Yemen Observer: http://www.yobserver.com
Posted in:
Sports, Health & Lifestyle
Written By: Thuria Ghaleb
Article Date: Jan 8, 2008 - 5:08:43 AM
Males have a three times greater risk of developing urinary stones and are five times more likely to have them recur than females, according to a new study from researchers at the University of Sana’a. The study suggests that physiological and hormonal factors in both sexes may play an important role in the formation and recurrence of the stones.
Researchers conducted their study on 250 urinary patients, 74 percent of them female and 26 percent male, who were examined in three Sana’a hospitals over the course of three months to identify the recurrence and prevention of urinary stones among Yemeni patients.
The process of forming stones in the kidney, bladder, and/or urethra (urinary tract) is called urolithiasis.
The development of the stones is related to decreased urine volume or increased excretion of stone-forming components such as calcium. The stones form in the pelvis of the kidney, the urine collecting area, and may range in size from tiny to staghorn stones the size of the renal pelvis itself.
About half of the patients studied suffered from urinary stones more than three times during their life, the study found. People between the ages of 31 to 50 years old were more prone to develop stones in their urinary tract than patients in other age groups, while just 14 percent of those above 50 years of age developed this problem. The study also found that middle-aged patients were more liable to have stones recur during their life compared to children and older people.
About 61 percent of urinary stone patients were prone to a second episode of recurrent stones less than two years after their initial diagnosis. Researchers thought that this recurrence period was short compared to those found in some studies conducted in developed countries. They proposed that the different preventative measures used by Yemeni patients and those from developed countries noticeably affected the time period between recurrences. They said that routine examinations are some of these measures and noted that most Yemeni urinary patients do not pay attention to follow-up exams.
The study found that the most common significant factors affecting the recurrence of urolithiasis were family history, occurrence of urinary tract infections, male as opposed to female gender, and the amount of water intake.
Urban patients were found to be less affected with urolithiasis than rural ones. Researchers speculated that people living in rural areas may have an increased exposure to sunlight while drinking smaller amounts of water.
Chewing qat expedited the process of forming recurrent stones, the study found. The researchers thought that most patients were sitting many hours per day chewing qat and did not drink enough water while doing so, which would help stones to re-form in a shorter period of time.
The recurrence of stones decreased among patients who practiced preventative measures - only 40 percent of these individuals had a second episode, compared to a rate of 61 percent in those who did nothing to alleviate their condition.
Ninety-two percent of Yemeni patients took the preventative measure of drinking more than two liters of water per day. The study found that in those patients who continued this practice, only 28 percent experienced a recurrent stone, compared to a second stone occurring in about 72 percent of those patients who stopped the increase in their water intake after just six months.
The study also found that most patients, 66 percent, were suffering from kidney stones, which are a common cause of blood in the urine and pain in the abdomen, flank, or groin. They occur in 1 out of every 20 people at some time in their life. Kidney stones are usually painless when in the kidney, but can cause severe pain as they travel from the kidneys to the bladder.
According to the study, half of the patients were treated by extracorporeal shock wave lithotripsy (ESWL), while open surgery was used to treat about 14 percent of patients. ESWL focuses high-energy shock waves from a source outside the body and uses this energy to crush the stone into tiny pieces. These pieces are then small enough to pass out of the body during urination. Endoscopic surgery was still required to treat 34 percent of urinary stone patients.
Endoscopic surgery uses scopes inserted through small incisions or natural body openings in order to diagnose and treat disease. The study recommended that patients with prior history of urolithiasis be put on a dietary program and undergo regular follow-up examinations. It also recommended that patients with a family history of the condition increase their daily intake of water.
Patients were also advised to continue practicing preventative care in order to delay or completely prevent the recurrence of stones.
The study was supervised by Dr. Mohammed al-Naib, a professor in the Faculty of Medicine and Health Sciences at Sana’a University, and was conducted by Wail al-Shera’i, Nabeel al-Yafa’i, Adnan Taleb, Mohammed Saleh, Amir al-Shehari, Fayzah al-Shamiri, Nada al-Aghbari, Yasmeen al-Azzani, Salwa al-Hamdi and Mohammed Ieesa.