To study a clinical problem in urolithiasis complicated with bacteriuria treated by extracorporeal shock wave lithotripsy (ESWL), we studied relationships between the frequency of bacteriuria and some clinical factors such as sex, location of, size of and composition of calculi in patients with upper urinary tract calculi. We also evaluated whether bacteriuria caused fever elevation after ESWL monotherapy. Six hundred seventy patients with upper urinary tract calculi, 440 renal calculi and 230 ureteral calculi, were subjected to the present study. The results were summarized as follows:
1) Bacteriuria was found in 40 of 440 patients with renal calculi (9%) and 12 of 230 patients with ureteral calculi (5%).
2) The frequency of bacteriuria was significantly higher in female (11%) than in male (6%) (p<0.05).
3) Ten strains of Pseudomonas aeruginosa, 7 of Escherichia coli and 6 of Proteus mirabilis were isolated in patients with bacteriuria.
4) On the location of renal calculi in patients with bacteriuria, 37 out of 40 patients (93%) were found in R2. In contrast, bacteriuria was the most frequently found in DS 6 (19%), whereas the positive rates were about 10% in DS 3 (7%), DS 4 (7%) and DS 5 (9%). The presence of bacteriuria was not related to the location of calculi or the size of calculi in patients with ureteral calculi.
5) Most of the calculi with bacteriuria were composed of magnesium ammonium phosphate or the mixture of calcium phosphate and carbonate with or without oxalate.
6) Patients with bacteriuria had a significantly higher rate of fever elevation after ESWL than those without bacteriuria (p<0.01).