struvite and Prostatic-Hyperplasia

More than ten per cent of stones are associated with a urinary tract abnormality. To verify whether the malformation influences stone composition, we studied the composition of stones observed in fifteen urological abnormalities.. This study is based on 1,461 stones associated with a clearly defined malformation analysed by infrared spectroscopy plus 402 bladder stones in men with benign prostatic hyperplasia.. In this series of 1,863 abnormalities, 732 (39.3%) involved the kidney, 561 (30.1%) involved the ureter and 570 (30.6%) involved the lower tract. Whewellite stones were predominant in all renal abnormalities with the exception of cysts, which were mainly associated with uric acid. The main differences concerned the second constituent: weddellite in horseshoe kidneys, carbapatite in Cacchi-Ricci disease and caliceal abnormalities. Struvite was uncommon (<10%). Whewellite was the main component in ureteric abnormalities except for megaureter and reflux in which carbapatite was predominant. Struvite was present in 10% to 30% of stones. Vesicourethral abnormalities were accompanied by calcium and magnesium phosphate stones (90% of cases), and struvite was present in 58% to 90% of cases. The exception to this general rule was bladder stones associated with benign prostatic hyperplasia, in which the main component was uric acid.. Significant differences in stone composition were observed as a function of anatomical abnormalities reflecting the fact that some abnormalities add infectious or metabolic risk factors to anatomical factors.

Topics: Female; Humans; Kidney; Kidney Diseases; Magnesium Compounds; Male; Middle Aged; Phosphates; Prostatic Hyperplasia; Struvite; Ureter; Ureteral Diseases; Urinary Calculi; Urinary Tract

The stones removed from 273 patients (220 males, 53 females) with bladder stones and 27 patients with urethral stones (males) were analyzed by infrared spectroscopy. Of these stones 50.0% contained magnesium ammonium phosphate (MAP), 39.9% calcium (oxalate and/or phosphate), 9.4% uric acid (urate), and 0.7% cystine. The disorders associated with bladder stones were prostatic hyperplasia and cancer (47.8%), neurogenic bladder (11.8%), urethral stricture (3.6%) and so on in males, and neurogenic bladder (48.1%), after operation of uterus (29.0%), bladder cancer (5.7%) and so on in females. Urinary infections were complications in 59.3% of patients with MAP stones, 41.2% with urate stones and 20.0% with calcium stones. The most often isolated bacteria from the infected urine were of the Proteus species.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bacteriuria; Calcium Oxalate; Calcium Phosphates; Chi-Square Distribution; Child; Child, Preschool; Cystine; Female; Humans; Magnesium Compounds; Male; Middle Aged; Phosphates; Prostatic Hyperplasia; Spectrophotometry, Infrared; Struvite; Urethral Diseases; Uric Acid; Urinary Bladder Calculi; Urinary Bladder, Neurogenic; Urinary Calculi; Urinary Tract Infections; Urologic Diseases

Six high operative risk patients with urinary retention caused by benign prostatic hyperplasia were managed with an intraprostatic spiral at our hospital. Three of them had severe coronary artery disease, 1 had uremia, 1 had cerebral stroke and 1 had poorly controlled diabetes mellitus. The urinary retention was successfully relieved by the intraprostatic spiral in all patients. No operative mortality or severe complication was encountered. One patient experienced a repeat attack of urinary retention due to proximal migration of the spiral. Four patients complained of urgency, which was relieved by anticholinergic agents. Stone incrustation was found on 2 out of 3 spirals removed (66%), and the stone turned out to be calcium phosphate and struvite by scanning electron microscopy and infrared spectrophotometry. In 1 patient, stone formation was so abundant that it almost obstructed the lumen of the redundant tip of the spiral. From our preliminary results, the intraprostatic spiral seems to be a good alternative to an indwelling catheter for patients awaiting prostatectomy. Nevertheless, the potential complication of stone incrustation should be anticipated and it is suggested to remove the device as soon as possible or to replace it at regular intervals.

Topics: Aged; Calcium Oxalate; Crystallization; Humans; Magnesium; Magnesium Compounds; Male; Middle Aged; Phosphates; Prostatic Hyperplasia; Stents; Struvite; Urinary Calculi; Urinary Retention