[Epidemiology of urinary stones in the French military during the operation Serval]

Abstract

Objectives: The renal colic crisis is a pathology frequently encountered in foreign operations recently conducted by the French army and often requires a medical repatriation in mainland France. Soldiers deployed in arid areas are at increased risk of developing urolithiasis. The purpose of our study is to analyze the risk factors, the frequency and the methods of management of symptomatic urinary stone disease for French military returnees for renal colic during Serval operation.

Methods: Our study focused on French soldiers repatriated from Mali for a renal colic care between January 11th and November 30th, 2013. For each patient, we recorded: age, sex, deployment date, crisis date, personal and family histories of urolithiasis, initial medical treatment, diagnosis and treatment to return to France.

Results: Three hundred and forty-eight soldiers were evacuated during Serval operation, among which 41 were due to the occurrence of renal colic crisis (11.7%). Twenty-nine percent of patients had a personal history of kidney stone disease symptomatically. The average residence time when the crisis appears is 60 days (10-120 days). Ninety-five percent of patients were asymptomatic at their arrival in France and 39% of patients had no stone found in CT scan. The average size of the stones found on the imaging was 2.71 mm (1-8mm). One patient required drainage by JJ ureteral endoprothese in order to have a quick ureteroscopy for recovery of its capacity.

Conclusion: The French military sent to Serval operation are exposed to multiple contributing factors of urolithiasis as the dehydration and the strong temperature. The analysis of our series reveals that the history of renal stone disease is the main factor favoring and the medical treatment is effective in almost all renal colic cases. The operational impact associated with this common condition in the Sahel region deserves an awareness of field practitioners to the screening and management of this disease in a precarious situation and a reflection of the staffs concerning the access onto the operating theater to appropriate diagnostic and therapeutic means that could facilitate the return to the combat unit.

Keywords: Epidemiology; Foreign operation; Lithiase urinaire; Opération extérieure; Traitement; Treatment; Urinary calculi; Épidémiologie.