Photmicrography of urinary deposits in stone clinic.

The importance of routine urine deposit study has not been projected satisfactorily in literature. This paper analyses the findings of urine microscopy of urinary stone patients who attended the stone clinic. A total number of 800 patients who attended the urinary stone clinic during the years 2005-2007 were selected for the study. Each patient had two samples of urine studied; early morning urine (EMU) and random. The patients were classified into different groups as proved stone patients (304), colic patients (289) and crystalluria patients (207). They were further classified as pre-treatment group and post-treatment group. The patients had chemotherapy depending on the biochemical abnormalities. The urine samples were centrifuged and the deposits examined under the low-power and high-power magnifications of the binocular microscope. The appropriate fields were photographed using a micro-photographic camera. 23% of the urinary samples studied contained deposits (36% of the EMU and 16% of the random samples). The most common deposits were red blood cells (RBC) (17%), pus cells (PC) (13%), calcium oxalate monohydrate (COM) crystals (7%), calcium oxalate dihydrate (COD) crystals (11%), uric acid crystals (2%), amorphous phosphates (1%), epithelial cells (13%) and sperms (7%). The unusual deposits included ammonium urate and cystine. Comparison of the results of deposits with those of 473 deposits from other laboratories showed that the present reports showed much more deposits than the outside ones. Deposits were more in the male patients (25%) compared to the females (19%). 83% of the patients with significant deposits had symptoms at the time of collection of sample, while 17% were not symptomatic. Among the patients with crystals, 53% had RBC associated and 49% had PC. RBCs were seen most in the COD crystal group. PC alone were seen in 2% and all were females. Percentage of urinary deposits was more in the pre-treatment group (32%) than in the post-treatment group (17%). Extent of crystalluria was more in the colic group (38%) compared to the crystalluria (22%) and stone (13%) groups. It is concluded from the study that accurate assessment of the urinary stone patient lies in a proper microscopic evaluation. It is mandatory that EMU should be examined as there is greater chance of identifying crystals and other deposits. Centrifuged deposits showed more deposits and these should be standards in urine examination. Regular urine deposit examination should be performed in all patients coming for follow-up.