#Renal calculus series#A large series from the National Spinal Cord Injury Statistical Center (NSCISC) found the incidence rate after the first year post-SCI was 8/1000 person-years 2 and 9/1000 person-years within their own center in Alabama. There is a great deal of variability because of the changes over time in the detection and management of stone disease, the calculation method, and the follow-up period. Several publications have reported on the frequency and rates of renal calculi in the SCI population ( Table 1). 2–5 The lifetime risk for urolithiasis in the general population is estimated at 12% for men and 6% for women 6 age standardized annual incidence rates are 0.36 to 1.22/1000 person-years. The risk of upper tract stone disease in patients with SCI is significantly higher than the general population. Traditional limitations of this procedure in patients with SCI have likely been overcome with new flexible scopes however, the medical literature has not specifically reported on its use among patients with SCI. Ureteroscopy is a common modality used in the general population to treat patients with upper tract stone disease. The literature suggests that the morbidity associated with percutaneous nephrolithotomy in these patients is considerable. Shockwave lithotripsy (SWL) is commonly used to manage stones in patients with SCI, and there have been reports of stone-free rates of 50% to 70%. The proportion of patients who have their stones treated with different modalities is largely unknown. The clinical presentation of stone disease in patients with SCI may involve frequent urinary infections or urosepsis, and at the time of presentation patients may need emergency renal drainage. There has been a reduction in struvite stones among these patients, likely as a result of advances in their urologic care. The potential risk factors for stones in the SCI population are lesion level, bladder management strategy, specific metabolic changes, and frequent urinary tract infections. They frequently have recurrent stones, staghorn calculi, and bilateral stone disease. Renal stone disease is common among patients with spinal cord injury (SCI).
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