A review of 171 consecutive patients with urinary lithiasis.

During a 3-year interval 171 patients with urinary tract calculi were seen and studied: 98 had kidney, 52 had ureteral and 21 had bladder calculi. In 54 of the 98 patients with kidney stones (55 per cent) abnormal elevations of the blood and/or urine calcium, uric acid or creatinine were noted. Of these 98 patients 54 (55 per cent) were treated with observation only, 42 (43 per cent) were treated surgically (with an operative mortality of 2.4 per cent) and in 2 the renal stones passed spontaneously. Sixty-two per cent of the patients with renal calculi had a history of stones. It is believed that asymptomatic renal stones located in a calix or calices and not associated with infection are best managed nonoperatively. The average age of the 52 patients presenting with ureteral calculi was 12 years younger than that of patients presenting with renal calculi (36 versus 48 years). In 46 per cent of these cases the ureteral calculi ultimately passed spontaneously. Conservative therapy of ureteral calculi with long-term expectant observation (weeks and even months) often is indicated in the obstructed and uninfected patient. Twenty-nine per cent of the patients with ureteral calculi had a history of stones.