Clinical Course of Recurrent Urolithiasis: A Pilot Study

BACKGROUND: Urolithiasis is one of the most common urological disorders, characterized by a chronic recurrent course. Various predictive models have been proposed to assess the risk of stone recurrence. However, their effectiveness remains limited, which necessitates further investigation into the clinical features of the disease, including its recurrent nature.

AIM: To evaluate the features of the clinical course of recurrent urolithiasis.

METHODS: This study included 471 patients admitted to a urology department between 2019 and 2021 with a diagnosis of urolithiasis (ICD-10 codes N20, N23). Statistical analysis of data was performed using RStudio (version 4.3.3).

RESULTS: Compared to patients with first-onset urolithiasis, those with recurrent disease had a higher body mass index (28.0 and 27.4 kg/m², respectively; p = 0.043), a higher prevalence of overweight (76.6% and 67.5%, respectively; p = 0.002), and a greater number of stones in each kidney and overall in both kidneys. The total stone volume was also significantly higher in recurrent urolithiasis: median 855 mm³ and 433 mm³, respectively (p < 0.001). A history of spontaneous stone passage was reported in 42% of patients, whereas 58% had previously undergone surgical intervention for urolithiasis. Patients with a history of surgical interventions for urolithiasis had a higher body mass index, a more frequent presence of obesity compared to patients with spontaneous stone passage (39.2% and 23.8%, respectively; p = 0.011), as well as a greater number of urinary stones in both kidneys.

CONCLUSION: Recurrent urolithiasis is more common among patients with excess body weight and is associated with more intensive stone formation than in patients with first-onset of urolithiasis. In recurrent urolithiasis, obesity is linked to an increased need for surgical intervention and a lower probability of spontaneous stone passage. In this context, body weight normalization appears to be the most appropriate strategy for reducing the risk of urolithiasis recurrence.