URETEROPELVIC JUNCTION OBSTRUCTION WITH A SIMULTANEOUS RENAL CALCULUS- LONG-TERM FOLLOW-UP

We reviewed 111 patients who presented with simultaneous renal calculi and a ureteropelvic junction obstruction. Of 34 patients with uretero pelvic junction obstruction and a coexisting struvite stone 62% had re current calculi. The use of antibiotics significantly affected the inc idence of recurrent struvite calculi. In particular, if prolonged prop hylactic antibiotics (greater than 3 months) were used 15% of the pati ents had recurrent stones, compared to 90% if only perioperative antib iotics (less than 15 days) were used (p <0.001). Patients with uretero pelvic junction obstruction and coexisting nonstruvite calculi were tr eated by either observation alone (53) or metabolic evaluation with ap propriate intervention (24). Metabolic evaluation of patients with non struvite calculi revealed that 76% had an identifiable metabolic abnor mality, treatment of which significantly decreased the incidence of re current renal calculi: 17% of the patients on interventional therapy h ad recurrent stones compared to 55% treated by observation alone (p <0 .001).