Does diabetes mellitus influence the surgical management of urinary tract stones among patients in the United Kingdom?

By: El Hadi M.1, D’Costa J.2, De Vogel C.2, Devarajan R.3, Otite U.4
Institutes: 1City Hospital, Sandwell and West Birmingham Hospitals Nhs Trust, Dept. of Urology, Birmingham, United Kingdom, 2University of Birmingham, School of Medicine, Birmingham, United Kingdom, 3University Hospital Coventry and Warwickshire, Dept. of Urology, Coventry, United Kingdom, 4Sandwell and West Birmingham Hospitals Nhs Trust, Dept. of Urology, Birmingham, United Kingdom

Introduction & Objectives

Urolithiasis is one of the most common urological problems in the United Kingdom; With an annual incidence of 1–2 cases per 1000 people in England. 6% of the adult population in 2013 were diagnosed with diabetes in England. Several studies suggest there is an association of diabetes with stone formation, recurrence, and morbidity. Our study aimed to compare the prevalence of risk factors like metabolic syndrome, urinary tract infections, age, gender and ethnicity among diabetics versus non-diabetics and to assess how diabetes affects the biochemical and surgical outcomes of urolithiasis.

Material & Methods

Patients who treated surgically for urolithiasis with either ureteroscopy or percutaneous nephrolithotomy over three years were retrospectively analysed. Information was cross-referenced with electronic notes to produce biochemical and surgical data.


Of 182 patients treated, 31 (17%) have type 2 diabetes. The mean age of diabetics was significantly higher than non-diabetics by nearly 12 years (p-value < 0.001). Hypertension, hyperlipidaemia, obesity and urinary tract infections were more prevalent among diabetics (p-value < 0.001, < 0.001, 0.01, 0.009 respectively). Diabetics were at higher risk of stone recurrence at 1 year (p-value =0.04) compared to non-diabetics. Stone recurrence was not significantly different at 3 and 5 years between the two groups. Diabetics had higher urinary oxalate, and nearly statistically significant lower phosphate levels (p-value=0.007, 0.076 respectively).


Diabetics with urolithiasis were significantly older and associated with metabolic syndrome. UTIs were more prevalent among diabetics which put them at risk of postoperative complications. Diabetics were at higher risk of stone recurrence at 1 year compared to non-diabetics. The biochemical urinary findings can guide the management of recurrent stone formers with diabetes.

  • Event: 4th Meeting of the EAU Section of Urolithiasis (EULIS)
  • Type: Abstract
  • Date: 05-10-2017
  • Views: 52
  • Nr: 29
  • Session: Medical management and physiology
  • Location: Thursday 5 October 2017, 14:00 - 15:30, Stolz 1