struvite and Ureteral-Calculi

Diagnostic imaging is usually required to determine the presence of urolithiasis. Double-contrast cystography is more accurate than survey radiography and approximately as accurate as ultrasonography. Knowledge of the mineral composition of calculi helps direct appropriate management of urolithiasis, and signalment can help predict composition with about 70% accuracy. In cats, about half of cystic calculi are struvite and half are calcium oxalate; most nephroliths and ureteroliths are calcium oxalate. In female dogs, struvite uroliths are the predominant type found in the bladder. In male dogs, breed plays a strong role in prediction of bladder urolith type. It is difficult to predict the composition of nephroliths and ureteroliths based on signalment alone in dogs. Urinalysis and imaging findings can help in predicting urolith composition, although chemical analysis is necessary for definitive diagnosis.

Topics: Animals; Calcium Oxalate; Cat Diseases; Cats; Diagnosis, Differential; Dog Diseases; Dogs; Female; Magnesium Compounds; Male; Pedigree; Phosphates; Radiography, Abdominal; Sex Factors; Struvite; Ultrasonography; Ureteral Calculi; Uric Acid; Urolithiasis

To assess the clinical outcome of a ferret undergoing a ureteroneocystostomy for treatment of urolithiasis.. A 10-month-old spayed female ferret.. The ferret was evaluated for straining to urinate and defecate, hematochezia, and a rectal prolapse. Plain radiographs revealed large cystic and ureteral calculi. Clinicopathologic analyses indicated the ferret was anemic with an elevated creatinine concentration. Exploratory laparotomy defined bilateral ureteral calculi that were unable to be successfully moved into the bladder. A cystotomy was performed to remove a large cystic calculus. Serial abdominal ultrasonographic examinations showed progressive hydronephrosis of the left kidney and persistent pyelectasia of the right kidney secondary to bilateral ureteral calculi. This confirmed a left ureteral obstruction secondary to the distal calculus while the right ureter remained patent.. A ureteroneocystostomy was performed to allow for left renal decompression. The ferret recovered well despite worsening hydronephrosis of the left kidney in the perioperative period. The ferret was discharged from the hospital 10 days after initial evaluation. At 3-week follow-up, abdominal ultrasonography confirmed resolution of hydronephrosis and ureteral dilation of the left kidney and ureter.. A ureteroneocystostomy successfully allowed renal decompression and ureteral patency in a ferret with urolithiasis. To the authors' knowledge, this is the first time this procedure has been reported in a ferret for treatment of a ureteral calculus obstruction and may result in good long-term outcome.

Topics: Animals; Female; Ferrets; Hydronephrosis; Struvite; Ureter; Ureteral Calculi; Ureteral Obstruction; Urolithiasis

To study urinary stone composition patterns in different populations around the world.. Data were collected by reviewing charts of 1204 adult patients of 10 countries with renal or ureteral stones (> 18 years) in whom a stone analysis was done and available. Any method of stone analysis was accepted, but the methodology had to be registered.. In total, we observed 710 (59%) patients with calcium oxalate, 31 (1%) with calcium phosphate, 161 (13%) with mixed calcium oxalate/calcium phosphate, 15 (1%) with carbapatite, 110 (9%) with uric acid, 7 (< 1%) with urate (ammonium or sodium), 100 (9%) with mixed with uric acid/ calcium oxalate, 56 (5%) with struvite and 14 (1%) with cystine stones. Calciumcontaining stones were the most common in all countries ranging from 43 to 91%. Oxalate stones were more common than phosphate or mixed phosphate/oxalate stones in most countries except Egypt and India. The rate of uric acid containing stones ranged from 4 to 34%, being higher in Egypt, India, Pakistan, Iraq, Poland and Bulgaria. Struvite stones occurred in less than 5% in all countries except India (23%) and Pakistan (16%). Cystine stones occurred in 1% of cases.. The frequency of different types of urinary stones varies from country to country. Calcium-containing stones are prevalent in all countries. The frequency of uric acid containing stones seems to depend mainly on climatic factors, being higher in countries with desert or tropical climates. Dietary patterns can also lead to an increase in the frequency of uric acid containing stones in association with high obesity rates. Struvite stones are decreasing in most countries due to improved health conditions.

Topics: Adult; Calcium Oxalate; Humans; Kidney Calculi; Struvite; Ureteral Calculi; Urinary Calculi

To determine if treatment of non-obstructing urolithiasis is effective in management of recurrent UTI.. A retrospective review was performed of patients undergoing elective management of non-struvite upper tract urinary calculi with recurrent UTI from 2009 to 2016. Recurrent UTI was defined at ≥ 3 UTI in 12 months, with symptoms and documented urine culture. Preoperative CT was performed in all patients to determine stone burden. All patients had postoperative imaging and ≥ 12 months of follow-up. Pre- and postoperative variables were between patients who had recurrent UTI after treatment versus those who did not.. 46 patients met inclusion criteria. 42 (91.3%) were female. Median age was 63.7 years (IQR 49.1, 73.4) and median total stone burden was 20 mm (IQR 14-35). Within the cohort, 20 (43.5%) underwent ureteroscopy only, 26 (56.5%) underwent PCNL ± URS, and none underwent ESWL. Median postoperative follow-up was 2.9 years (IQR 2.0, 4.3). Only five patients (10.9%) had recurrent UTI after treatment. 80% were with the preoperative pathogen. The presence of residual stone was an independent risk factor for recurrent UTI after treatment (p < 0.046). Diabetes, hypertension, immunosuppression and chronic kidney disease were not.. Stone removal for patients with recurrent UTIs was associated with a high rate of success (89.1%) in elimination of further recurrent UTIs. Residual fragments are independently associated with persistent recurrent UTIs and thus, complete stone removal is of paramount importance in treatment of this patient population.

Topics: Aged; Female; Humans; Incidence; Kidney Calculi; Male; Middle Aged; Nephrolithotomy, Percutaneous; Recurrence; Retrospective Studies; Struvite; Treatment Outcome; Ureteral Calculi; Ureteroscopy; Urinary Tract Infections

This study aimed to assess the accuracy of low-dose dual-energy computed tomography (DECT) in predicting the composition of urinary calculi.. A total of 52 patients with urinary calculi were scanned with a 128-slice dual-source DECT scanner by use of a low-dose protocol. Dual-energy (DE) ratio, weighted average Hounsfield unit (HU) of calculi, radiation dose, and image noise levels were recorded. Two radiologists independently rated study quality. Stone composition was assessed after extraction by Fourier transform infrared spectroscopy (FTIRS). Analysis of variance was used to determine if the differences in HU values and DE ratios between the various calculus groups were significant. Threshold cutoff values to classify the calculi into separate groups were identified by receiver operating characteristic curve analysis.. A total of 137 calculi were detected. FTIRS analysis differentiated the calculi into five groups: uric acid (n=17), struvite (n=3), calcium oxalate monohydrate and dihydrate (COM-COD, n=84), calcium oxalate monohydrate (COM, n=28), and carbonate apatite (n=5). The HU value could differentiate only uric acid calculi from calcified calculi (p<0.001). The DE ratio could confidently differentiate uric acid, struvite, calcium oxalate, and carbonate apatite calculi (p<0.001) with cutoff values of 1.12, 1.34, and 1.66, respectively, giving >80% sensitivity and specificity to differentiate them. The DE ratio could not differentiate COM from COM-COD calculi. No study was rated poor in quality by either of the observers. The mean radiation dose was 1.8 mSv.. Low-dose DECT accurately predicts urinary calculus composition in vivo while simultaneously reducing radiation exposure without compromising study quality.

Topics: Adult; Apatites; Calcium Oxalate; Female; Humans; Image Interpretation, Computer-Assisted; Kidney Calculi; Magnesium Compounds; Male; Middle Aged; Phosphates; Prospective Studies; Radiation Dosage; Struvite; Tomography, X-Ray Computed; Ureteral Calculi; Uric Acid; Waist Circumference; Young Adult

The goal of this prospective study was to characterize ureteral stents encrustation in stone formers.. We report the results of a study based on 658 double-J stents (412 men and 246 women) collected from patients with in situ urinary calculi. The mean age was 48.2+/-16.0 years without differences between genders. Ureteral stent encrustation was analysed by infrared spectroscopy. Results are expressed according to the main component.. The mean indwelling time was 73.5+/-73.2 days. The main component in stent encrustations was calcium oxalate (43.8%), essentially the monohydrate form (27.1%), followed by proteins (27.4%), calcium phosphates (16.4% with 8.4% brushite), and uric acid (5.2%). Struvite, detected on 49 stents, was the main component in 2.4% of cases. Significant differences according to gender and age were found: calcium oxalate monohydrate, which represented 24.5% in 20 to 29 years old men class increased to 37.0% in 50 to 59 years class and then decreased in older patients. Calcium oxalate dihydrate increased with age up to 70 years in women while it felt dramatically in man beyond 50 years old. Brushite was more abundant in young men (20.4% in patients aged 20-29 years) and was decreasing beyond this age while it remained in stable proportion for all age classes in women. Increasing prevalence of uric acid encrustations with age was observed, especially in men beyond the age of 70 years. Mineral encrustations increased with the indwelling time, the part of mineral being preponderant after 15 days: 7,3% of the stents had become massively encrusted within 113 days mean period. The comparison between biomaterials showed that silicone stents were significantly less encrusted than polyurethane stents.. Stent encrustation constitutes a serious complication of ureteral stent use in stone formers. Lithogenic factors should be considered for the prevention of stent encrustation in these patients.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Calcium Oxalate; Calcium Phosphates; Female; Hemostatics; Humans; Magnesium Compounds; Male; Middle Aged; Phosphates; Polyurethanes; Prospective Studies; Proteins; Risk Factors; Sex Factors; Silicones; Spectrophotometry, Infrared; Stents; Struvite; Ureteral Calculi; Uric Acid; Urinary Calculi; Urinary Catheterization

To determine trends in urolith composition in cats.. Retrospective case series.. 5,230 uroliths.. The laboratory database for the Gerald V. Ling Urinary Stone Analysis Laboratory was searched for all urolith submissions from cats from 1985 through 2004. Submission forms were reviewed, and each cat's age, sex, breed, and stone location were recorded.. Minerals identified included struvite, calcium oxalate, urates, dried solidified blood, apatite, brushite, cystine, silica, potassium magnesium pyrophosphate, xanthine, and newberyite. During the past 20 years, the ratio of calcium oxalate stones to struvite stones increased significantly. When only the last 3 years of the study period were included, the percentage of struvite stones (44%) was higher than the percentage of calcium oxa-late stones (40%). The most common location for both types of uroliths was the bladder. The number of calcium oxalate-containing calculi in the upper portion of the urinary tract increased significantly during the study period. The number of apatite uroliths declined significantly and that of dried solidified blood stones increased significantly, compared with all other stone types. No significant difference in the number of urate stones was detected.. The increasing proportion of calcium oxalate uroliths was in accordance with findings from other studies and could be a result of alterations in cats' diets. However, the decreased percentage of calcium oxalate calculi and increased percentage of struvite calculi observed in the last 3 years may portend a change in the frequency of this type of urolith.

Topics: Age Factors; Animal Feed; Animals; Breeding; Calcium Oxalate; Calcium Phosphates; Cat Diseases; Cats; Female; Magnesium Compounds; Male; Phosphates; Retrospective Studies; Sex Factors; Struvite; Ureteral Calculi; Urolithiasis

We studied the relationship of stone frequency and composition to age, sex and stone weight.. A retrospective study was performed of all 15,624 stones submitted for analysis with infrared and wet chemical methods in Newfoundland and Labrador from 1979 to 1998.. There were 1,067 bladder stones of which 216 contained magnesium ammonium phosphate. The remaining 14,557 stones were from the kidney and ureter, and 11,707 were composed only of calcium oxalate and/or phosphate. Of the remaining 2,850 kidney and ureter stones magnesium ammonium phosphate was present in 573, uric acid/urate without magnesium ammonium phosphate in 1,109 and other compounds in 1,168. The 11,707 oxalate phosphate group was subdivided by infrared peak analysis based on oxalate-to-phosphate ratio into phosphate-ratio 1 or less, intermediate-1 to 10 and oxalate-10+. Oxalate comprised 65% of the 11,707 stones compared to 16% for phosphate. Women submitted 52% of phosphate stones compared with 28% of oxalate stones. From the first (1980 to 1983) to the last (1995 to 1998) complete 4-year study periods, there was a relative increase in oxalate and decrease in phosphate stones, associated with increasing age from decades 5 to 6 for oxalate and phosphate stones, except that the age peak for phosphate stones in women remained in decade 3. Median weight of 1, 828 phosphate stones was 43 mg. (mean 234) compared with 25 mg. (mean 98) for 7,634 oxalate stones. Male-to-female ratio was 0.91 for phosphate stones compared with 2.62 for oxalate stones.. Phosphate stones were on average heavier and relatively more common in women, had an earlier age peak frequency in women than oxalate stones and became less frequent during our last 4-year study period. In contrast, oxalate stones were much more common, of lighter weight and became more frequent with time.

Topics: Adolescent; Adult; Age Factors; Aged; Child; Female; Humans; Kidney Calculi; Magnesium Compounds; Male; Middle Aged; Oxalates; Phosphates; Retrospective Studies; Sex Factors; Struvite; Ureteral Calculi; Urinary Bladder Calculi; Urinary Calculi

We analyzed a series of 61 stones from children aged 3 to 14 years old using Fourier transform infrared spectroscopy. The calculi were collected from urology departments of the University Hospitals of Oran, Sidi-Bel-Abbès and Mostaganem in West Algeria. This series is the first investigation concerning the composition of stones in children based on infrared analysis. Calculi were more frequent in males (75.4%) and mainly localized in the bladder (55.8%). Upper urinary tract calculi were more frequent in children over the age of 10 years, and the sex ratio was about 1. Calcium oxalate monohydrate was present in 70.5% of stones and was the main component in 50.8% of cases both in whole stones and nuclei. In contrast, calcium oxalate dihydrate was the main component in only 9.8% of calculi although it was present in 75.4% of stones. Ammonium urate was detected in 29.5% of stones and was always the main component of nuclei. Uric acid, observed in 31.1% of calculi, was the major constituent in 14.7% of stones and 19.7% of nuclei. Magnesium ammonium phosphate was observed in 24.6% of stones as a consequence of urinary tract infection by urea-splitting bacteria. Our observations emphasized that the anatomical location of stone and their composition were in accordance with those previously reported in other countries.

Topics: Adolescent; Age Factors; Algeria; Calcium Oxalate; Child; Child, Preschool; Female; Humans; Kidney Calculi; Magnesium Compounds; Male; Phosphates; Sex Factors; Spectrum Analysis; Struvite; Ureteral Calculi; Uric Acid; Urinary Bladder Calculi; Urinary Calculi

Topics: Aged; Calcium Oxalate; Clinical Competence; Combined Modality Therapy; Endoscopes; Endoscopy; Equipment Design; Female; Humans; Kidney; Lithotripsy; Magnesium Compounds; Male; Middle Aged; Phosphates; Struvite; Ureter; Ureteral Calculi; Ureteral Obstruction

Topics: Calcium Oxalate; Hardness; Humans; Kidney Calculi; Lithotripsy; Magnesium Compounds; Phosphates; Radiography; Struvite; Ureteral Calculi; Uric Acid

The composition of 2,755 calculi obtained from the upper urinary tract (1,409 by spontaneous passage and 1,346 by urological procedures) was analyzed using an infrared spectrophotometer, and the spontaneous passage rate was investigated in relation to the composition as well as other variables, such as stone size, and patient age and sex. Mixed stones of calcium oxalate and calcium phosphate were most frequently found, followed by those of calcium oxalate. The mean size (the maximum diameter) was largest in struvite stones and smallest in calcium oxalate ones. The sizes of stones from women were significantly larger than those from men (p < 0.01). As expected, the stone passage rates were inversely related to increasing stone size. The size of 55.6% of the stones passed was < or = 5 mm, and that of 96.6% of the stones < or = 10 mm.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Calcium Oxalate; Calcium Phosphates; Child; Child, Preschool; Cystine; Female; Humans; Infant; Kidney Calculi; Magnesium; Magnesium Compounds; Male; Middle Aged; Phosphates; Spectrophotometry, Infrared; Struvite; Ureteral Calculi; Uric Acid

High energy pulsed dye laser lithotripsy (Candela MDL-2000), with energy output upgraded to a maximum of 140 mJ. at the laser fiber tip using the 320 mu core fiber, was compared to the initially commercialized device, with the energy output fixed at 60 mJ. using the 200 mu core fiber (Candela MDL-1). A total of 31 treatments in 28 patients was performed with the Candela MDL-1 device. Complete disintegration or at least fragmentation to spontaneously passable fragments occurred in 18 of 31 cases (58%). Only in 11 of the 24 calcium oxalate monohydrate calculi (46%) was fragmentation achieved. Another 73 laser lithotripsies in 72 patients were performed with the Candela MDL-2000 device. Complete disintegration or at least fragmentation to spontaneously passable fragments was achieved in 67 of 73 treatments (92%). Calcium oxalate monohydrate calculi were successfully treated in 41 of 45 procedures (91%). There was no response to the laser treatment in the only cystine calculus.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Calcium Oxalate; Child; Female; Humans; Laser Therapy; Lithotripsy; Lithotripsy, Laser; Magnesium; Magnesium Compounds; Male; Middle Aged; Phosphates; Struvite; Ureteral Calculi; Uric Acid

The authors report about 12 cases of long ureteral calculi, 16 to 39 mm in size, observed over 10 years. They were all made of a mixture of ammonium-magnesium phosphate and calcium phosphocarbonate. Infection was the revealing symptom, either in the form of simple bacteriuria or as acute pyelonephritis or sepsis. These calculi, found in a lumbar or pelvic location, were very long, radiopaque but with a moderate radiological density, homogeneous and have regular contours. They were straight, sometimes slightly bent, rarely (one case out of 12) arciform. In 11 of 12 cases, the affected patient was female. In most cases, the urine was infected by Proteus mirabilis. In spite of their size, the calculi caused total obstruction in 3 of 12 cases only. They were or were not associated to ipsilateral coral calculi of the same chemical type. Destruction was easily achieved with physical agents. The etiological, radiological and therapeutic characteristics of these calculi give them a specific place among ammonium-magnesium phosphate calculi.

Topics: Adult; Aged; Aged, 80 and over; Calcium Carbonate; Female; Hemostatics; Humans; Lithotripsy; Magnesium; Magnesium Compounds; Male; Middle Aged; Phosphates; Proteus Infections; Proteus mirabilis; Radiography; Struvite; Ureteral Calculi; Ureterostomy; Urinary Tract Infections

The pulsed dye laser represents a new tool in the treatment of ureteral calculi. Laser energy channeled through a delicate optical fiber is used to disimpact and fragment calculi. Standard ureteroscopic instruments including graspers, baskets and dilatation balloons can be used with the laser system. Interchangeable optical fibers ranging from 200 to 400 micrometers deliver up to 120 mJ of energy to the stone's surface. For two weeks in 1989 an endourology clinic was held in upper Egypt. Eighty patients ranging in age from nine years to sixty-seven years old were evaluated and treated endoscopically. Endoscopes ranging from 6.9F to 12.5F were used to deliver the optical fiber. All stones visualized endoscopically were fragmented. Greater than 60 percent of the stones fragmented were composed of pure calcium oxalate monohydrate. Schistosoma hematobium was endemic among our study group. Bilharzial strictures of the distal ureter were noted in 30 percent of these patients. Treatment of these strictures using both balloon dilatation and graduated Teflon dilators is reviewed. Techniques in treating different types of ureteral calculi were explored. Large calcium oxalate dihydrate stones were treated most efficiently with the 3-point fragmentation technique. The shear off-center technique was used for the calcium oxalate monohydrate calculi. Variations in total energy delivered and frequency of pulsation allowed for prompt stone disimpaction as well as prevention of retrograde fragment migration. Concurrent use of stone baskets and graspers with the pulsed dye laser was explored.

Topics: Adolescent; Adult; Aged; Calcium Oxalate; Catheterization; Child; Coloring Agents; Endoscopes; Endoscopy; Humans; Kidney Calculi; Kidney Calices; Laser Therapy; Lithotripsy; Magnesium; Magnesium Compounds; Male; Middle Aged; Phosphates; Schistosomiasis; Struvite; Ureteral Calculi; Ureteral Obstruction; Uric Acid

At Osaka City University Hospital, we performed extracorporeal shock-wave lithotripsy (ESWL) for 1277 patients in a total of 1788 sessions using Dornier kidney lithotripter Model HM III from July, 1985 to the end of December, 1988. Among the patients with a solitary stone, 911 cases were available for the follow-up study and we have compared the results among these cases in respect to the stone location and size. The results obtained were as follows: the ratio of kidney stone to ureter stone was found to be 2.2:1 in male, and 3.8:1 in female patients. This indicates that ureter stones are more frequently found in male than in female patients. In addition, we compared the size of kidney stones found in the patients including 415 male and 243 female patients. Stones larger than 20 mm were more frequently found in female than in male patients. Moreover, a stone composition study of these patients showed that the contents of both phosphate calcium and magnesium ammonium phosphate were higher in female than in male patients. ESWL performed against stones at pelvis and calyces exhibited the best results. The results obtained with the stones less than 20 mm in diameter were especially favorable with a success rate of 100% for the stones less than 10 mm and 83% for the stones 10-20 mm, in diameter, while the results with the stones larger than 20 mm in diameter were rather poor with a success rate of 31%. ESWL performed against ureter stones showed poor results with a success rate of 63% for the stones smaller than 20 mm in diameter.

Topics: Calcium Phosphates; Evaluation Studies as Topic; Female; Humans; Kidney Calculi; Lithotripsy; Magnesium; Magnesium Compounds; Male; Phosphates; Sex Factors; Struvite; Ureteral Calculi

Routine thermogravimetric (TG) analysis of 501 upper urinary calculi from the State of Jammu and Kashmir is described. The technique is simple, rapid and quantitative, and the equipment is easily maintained. The technique was found to be helpful in 95.4% of urinary stones and it is suggested that TG analysis may be employed as a technique of first choice in the routine quantitative analysis of all urinary calculi.

Topics: Calcium Oxalate; Calcium Phosphates; Humans; Kidney Calculi; Magnesium; Magnesium Compounds; Phosphates; Struvite; Thermogravimetry; Ureteral Calculi

The greater frequency of renal stones seen on excretory urograms in women, compared with the greater frequency of ureteral stones in men has been termed a sexual paradox. We assessed stone composition and weight, and sex as possible explanatory factors. A total of 4,014 renal and ureteral calculi was analyzed. For the 3,119 calculi in which only calcium oxalate and/or phosphate was detected by infrared and wet chemical analysis, there was a strong relationship between the oxalate-to-phosphate weight ratio and sex (p less than 0.0001). The mean weight for phosphate stones was 330 mg. but for oxalate stones it was 107 mg. Male-to-female ratios were 2.7, 2.2 and 1.8 for stone weight groups of 20 or less, 21 to 100 and more than 100 mg. The male-to-female ratio was 0.87 for the 171 stones containing magnesium ammonium phosphate; the average weight was 508 mg. for men and 1,560 mg. for women. The tendency for phosphate stones to be heavier and relatively more common in women compared to predominantly oxalate stones may partly account for the sexual paradox.

Topics: Calcium Oxalate; Calcium Phosphates; Female; Humans; Kidney Calculi; Magnesium; Magnesium Compounds; Male; Phosphates; Sex Characteristics; Struvite; Ureteral Calculi

Topics: Adult; Ampicillin; Bacteriuria; Drug Combinations; Female; Humans; Magnesium; Magnesium Compounds; Phosphates; Pregnancy; Pregnancy Complications, Infectious; Recurrence; Staphylococcal Infections; Staphylococcus; Struvite; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Ureteral Calculi

A case of milk-of-calcium with an exceptional location is reported. The characteristics of milk-of-calcium are presented, with stasis and urinary tract infection being the most important etiologic factors in this case. Structurally the stones are formed by a central core of calcium phosphate surrounded by magnesium-ammonium phosphate (struvite).

Topics: Adult; Calcium Phosphates; Female; Humans; Magnesium; Magnesium Compounds; Phosphates; Struvite; Ureteral Calculi; Ureterocele

We report the results of 1,000 consecutive patients who underwent percutaneous removal of renal and ureteral stones. Removal was successful for 98.3 per cent of the targeted renal stones and 88.2 per cent of the ureteral stones. Complications, evolution and technique are discussed. Percutaneous techniques are an effective way to handle the majority of renal calculi and these techniques will continue to be important as shock wave lithotripsy becomes more widespread in the United States.

Topics: Blood Transfusion; Cystine; Female; Hemorrhage; Humans; Intraoperative Complications; Kidney; Kidney Calculi; Length of Stay; Lithotripsy; Magnesium; Magnesium Compounds; Male; Nephrostomy, Percutaneous; Phosphates; Postoperative Complications; Struvite; Time Factors; Ureteral Calculi

Topics: Acinonyx; Animals; Animals, Zoo; Carnivora; Cats; Dogs; Hemostatics; Kidney Calculi; Magnesium; Magnesium Compounds; Male; Phosphates; Struvite; Ureter; Ureteral Calculi

During a 5 year period, 500 stones from the upper urinary tract and 100 from the urinary bladder of as many unselected and consecutive patients were obtained in one hospital and analysed crystallographically. 90.4% of the upper urinary tract stones and 65% of the bladder stones belonged to the groups of calcium stones, while 6.6% and 24%, respectively, were triple phosphate stones. The contribution of calcium stones to this material is higher and that of triple phosphate stones lower than in comparable materials. Frequency variations between materials also exist within the groups of calcium stones, and for uric acid, urate and cystine stones. On the basis of published material, it is not possible to say if these differences are renal or reflect variations in the selection of stones and the methods of analysis. Reports on stone materials should include information on these aspects in order to allow meaningful comparison. Distinction between stones from the upper urinary tract and from the bladder is mandatory. The composition pattern reported here is believed to be as representative as is possible to obtain. A major part of stones from the upper urinary tract is, however, lost for analysis following spontaneous passage. Such stones are more often pure calcium oxalate and less often triple phosphate stones than those which are obtained by surgical methods, and the extent to which they are obtained will influence the findings in stone materials.

Topics: Adult; Aged; Calcium Carbonate; Calcium Oxalate; Calcium Phosphates; Crystallography; Cystine; Female; Humans; Kidney Calculi; Magnesium; Magnesium Compounds; Male; Middle Aged; Phosphates; Struvite; Ureteral Calculi; Uric Acid; Urinary Bladder Calculi; Urinary Calculi