BAB I

INTRODUCTION

Urolithiasis is a widespread disease that affects the urinary system and a

considerable, high-priced reason of morbidity.2 Urinary calculi are the third most
common affliction of the urinary tract, exceeded by urinary tract infection and
pathologic condition of the prostate.1
Urolithiasis is a common disease that affects urinary tract in all age groups.
Both in adults and in children, stone size, location, renal anatomy, and other factors,
can influence the success of treatment modalities. The reported prevalence rate of
stone disease is 5%-12% in men, 4%-7% in women. Men’s possibility of forming
stones is more than women’s. However, the ratio has decreased from a 3:1-male to
female predominance to less than 1.3:1.2
There is an increasing incidence of urinary tract stone disease worldwide,
and the recurrence risk is high.3 Over the years, there has been a great advancement
in technology for minimally invasive treatment of urinary stones. The epoch of open
pyelolithotomy has supplanted and currently there are much less invasive
interventions, for instance, percutaneous nephrolithotomy (PCNL), ureteroscopy,
shockwave lithotripsy (SWL), and RIRS (retrograde internal surgery). However,
recurrent stone formation is still a major issue among patients with urolithiasis.2
It has been observed that renal stones are associated with systemic diseases
like Type 2 diabetes mellitus, obesity, dyslipidemia, and hypertension. Lifestyle
and environmental factors contribute significantly in their formation.6 Presentation
of renal colic is most common and therefore treatment is not delayed.7
The lifetime prevalence of kidney stone disease is estimated at 1% to 15%,
with the probability of having a stone varying according to age, gender, race, and
geographic location. In the United States, the prevalence of stone disease has been
estimated at 10% to 15%.4 The Afro-Asian stone-forming belt stretches from
Sudan, the Arab Republic of Egypt, Saudi Arabia, the United Arab Emirates, the
Islamic Republic of Iran, Pakistan, India, Myanmar, Thailand, and Indonesia to the
Philippines. In this area of the world, the disease affects all age groups, from less
than 1 year old to more than 70 years old, with a male-to-female ratio of 2 to 1. The
prevalence of calculi ranges from 4% to 20%.8 In Indonesia, urinary tract stone
disease still hold the largest share of total patients in urologic clinic, with the precise
incidence still undetermined.5
Based on riskesdas 2013, the prevalence of kidney stone patients based on
doctor-diagnosed interviews in Indonesia is 0.6 %. The highest prevalence in DI
Yogyakarta (1.2%), followed by Aceh (0.9%), West Java, Central Java, and Central
Sulawesi respectively by 0.8%.9

1. Tanagho, E., A., and McAninch, J., W. 2008. Urinary Stone Disease. In:
Smith General Urology. 17th edition. McGraw-Hill Companies. 246-277.
2. Mehmet, N.,M., et al. 2015. Effect of urinary stone disease and its treatment
on renal function. World J Nephrol; 4(2): 271-276.
3. Tiselius, H.G., et al. 2017. Metabolic Work-up of Patients with Urolithiasis:
Indications and Diagnostic Algorithm. European Urology Focus: 3 (2017)
62–71.
4. Campbell
5. Prasadja, N., et al. 2011. Stone Free Rate Difference In Kidney Stones
Patients with and without Tamsulosin After ESWL. JURI; 18(2): 36-43.
6. Aggarwal, R., et al. 2017. Renal Stones: a Clinical Review. EMJ Urol; 5[1]:
98-103.
7. Pfau, A., and Knauf, F. 2016. Update on Nephrolithiasis: Core Curriculum
2016. Am J Kidney Dis; 68(6): 973-985.
8. Lopez, M., and Hoppe, B. 2010. History, epidemiology and regional
diversities of urolithiasis. Pediatr Nephrol; 25:49–59.
9. Riskesdas. 2013. Kementrian Kesehatan Indonesia.