renal calculus were calculated by renal unit and stratified by two additional diagnostic features for calcification (echogenic focus, posterior acoustic shadowing). Eighty-five patients formed the study population. Isolated sonographic twinkling artifact had sensitivity of 0.78 (82/105), specificity of 0.40 (26/65), and a positive likelihood ratio of 1.30 for the diagnosis of renal calculus. Specificity and positive likelihood ratio improved and sensitivity declined when the following additional diagnostic features were present: sonographic twinkling artifact and echogenic focus (sensitivity, 0.61 [64/105]; specificity, 0.65 [42/65]; positive likelihood ratio, 1.72); sonographic twinkling artifact and posterior acoustic shadowing (sensitivity, 0.31 [33/105]; specificity, 0.95 [62/65]; positive likelihood ratio, 6.81); all three features (sensitivity, 0.31 [33/105]; specificity, 0.95 [62/65]; positive likelihood ratio, 6.81). Isolated sonographic twinkling artifact has a high false-positive rate (60%) for the diagnosis of renal calculus in patients without known urolithiasis.

Management of Ureterolithiasis in a Patient with Crossed Unfused Renal Ectopia.

Crossed renal ectopia is a rare congenital anomaly in which both kidneys are situated on one side and fused together in 85%–90% of cases. The management of urinary calculi in patients with crossed renal ectopia continues to pose challenges to urologists because the aberrant anatomy may make access and clearance of the calculi more difficult to accomplish. Here, we report a case of inferior crossed renal ectopia, without fusion, and a ureteral stone in which the patient was treated successfully by extracorporeal shock wave lithotripsy.

Robotic Management of Localized Adenocarcinoma Prostate with Large Vesical Calculus: A Report of Two Cases

ABSTRACT Introduction Bladder outlet obstruction (BOO) accounts for more than 75% of cases of vesical calculi in patients aged above 50 years. There are special group of patients who have large vesical calculus with localized adenocarcinoma prostate requiring treatment for both bladder calculi and malignancy. We are sharing our technique of extraperitoneal robot-assisted radical prostatectomy (RRP) and removal of vesical calculus in two patients of localized adenocarcinoma prostate with large vesical calculus (≥ 4 cm). Two patients with localized prostate cancer with large vesical stone underwent simultaneous cystolithotomy and extraperitoneal radical prostatectomy. Their perioperative period was uneventful. Large vesical stones with localized prostate cancer can be easily managed simultaneously by an experienced robotic surgeon. How to cite this article Bora GS, Dogra PN, Singh P. Robotic Management of Localized Adenocarcinoma Prostate with Large Vesical Calculus: A Report of Two Cases. J Postgrad Med Edu Res 2016;50(1):36-38.

Prospective Outcomes of Ultra Mini Percutaneous Nephrolithotomy: A Consecutive Cohort Study

Ultra mini percutaneous nephrolithotomy is a less invasive technique of percutaneous nephrolithotomy to treat small to medium sized calculi. We prospectively evaluated the outcomes of ultra mini percutaneous nephrolithotomy in a single surgeon, consecutive cohort study. Data on 94 patients who underwent ultra mini percutaneous nephrolithotomy were collected. Mean ± SD calculus size was 15.9 ± 4.5 mm and mean density was 1,106 ± 167 HU. Access was achieved via the upper pole in 8 cases, interpolar in 33 and lower pole in 54. Mean operative time was 54 minutes (range 28 to 120). Mean hemoglobin loss was 0.81 gm/dl and the mean creatinine increase was 0.05 mg/dl. There were no transfusions or kidney injuries. Grade I and IIIb complications were observed in 4 and 1 patients, respectively. The most serious complication was aperinephric collection. Postoperatively oral analgesia was sufficient in 86patients (91%). Mean length of stay was 38.2 ± 15.9 hours. Nephrostomy drainage was used in 13 patients while 7 (7%) required a stent for 1 week. Intraoperatively 99% of renal units were stone free (absence of detectable calculi) on fluoroscopy, and 74% and 81% were stone free on day 1 postoperative ultrasound and 1-month computerized tomography, respectively. The 10 to 20 mm stones showed less bleeding, shorter operative time and a significantly lower requirement for nephrostomy or a Double-J(®) stent. Ultra mini percutaneous nephrolithotomy appears to be effective and safe with a short length of stay. It may be a valuable addition to the armamentarium to treat 10 to 20 mm calculi in patients who wish to avoid routine nephrostomy or stents. Randomized, controlled trials are required.

Discussion of Relationship between Hematuria and Ultrasonic Renal Calculi in Young Man After Exercise

&lt;strong&gt;Objective: &lt;/strong&gt;To discuss the relationship between hematuria and ultrasonic renal calculi in young man after exercise. &lt;strong&gt;Method:&lt;/strong&gt; In the medical observation, 48 cases of young male patients with hematuria after exercise in our hospital from January 2011 to December 2012 were selected as the observation objects, the subjects were transient hematuria, and 92 patients without hematuria were selected as the contrast, all patients underwent ultrasound examination, the detection rate of renal calculi and the ultrasonic manifestation were retrospectively analyzed. &lt;strong&gt;Results: &lt;/strong&gt;The incidence of renal calculi of the young and middle-aged male patients with hematuria after exercise is statistically different in different parts and different age (&lt;em&gt;p&lt;/em&gt; &amp;lt; 0.05), and the incidence rate of renal calculi in patients with hematuria after exercise and patients without hematuria was significantly different (&lt;em&gt;p&lt;/em&gt; &amp;lt; 0.05), as shown in Table 1, Table 2. There was no obvious linear relationship between the degree of hematuria and the incidence of renal calculi after young men's exercise, as shown in Table 3. &lt;strong&gt;Conclusion: &lt;/strong&gt;From this clinical research results we can know that renal calculi is the main cause of hematuria after exercise for the young man, and the clinical examination and diagnosis of renal calculi with ultrasonography has higher clinical detection rate, therefore the clinical application value is higher.

E58 Urinary calculi in patients with Sjögren's syndrome

E58 Urinary calculi in patients with Sjögren's syndrome