Patients Preference in the Management of Urinary Stone Disease

Abstract

Objective:To assess patients' preference in choosing modality of treatment for the urinary stone
disease.
Material & Methods: 100 consecutive patients with urinary stone disease were interviewed
through self designed questionnaire. Following parameters were evaluated: presentation,
biochemical & radiological investigations, previous treatment, patient's preference in choosing
modality of treatment (hakeem, homeopathy, allopathy & spiritual treatment), duration of
treatment and cost. Ultimate management of patients was also assessed.
Results: Mean age of the patients were 38.43 years. There were 61 males and 39 females.
Mean duration of illness was 4.3 years. Mean stone size was 3.83 cm. Seventy six patients had
kidney stones, four patients were with ureteric stones, eleven patients had bladder stones and
twelve patients had bilateral renal stones. Seven patients were in renal failure due to stones. First
priority was hakeem/ quacks in 45%, allopathic in 39%, homeopathic in 17% & spiritual treatment
in 03% patients. Mean cost of treatment of different modalities was as follows: Allopathic Rs
4,530/-, Homeopathic Rs 2,747/-, Hakeem Rs 2,427- & Spiritual Rs 907/-. Fifty five patients
underwent pyelolithotomy, 10 patients percutaneous nephrolithitomy (PNL), eleven patients
Nephrectomy, 4 patients ureteroscopic removal of stone (URS), 11 patients Vesicolithotmy/
Litholapaxy and 4 patients extracorporeal shock wave lithotripsy (ESWL). Mean post-op stay was
10.5 days.
Conclusion: In spite of recent advances in medical science, allopathy is not the first choice for
vast majority of the patients in the management of urinary calculi. Our population is still under the
influence of hakeems, quacks and homeopaths. Reasons are illiteracy, poverty, fear of surgery
and negative propaganda through media. Patients with small stones requiring ESWL end up with
major surgical procedures, like pyelolithotmies and nephrectomies. Some of them develop renal
failure because of inappropriate management