title: Management of stone disease: 17 years experience of a stone clinic in a developing country.
abstract: OBJECTIVE
  To review 17 years experience of the stone clinic with incorporating the changes in practice over the years and to report the benefits of stone clinic in a developing country.
  
  
  METHODS
  The SIUT Stone clinic was established in 1990 with installation of HM4 Lithotriptor. This clinic is run jointly by a Urologist, Dietitian, Nephrologist, Biochemist and Radiologist. From 1990 - 2007, about 38,749 stone patients received treatment with ESWL (55%), PCNL (6.0%), URS (15.5%), litholopaxy 4.0% and open surgery 19.7%. These patients after treatment were followed in the stone clinic with stone analysis and 24 hours urine metabolic studies where indicated. Dietary and oral hydration programme combined with medical therapy was also instituted. Recurrence rate was noted in those patients who were advised diet modification, oral hydration and medical treatment. Complications of stone disease were documented during the follow-up period.
  
  
  RESULTS
  In ESWL group 8226 patients were followed in the stone clinic for 5 years. In this group, 185 (2.2%) had recurrence of renal calculi. In PCNL group 1306 patients were followed, and 16 (1.1%) had recurrence. In the open surgery group of 1294 patients, 17 (1.3%) had recurrence of renal calculi. The complications of stone disease noted were renal failure and infections in 162 (1.5%) patients, during the follow-up period.
  
  
  CONCLUSIONS
  This study shows the beneficial effect of a stone clinic in a developing country and positive effect on the reduction of recurrence and complications of stone disease. Our experience promotes the need to open more specialized stone clinics in areas where stone disease is highly prevalent.
authors.affiliation: Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan.
authors.forename: Manzoor
authors.initials: M
authors.lastname: Hussain
authors.forename: Syed Adibul Hasan
authors.initials: SA
authors.lastname: Rizvi
authors.forename: Hasan
authors.initials: H
authors.lastname: Askari
authors.forename: Gauhar
authors.initials: G
authors.lastname: Sultan
authors.forename: Murli
authors.initials: M
authors.lastname: Lal
authors.forename: Bux
authors.initials: B
authors.lastname: Ali
authors.forename: Syed Ali Anwar
authors.initials: SA
authors.lastname: Naqvi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D052878:Urolithiasis / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult