The effect of specific and nonspecific medical treatments applied according to risk factors on recurrence rate in patients with urinary system stone disease with high recurrence risk

Patients with high risk of recurrence were followed up by recommending specific medical treatment according to the metabolic risk factor present, and nonspecific medical treatment was recommended in addition to lifestyle changes for stone patients without risk factors, and it was aimed to evaluate the patients in terms of recurrence. 64 urinary system stone patients over 18 years of age at high risk for recurrence were included in the study. After the existing stones of these patients were detected by non-contrast computed tomography, stone-freeness was achieved with the appropriate method for patients. Stone-freeness was confirmed by plain abdominal X-ray and urinary ultrasonography performed in the postoperative period. Then, detailed metabolic evaluation was performed on the patients. The obtained stone fragments were analyzed by X-ray diffraction method. Then, patients were grouped according to stone types and whether they had metabolic risk factors or not. Specific medical treatment was applied to those with metabolic risk factors and nonspecific treatment was applied to those who did not. Then, patients were evaluated for recurrence. According to the stone analysis of the patients, the most common type of stone was calcium oxalate stone with a rate of 68.8%. Metabolic risk factors were detected in 65.6% of the patients. The most common metabolic risk factor observed in the patients was hypocitraturia with a rate of 53.1%. The recurrence rate was found to be 15.6% during the mean 2-year follow-up period of the patients. Similar rates of recurrence were found between the patients who received specific medical treatment and those who were followed up with non-specific treatment during the 2-year follow-up. Lifestyle changes and medical treatment have an important place in preventing recurrence in urinary system stone disease. In the literature, there are studies that support and oppose the necessity of specific medical treatment. In our study, we concluded that recurrence rates decreased in high-risk patients who received specific medical treatment, and regressed to levels similar to those in low-risk patients.