struvite and Urinary-Retention

Topics: Aged, 80 and over; Bacterial Proteins; Carcinoma, Transitional Cell; Catheter-Related Infections; Corynebacterium; Corynebacterium Infections; Crystallization; Cystitis; Disease Susceptibility; Female; Humans; Hydronephrosis; Male; Postoperative Complications; Prostatectomy; Prostatic Neoplasms; Struvite; Urease; Urinary Bladder Neoplasms; Urinary Catheterization; Urinary Retention

To determine the incidence, mode of presentation, first line of management and composition of non-recurrent urolithiasis in Kuwait.. Consecutive patients admitted between January 1999 and December 2002 with non-recurrent urolithiasis were prospectively analyzed.. The average annual incidence of hospital admission for non-recurrent urolithiasis in Kuwait was 43.44 per 100,000 population, representing men and women (ratio, 9:1) with a median age of 41.91 years. Of the hospital admissions for non-recurrent urolithiasis, 57.2% of cases were acute. Overall, the most predominant symptom was flank pain, while the least common symptom was acute urinary retention. Ureteroscopic stone manipulation was the most common initial treatment modality in the present series, as it was utilized in 43.3% and 37.09% for patients admitted on elective and emergency basis, respectively. Of the calculi available for chemical analysis, 91% contained calcium, 73% contained calcium oxalate, 17% contained mixed calcium and 1% contained calcium phosphate. The composition of the rest of the stones were urate in 7%, struvite in 1% and cystine in 1%.. Urolithiasis is a common disease in the Kuwait region that mainly presents with flank pain. Ureteroscopic calculus removal is the most common modality of treatment. The majority of the calculi seen in Kuwait contained calcium.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Calcium; Calcium Oxalate; Cystine; Cystoscopy; Female; Flank Pain; Hospitalization; Humans; Kuwait; Lithotripsy; Magnesium Compounds; Male; Middle Aged; Phosphates; Prospective Studies; Struvite; Ureteroscopy; Uric Acid; Urinary Calculi; Urinary Diversion; Urinary Retention

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