Clinic Study Of The Relationship Between Urinary Tract Infection And Recurrent Kidney Stone

Background Urinary stone disease is the most common urology disease, and often accompanied by pain and obstruction, and will do damage to kidney function if left untreated. With the minimally invasive surgeries becoming perfect, treatment for urinary stone disease has made great improvements. However, the high recurrence rate after surgeres still challenges the urology surgeons.Objectives There has been proved to be a close relationship between urinary stone disease and urinary tract infection, and we try to clarify this relationship and get a better understanding of how anti-infection therapy can affect the prognosis of kidney stone.Patients and methods Review of38patients from2011.11.01～2013.03.31from Minimally Invasive Urology Center of Shandong Provincial Hospital affiliated to Shandong University. The patients we choose all have unilateral kidney stones or accompanied with ureter stone disease and had successful surgeries, as well as no urinary tract obstruction or obvious metabolic diseases. After discharged from hospital, they were all under diet instructions, and drunk lots of water, did check-ups regularly. Their ages range from22～69, the average age is48.71±9.86. Of all the patients,4patients had a percutaneous nephrostomy first. We analysis the results of urinalysis and urine culture, anti-infection time before and after their surgery, and whether or not they have a relapse after such a long time to find the relationship between urinary infection and kidney stone recurrence. Furthermore, we want to find how much anti-infection therapy can prevent the recurrence of kidney stone disease.Results Of all patients,34had a positive result of urinalysis,17had positive result of urine culture.4patients underwent percutaneous nephrostomy first. All patients had anti-infection therapy time3～16days. The surgeries were performed by the same surgeon. All patients had anti-infection therapy3-15days until clinical symptoms were removed.30patients leaved hospital with a negative result of urinalysis while8were not. After1months to3months all patients removed their tubes, with36patients having a positive result of urinalysis and11having a positive result of urine culture.8patients left hospital with positive urinalysis results. After12～29months’ follow-up study,5patients had a relapse. Of the30patients with negative urinalysis or rational anti-infection therapy,1patients had a recurrence kidney stone. Of the8patients with positive results or without rational anti-infection therapy there are4patients had a relapse.Conclusions Chinese guidelines for diagnosis and treatment of urology disease of2011points out that metabolic diseases, urinary tract obstruction, infection, foreign substances and drugs are the common reasons for urinary stone disease. Recent study has already shown epithelial injury that comes from high concentration of substance in urine and infection and the interaction between urine crystal and epithelial cells plays an important role in the formation of urinary stones.1. We learn that anti-infection therapy could be used in preventing the recurrence of non-infection stone disease as well as infection stones. Despite small population, we can see the anti-infection therapy really works in preventing the recurrence of kidney stone.2. Different therapy should be used in prevent different kidney stone diseases.3. Appearance of RBC and WBC in the urine demonstrated that urinary epithelial cells have been damaged. Immediate means should be taken to prevent the formation of kidney stone, including drinking more water and using antibiotics to control the infection.