Diagnosis Of Urinary Calculi Research Articles

The value of dual-energy computed tomography (DECT) in the diagnosis of urinary calculi: a systematic review and meta-analysis of retrospective studies.

Dual-energy computed tomography (DECT) imaging technology opens a new idea and method for analyzing stone composition, which can obtain several quantitative parameters reflecting tissue-related information and energy images different from traditional images. However, the application of DECT in diagnosing urinary calculi remains unknown. This study aims to evaluate the value of DECT in diagnosing urinary calculi by meta-analysis. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched to articles published from the establishment of the databases to April 18, 2023. We reviewed the articles on the diagnosis of urinary calculi detected by DECT, established standards, screened the articles, and extracted data. Two researchers carried out data extraction and the Cohen's unweighted kappa was estimated for inter-investigator reliability. The quality of the literature was evaluated by the diagnostic test accuracy quality evaluation tool (QUADAS-2). The heterogeneity and threshold effects were analyzed by Meta-Disc 1.4 software, and the combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic ratio were calculated. The combined receiver-operating characteristic (ROC) curve was drawn, and the value of DECT in the diagnosis of urinary calculi was evaluated by the area under the curve (AUC). The meta-analysis was registered at PROSPERO (CRD42023418204). One thousand and twenty-seven stones were detected in 1,223 samples from 10 diagnostic tests. The analyzed kappa alternated between 0.78-0.85 for the document's retrieval and detection procedure. The sensitivity of DECT in the diagnosis of urinary calculi was 0.94 (95% CI [0.92-0.96]). The positive likelihood ratio (PLR) of DECT in the diagnosis of urinary stones was 0.91 (95% CI [0.88-0.94]), and the negative likelihood ratio (NLR) was 0.08 (95% CI [0.05-0.11]). The specificity of DECT for detecting urinary calculi was 0.91 (95% CI [0.88-0.94]). The area under the curve of the summary receiver operator characteristic (SROC) was 0.9875. The sensitivity of dual-energy CT in the diagnosis of urinary calculi diameter <3 mm was 0.94 (95% CI [0.91-0.96]). The PLR of DECT in the diagnosis of urinary stones diameter <3 mm was 10.79 (95% CI [5.25 to 22.17]), and the NLR was 0.08 (95% CI [0.05-0.13]). The specificity of DECT for detecting urinary calculi <3 mm was 0.91 (95% CI [0.87-0.94]). The SROC was 0.9772. The DECT has noble application value in detecting urinary calculi.

Age, Benign Prostatic Hyperplasia, Geography of Residence, and Occupation are Predictors of Bladder Calculi in Men: A Three-Year Data Analysis.

The formation of bladder calculi is a complex multifactorial process. Our objective was to identify predictors of bladder calculi in men. This cross-sectional study was conducted at a regional public hospital. We used medical records from 2017 to 2019 for men diagnosed with urinary calculi or benign prostatic hyperplasia (BPH). The diagnosis of urinary calculi was based on urinalysis, plain x-ray, and ultrasonography (USG). The diagnosis of BPH was based on digital rectal examination (DRE), USG, and American Urological Association (AUA) Symptom Index to assess the severity of BPH. The data were analyzed using Kruskal-Wallis, Mann-Whitney U, Chi-square tests, and binary logistic regression. Of 2010 study participants, 66.0% were men with urinary calculi, 39.7% had BPH, 21.0% were aged 70 years or more, 12.5% lived in limestone mountain areas, and 24.6% had occupations that were mainly outdoors. Urinary calculi in men with BPH were found in the urethra (3.0%), bladder (27.6%), ureter (2.2%), and kidney (1.1%). Of all men with urinary calculi, the odds of having bladder calculi in men aged 70 years or more was 13.484, 95% confidence interval (95% CI): 8.336-21.811; In men with BPH was 11.182, 95% CI: 6.440-19.416; In men who lived in limestone mountain area was 1.894, 95% CI: 1.242-2.887; In men whose occupation is mainly outdoor was 3.240, 95% CI: 1.954-5.375, compared to reference groups. Age, BPH, geography of residence, and occupation were predictors of bladder calculi in men.

Analysis of the Application Value of X-Ray Digital Tomographic Fusion Technique in Urinary System Diseases.

Objective To explore the application value of the X-ray digital tomographic fusion technique in the diagnosis of urinary system diseases. Methods 500 patients with suspected urinary diseases in our hospital were examined by three methods: X-ray digital tomographic fusion imaging (DTS), intravenous pyelography (IVP), and abdominal plain film (KUB), and the image quality before and after tomographic fusion was objectively evaluated. The image quality could be divided into three grades: excellent, good, and poor. Results The image excellent rate of DTS (88%) was higher than that of IVP (27.5%). The sensitivity of DTS in the diagnosis of renal cyst and space occupying of the bladder was higher than that of IVP (P < 0.05). The accuracy rate of DTS in the diagnosis of urinary calculi was 93.33%, higher than 63.3% of KUB (P < 0.001). The accuracy rate of DTS in the diagnosis of ureteral stricture was 90%, higher than 65% of IVP (P=0.03). The accuracy of DTS in the diagnosis of hydronephrosis was higher than that of IVP and KUB (P < 0.05). Conclusion In the examination of urinary system-related diseases, high-definition images can be obtained by timely using sectional fusion technology. Compared with conventional IVP, space occupying lesions such as the bladder and kidney can be displayed more clearly with the help of the tomographic fusion technique, which is helpful to improve the possibility of finding lesions and is of great significance in clinical application.

The analysis of microbial spectrum and antibiotic resistance of uropathogens isolated from patients with urinary stones.

The characteristics and resistance patterns of urine bacteriology in patients with urinary tract stones have not been extensively studied. This study aims to investigate the microbial spectrum and antibiotic resistance of uropathogens isolated from urinary tract infections in patients with urinary stones and provide a basis for appropriate antimicrobial treatments. The results of positive bladder midstream urine cultures and their antimicrobial susceptibility were retrospectively analysed from hospitalised patients with diagnosis of urinary calculi and urinary tract infections between January 2010 and December 2015. A total of 3892 samples were analysed during the study period: 2201 were female patients (56.6%) and 1691 were male patients (43.4%). The 4 most common uropathogens were Escherichiacoli (48.7%), Klebsiellapneumoniae (10.4%), Enterococcusfaecalis (8.7%) and Proteusmirabilis (5.2%). Both E.coli (60.8%) and Proteus mirabilis (7.5%) were higher in female patients than in male patients (32.8%; 2.3%; P<.05). ESBL-positive E.coli accounted for 59.5% of total number of E.coli, while ESBL-positive K.pneumoniae comprised 42.0% of total K.pneumoniae. The majority of uropathogens in patients with stones had high resistance to fluoroquinolones, ceftriaxone, ceftazidime, cefepime, penicillins, sulfonamides and monobactams (resistance >20%). The microbial spectrum in patients with urinary stones had a complex pattern. The uropathogens showed marked multidrug resistance and a large proportion of the uropathogens were able to produce β-lactamase.

The value of X-ray digital tomosynthesis in the diagnosis of urinary calculi.

Urinary calculus is a common and recurrent condition that affects kidney function. The present study evaluated the use of digital tomosynthesis (DTS) and Kidneys-Ureters-Bladder (KUB) radiography as methods of diagnosing urinary calculi. Unenhanced multidetector computed tomography (UMDCT) was used in the diagnosis of calculi. KUB radiography and DTS procedures were conducted on patients prior to and following bowel preparation to detect kidney, ureteral and bladder calculi. Differences in diagnostic performance of KUB radiography and DTS imaging on prepared and unprepared bowel were evaluated using the χ2 test. The consistency of diagnostic results between two examining physicians was analyzed using the κ test. A total of 138 calculi from 80 patients were detected via UMDCT. The calculi detection rates of KUB prior to and following bowel preparation were 47.8 and 66.7% respectively, and the calculi detection rate of DTS prior to and following bowel preparation were 94.2 and 96.4%, respectively. The detection rates of calculi >5 mm via KUB prior to and following bowel preparation were 56.6 and 73.5% respectively, and in DTS they were 100% prior to and following bowel preparation. Economically, DTS performed on the unprepared bowel was the most cost effective, followed by DTS on the prepared bowel, KUB on the unprepared bowel and KUB on the prepared bowel. Therefore, the current study concluded that DTS may be an appropriate first-line imaging technique in patients with urinary calculi.

컬러 도플러 초음파에서 Twinkling artifacts의 유용성

연구의 목적은 컬러 도플러 초음파를 이용하여 twinkling artifact(AT)의 발생 강도를 비교함으로서 요로결석 진단에 twinkling artifact의 유용성을 알아보고자 In vitro와 In vivo로 진행되었다. In vitro 실험은 수조에 도토리묵을 넣고 도토리묵의 표면에 물질을 올려놓고 컬러 도플러 초음파를 시행하여 twinkling artifact의 발생 정도를 실험하였다. In vivo 실험은 요로결석 환자 31명(신장결석 ; 16명, 요관결석: 15명)을 대상으로 하였다. In vitro 및 In vivo 검사에서 twinkling artifact 발생 강도는 0에서 3등급으로 분류하였다. In vitro 검사에서 표면이 거친 소금, 나사, 큐빅 물질에서 높은 등급의 twinkling artifact가 발생하였다. 회색도(B-mode) 영상에서 요로결석 검출률은 신장에서 37%, 요관에서 60%로 나타났다. 모든 요로결석 환자에서 twinkling artifact 발생하였다. 컬러 도플러 초음파에서 twinkling artifact 발생 정도는 물질의 표면의 거칠기와 관계가 있었다. 회색도 영상에서 요로결석이 분명하게 검출이 되지 않고 twinkling artifact가 발생한다면 요로결석 확진할 수 있다. The aim of the study was to investigate the diagnostic value of the color Doppler twinkling artifact in disease of urinary system. The intensity of twinkling artifact(TA) with color Doppler was classified into 3 levels, 0(non-TA) to 3(distinct TA). In the in vitro study, acorn jelly with various materials on top was examined using color Doppler at B-mode sonography in a water bath for TA. 31 patients with diagnosis of urinary calculi(renal stones 16, urinary stones 15) based on B-mode sonography were studied in vivo for TA. The materials with rough surfaces such as salt, screw and cubics at B-mode sonography with color Doppler contributed to causing TA. At B-mode sonography without color Doppler 37% of renal stones and 60% of ureter stones were detected. but at B-mode sonography with color Doppler TA was demonstrated for all cases. Superficial roughness of materials affected occurrence of TA at B-mode sonography with color Doppler. Therefore, TA at B-mode sonography without color Doppler could play a role in confident diagnosis of the disease of urinary system.

Comparing the diagnostic accuracy of ultrasound in the community and in the hospital setting for urinary calculi: A retrospective cohort study

Objective: The objective of this article is to test whether there is a significant difference in diagnostic accuracy between hospital and community-based ultrasound (US) for the detection of urinary calculi in the United Kingdom (UK). Materials and methods: A 30-month, single-blind, retrospective cohort study of all patients referred to Kent and Canterbury Hospital urology multidisciplinary meeting for suspected urinary calculi was conducted. Only those investigated with US and non-contrast computed tomography (NCCT, the gold standard) for their calculi were included. Concordance of US and NCCT was stratified by US location: i.e. either the hospital or community setting (e.g. the latter via general practitioners (GPs) or independent radiographers). Fisher’s exact test was subsequently utilised to test for any significant difference between these two patient groups. Results: Of 2464 patients referred, 257 had both ultrasound and NCCT in their diagnostic workup. Of these, 150 and 107 patients had their US performed in hospital and community settings, respectively. No significant difference in the accuracy of US was detected between the two groups for the detection of urinary calculi when compared with NCCT. Conclusion: US carried out by independent radiographers and GPs in the community is just as accurate as US carried out by hospital sonographers for the detection of urinary calculi in the UK. Greater use of community US for the diagnosis of urinary calculi may promote greater patient/GP satisfaction and reduce hospital attendance without loss of diagnostic accuracy.

Role of CT scan in the diagnosis and treatment of urinary calculus

Urinary calculus is a common disease of urinary system. With the improvement of people′s living standard, the incidence rate of urinary calculus increased year by year. Compared with other methods, spiral CT has a great advantage in the diagnosis of urinary calculus. The current commonly used examinations including spiral CT plain scan, low dose spiral CT scan, CT urography, and dual source dual energy CT imaging. The advantages and characteristics of different types of CT are analyzed and compared, which is helpful for clinicians to choose the most proper examination, to make the most of the advantages of various checks, so as to improve the accuracy of diagnosis and effectiveness of treatment. Key words: Urologic diseases; Calculi; Tomography, spiral computed; Diagnosis; Treatment outcome

Increased risk of bone fracture among patients with urinary calculi: a nationwide longitudinal population-based study.

Urinary calculi were associated with higher risk of vertebral and upper limb fracture. Therefore, patients with urinary calculi should be evaluated carefully because they may have a higher risk of subsequent fracture later in life. The contribution of urinary calculi to reduced bone mineral density has been recognized. However, the association of urinary calculi with the risk of fracture remains inconclusive. The aim of the study was to determine the risk of overall fracture and fractures at different anatomic sites in patients with urinary calculi. The records of inpatients and outpatients with urinary calculi were retrieved from the Taiwan National Health Insurance Database from 2000 to 2010. Among patients with urinary calculi at the cohort entry, controls were matched using propensity scores on a 1:1 ratio. All subjects were followed up from the date of enrollment until fracture occurrence, death, or December 31, 2010. There were 46,243 Medicare beneficiaries with a diagnosis of urinary calculi and 46,243 controls without calculi enrolled. Among these patients, 6005 patients with a diagnosis of urinary calculi and 5339 controls developed fractures during a median follow-up period of 5.3 years. Patients with urinary calculi had a higher incidence of fracture compared with controls (23.9 versus 22.1 per 1000 person-years) and a greater risk of overall fractures (adjusted hazard ratio [aHR] 1.08, 95 % confidence interval [CI], 1.04-1.12), mainly located at the vertebrae (aHR 1.15, 95 % CI, 1.06-1.25) and upper limb (aHR 1.07, 95 % CI, 1.01-1.14), but the risk for hip fracture was not increased (aHR 1.09, 95 % CI, 0.96-1.22). Urinary calculus is independently associated with higher risk of subsequent fracture. Patients with urinary calculi should pay attention to the future vertebral and upper limb fractures.

Managing stones in pregnancy: an update

The diagnosis of urinary calculi in pregnancy may be challenging, requiring a high index of clinical suspicion and judicious imaging selection. Investigations and intervention must be tailored not only to the pregnant patient's symptoms, but also the stage of pregnancy. A multidisciplinary team approach consisting of the perinatology team, urologist, interventional radiologist and anesthesiologist is required. Management should proceed from conservative to more invasive approaches. In the majority of cases, expectant management as first-line therapy will be successful. Temporizing measures or definitive intervention will be required in select circumstances.

MP12-17 VARIABILITY OF PIXEL BRIGHTNESS INTENSITY CAN BE USED TO FURTHER CHARACTERIZE A STONE’S COMPOSITION

You have accessJournal of UrologyImaging/Radiology III1 Apr 2014MP12-17 VARIABILITY OF PIXEL BRIGHTNESS INTENSITY CAN BE USED TO FURTHER CHARACTERIZE A STONE’S COMPOSITION Yaniv Larish, Leonard Glickman, and Jay A. Motola Yaniv LarishYaniv Larish More articles by this author , Leonard GlickmanLeonard Glickman More articles by this author , and Jay A. MotolaJay A. Motola More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.452AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Non-contrast CT (NCCT) is the gold standard of imaging in the diagnosis of urinary calculi. Composition of stones can be determined based on a stone’s pixel brightness intensity as measured by mean Hounsfield units (mHU) with varying degrees of certitude. In this study, we sought to evaluate the variability of pixel intensity by measuring the standard deviation of HU values (HUsd) within specific stone types to improve the accuracy of determining a stone’s composition. METHODS A single-institution, retrospective, chart review was performed from June 2009 to July 2013 identifying patients with GU calculi. All patients had a NCCT scan of the abdomen and pelvis which confirmed the presence of a GU stone. All calculi were treated with endoscopic management during which stone specimen was retrieved for analysis. Stone composition was determined by infrared spectroscopy. CT scans were reviewed by two urologists who were blinded to the stone’s chemical composition. The radiographic characteristics of the stone, including mHU and HUsd were measured. RESULTS 155 patients with 191 distinct stone episodes were identified. Patients with multiple stones in a single renal unit were excluded from analysis. The mean time between CT scan and surgery was 27 days. 72%, 17%, 6%, and 5% of the stones were composed of calcium oxalate (CaOx), uric acid (UrA), calcium phosphate (CP), and cystine (CY), respectively. Inter-rater reliability demonstrated good agreement between the two reviewers (r=0.89 and 0.74 for mHU and HUsd respectively). The mHU values were 697.78, 425.83, 706.86, and 634.67 for CaOx, UrA, CP, and CY, respectively. There was a significant difference when comparing UrA to each of the other three stone types: CaOx, CP, and CY (p<.0001, 0.0028, 0.0482, respectively). The HUsd values were 126.22, 61.56, 128.22, and 60.16 for CaOx, UrA, CP, and CY, respectively. There was a significant difference comparing UrA to CaOx and to CP (p<.0001, 0.0008, respectively) and a significant difference comparing CY to CaOx and to CP (p= 0.0001 and 0.0034 respectively). CONCLUSIONS The HU information obtained from CT scans has been limited to the mHU number. The HUsd is a previously ignored and readily obtainable variable that should be used to increase the clinician’s confidence in determining a stone’s composition and guiding treatment. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e112 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Yaniv Larish More articles by this author Leonard Glickman More articles by this author Jay A. Motola More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Association of bladder pain syndrome/interstitial cystitis with urinary calculus: a nationwide population-based study

Although one prior study reported an association between bladder pain syndrome/interstitial cystitis (BPS/IC) and urinary calculi (UC), no population-based study to date has been conducted to explore this relationship. Therefore, using a population-based data set in Taiwan, this study set out to investigate the association between BPS/IC and a prior diagnosis of UC. This study included 9,269 cases who had received their first-time diagnosis of BPS/IC between 2006 and 2007 and 46,345 randomly selected controls. We used conditional logistic regression analysis to compute the odds ratio (OR) and its corresponding 95 % confidence interval (CI) for having been previously diagnosed with UC between cases and controls. There was a significant difference in the prevalence of prior UC between cases and controls (8.1 vs 4.3 %, p < 0.001). Conditional logistic regression analysis revealed that cases were more likely to have been previously diagnosed with UC than controls (OR = 1.70; 95 % CI = 1.56-1.84) after adjusting for chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraine, sicca syndrome, allergy, endometriosis, and asthma. BPS/IC was found to be significantly associated with prior UC regardless of stone location; the adjusted ORs of kidney calculus, ureter calculus, bladder calculus, and unspecified calculus when compared to controls were 1.58 (95 % CI = 1.38-1.81), 1.73 (95 % CI = 1.45-2.05), 3.80 (95 % CI = 2.18-6.62), and 1.83 (95 % CI = 1.59-2.11), respectively. This work generates the hypothesis that UC may be associated with BPS/IC.

Association between osteoporosis and urinary calculus: evidence from a population-based study

This population-based case-control analysis investigated the association between osteoporosis and prior urinary calculus (UC) in Taiwan. We succeeded in detecting an association between osteoporosis and prior UC (adjusted odds ratio = 1.66). This association was consistent and significant regardless of stone location. UC has been demonstrated to be a risk factor for osteoporotic fractures, but no studies to date have directly investigated the association between UC and osteoporosis. This case-control analysis aimed to investigate the association of osteoporosis with prior UC using a population-based dataset in Taiwan. We first identified 39,840 cases ≥40 years who received their first-time diagnosis of osteoporosis between 2002 and 2009 and then randomly selected 79,680 controls. We used conditional logistic regression analyses to compute the odds ratio (OR) and the corresponding 95 % confidence interval (CI) for having been previously diagnosed with UC between cases and controls. The OR of having been previously diagnosed with UC for patients with osteoporosis was 1.66 (95 % CI = 1.59-1.73) when compared to controls after adjusting for geographic location, urbanization level, type I diabetes mellitus, coronary heart disease, hyperlipidemia, rheumatoid arthritis, stroke, renal disease, Parkinson's disease, hyperthyroidism, chronic hepatopathy, Cushing's syndrome, malabsorption, gastrectomy, obesity, and alcohol abuse/alcohol dependence syndrome. The results consistently showed that osteoporosis was significantly associated with a previous diagnosis of UC regardless of stone location; the adjusted ORs of prior kidney calculus, ureter calculus, bladder calculus, and unspecified calculus when compared to controls were 1.71 (95 % CI = 1.61-1.81), 1.60 (95 % CI = 1.47-1.74), 1.59 (95 % CI = 1.23-2.04), and 1.69 (95 % CI = 1.59-1.80), respectively. This study succeeded in detecting an association between osteoporosis and prior UC. In addition, our findings were consistent and significant regardless of stone location.

Urinary calculi and an increased risk of stroke: a population‐based follow‐up study

Study Type--Prognosis (cohort) Level of Evidence 2b. What's known on the subject? and What does the study add? Although early studies failed to detect an association between urinary calculi (UC) and subsequent cardiovascular risk, there is growing evidence among more recent research supporting this association with some studies more specifically suggesting that stroke is a major concern for UC sufferers. After adjusting for potential confounding factors, UC patients were more likely to have experienced a stroke then those without UC during the five-year follow-up period (hazard ratio = 1.43, 95% Cl = 1.35-1.50, P < 0.001). • To examine in a population-based study the relationship between a history of nephrolithiasis and/or ureterolithiasis and the subsequent risk of stroke, as previous studies have shown that stone disease is associated with several cardiovascular risk factors. However, none of the studies that have investigated the relationship between urinary calculi (UC) and stroke were able to detect an association at a significant level. • We used data sourced from the Taiwan Longitudinal Health Insurance Database 2000. • In all, 25,181 adult patients newly diagnosed with UC were recruited as a study cohort, along with 125,905 matched enrolees with no history of stone disease as a comparison cohort. • All the subjects were tracked for a 5-year period beginning from their index ambulatory care visits, and those who subsequently had a stroke identified. • Cox proportional hazards regressions were used to compare the risk of stroke between the study and comparison cohorts. • During the 5-year follow-up period, the incidence rate of stroke was 1.78 (95% confidence interval [CI] 1.71-1.86) per 100 person-years in patients with UC and 1.25 (95% CI 1.22-1.27) per 100 person-years in patients without UC. • After adjusting for hypertension, diabetes, hyperlipidaemia, cardiovascular disease, urbanization level, gout, and obesity, patients with UC were more likely to have had a stroke than those without UC during the 5-year follow-up period (hazard ratio 1.43, 95% CI 1.35-1.50, P < 0.001). • Our results suggest that there is an increased risk of stroke during the first 5 years after a diagnosis of UC.

658 ARE THERE DISPARITIES IN THE EMERGENCY CARE OF KIDNEY STONE PATIENTS? AN ANALYSIS OF THE NATIONAL HOSPITAL AMBULATORY MEDICAL CARE SURVEY (NHAMCS)

study, and the mean age was 47.3 years with a standard deviation of 15.6 years and only 37.3% of whom were women. 2,050 of 205,268 subjects (1.00%) had received the diagnosis of depressive disorder during the one-year follow-up period, including 751 (1.46% in the study cohort) with urinary calculi and 1,299 (0.84% in the comparison cohort) without urinary calculi. The stratified Cox proportional analysis shows that after adjusting after adjusting for, monthly income, geographic region and urbanization level of the community in which the patient resided, the increased depressive disorder risk of patients with urinary calculi persisted at about the same level as in the unadjusted analysis (hazard ratio, 1.75; 95% CI, 1.60 to 1. 92; p 0.001). CONCLUSIONS: Our results reveal that an increased risk of depressive disorder within one year following the diagnosis of urinary calculi.

Increased risk of depressive disorder within 1 year after diagnosis with urinary calculi in Taiwan

This study investigated the risk of subsequent depressive disorders (DD) following a diagnosis of urinary calculi (UC) in Taiwan. In total, 67,917 adult patients newly diagnosed with UC were recruited, along with 153,951 age-matched enrollees who were used as a comparison group. A stratified Cox proportional hazard regression analysis revealed that the adjusted hazard of DD within a 1-year period following diagnosis with UC was 1.75 times greater for patients with UC than for comparison patients.

Association Between Obstructive Sleep Apnea and Urinary Calculi: A Population-based Case-control Study

To hypothesize an association between obstructive sleep apnea (OSA) and urinary calculi (UC) and assess the presence of such an association using a national population-based dataset. Elevated systemic proinflammatory pathways found in OSA patients may be linked to increased cardiovascular risk. Similar pathways have been identified in patients with UC. We identified 53,791 patients who had received a new diagnosis of UC between 2003 and 2008 from a dataset based on Taiwan's National Health Insurance program. We randomly selected 161,373 controls and then identified subjects with prior OSA in both groups. Odds ratios (ORs) for prior OSA in UC patients compared with controls were estimated in conditional logistic regression analyses by sex and by age group. Prevalences of prior OSA were 1.2% in all subjects, 1.5% in patients with UC, and 1.1% in controls. After adjusting for patients' monthly income, geographic location, urbanization level, hypertension, diabetes, coronary heart disease and hyperlipidemia, and obesity, the OR for prior OSA in UC patients was 1.38 (95% CI 1.30-1.49) compared with controls. Prior OSA was associated with UC both in both males (OR 1.30, 95% CI 1.18-1.41) and females (OR 1.45, 95% CI 1.22-1.67). Notably, the adjusted OR was most pronounced in the youngest age group, <35 years (OR 2.57, 95% CI 1.97-3.34). We conclude that patients with UC had a higher prevalence of prior OSA. The OR for prior OSA was most pronounced in the youngest age group.

Association Between Urinary Calculi and Erectile Dysfunction: A Case‐Control Study

Stone disease is associated with systemic metabolic and hormonal disorders that share common risk factors with erectile dysfunction (ED); however, few studies have investigated the association between ED and urinary calculi (UC). This case-control study aims to estimate the association of ED with UC using a nationwide, population-based database in Taiwan. We identified 5,620 patients with ED as the study group and randomly selected 16,860 patients as the controls. We estimated the odds ratio (OR) and 95% confidence interval (CI) of having previously been diagnosed with UC according to the presence/absence of ED using conditional logistic regression after adjusting for hypertension, diabetes, coronary heart disease, and hyperlipidemia. We measured the prevalence and risk of UC between the cases and controls. We only included UC cases if the UC diagnosis was made previous to the index date. Of the sampled patients, 3,855 (17.2%) were found to have been diagnosed with UC prior to the index date; 1,251 (22.3%) ED patients and 2,604 (15.4%) controls had been diagnosed with UC, respectively. After adjusting for confounders, the OR in ED patients who had prior UC was 1.46 (95% CI = 1.35-1.58) when compared with controls. The ORs of UC for ED patients were somewhat higher in younger groups. In particular, when compared with controls the adjusted OR in ED patients between 40 and 49 years old for prior UC was 1.73 (95% CI = 1.48-2.02). ED is associated with cases having a prior diagnosis of UC, particularly in younger populations.

Diagnosis of urinary calculi

Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional Study

A prospective comparative study of non-contrast helical computed tomography and intravenous urogram for the assessment of renal colic

Objective: To compare noncontrast helical computed tomography (NCHCT) and intravenous urography (IVU) for diagnosis of urinary calculi in evaluation of renal colic. Materials and methods: A 4-month prospective paired study compared NCHCT and IVU in patients being evaluated for renal colic. Each patient was studied with NCHCT followed by an IVU. An IVU was regarded as positive if any of the following were identified: delayed filling, hydronephrosis, hydroureter, ureteral calculus, or extravasation of contrast. A NCHCT was regarded as positive if any of the following were identified: hydronephrosis, hydroureter, ureteral calculus, or perinephric or ureteral inflammatory change. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) were reported using the clinical outcome as the gold standard, by either observation of passage or retrieval of calculus. Bladder distention was noted on NCHCT relative to the level of the acetabulum. The charts were also reviewed retrospectively for the results of urinalysis. Results: One hundred sixty-eight patients had both examinations interpreted. Nineteen positive NCHCT and IVU studies were eliminated due to lack of observation or retrieval of calculus, leaving 149 studies for interpretation. NCHCT had Se 0.98, Sp 0.95, PPV 0.98, and NPV 0.95. IVU had Se 0.83, Sp 0.95, PPV 0.97, and NPV 0.67. In 13/168 (8 %) cases, and in 9/37 (24 %) negative cases, NCHCT offered an alternative diagnosis. Ureterovesical junction (UVJ) calculus was identified on 84 NCHCT scans, with near-even distribution between well, partially, and poorly distended bladder. No UVJ calculus was identified on IVU that was not present on NCHCT. Absence of hematuria was found in 26 % of patients with proven urolithiasis. Conclusion: NCHCT is superior to IVU for the evaluation of renal colic. NCHCT identifies significant pathology in 24 % of cases negative for ureteral obstruction/calculus. Bladder distention does not play an important role in detection of UVJ calculus. Hematuria is not universally present in patients with painful urolithiasis.