Study of risk factor of urinary calculi according to the association between stone composition with urine component

Wang, Pan; Zhang, Hongxian; Zhou, Jiaolin; Jin, Shangjia; Liu, Chong; Yang, Boxin; Cui, Liyan

doi:10.1038/s41598-021-87733-7

“…One-fourth of patients need in-hospital surgical intervention, which occupies the first place among urology inpatients. It is easy to recur after treatment, and the 10-year recurrence rate is as high as 50% [ 2 ]. In recent years, with the change of quality of life and lifestyle of Chinese residents, the incidence of urinary calculi in China is increasing year by year.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Flexible Ureteroscopic Lithotripsy and Percutaneous Nephrolithotomy in the Treatment of Complex Upper Urinary Tract Nephrolithiasis

Yang¹,

Huang

²

,

Li³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. A case-control study was conducted to compare the efficacy and prognostic factors of flexible ureteroscopic lithotripsy (FURL) and percutaneous nephrolithotomy (PCNL) when treating complex upper urinary tract renal calculi based on a retrospective cohort study. Methods. The study period was from October 2019 to December 2021. A retrospective study was carried out on 100 patients with complicated upper urinary tract nephrolithiasis who underwent surgery in the Urology Department of our hospital. They were assigned into two groups: FURL and PCNL groups. The intraoperative blood loss, operation time, hematuria duration, hospital stay, primary stone removal rate, incidence of intraoperative and postoperative complications, VAS score, level of inflammatory factors, and micturition function were compared. According to the postoperative prognosis, the patients were reassigned into two groups: good prognosis group ( n = 38 ) and poor prognosis group ( n = 106 ). The factors related to poor prognosis after FURL and PCNL were screened, and multivariate loglistic regression analysis was adopted to determine the risk factors. Results. The primary stone clearance rate in the PCNL group was significantly higher than that in the FURL group, and there was no significant difference in the incidence of intraoperative and postoperative complications between the two groups ( P > 0.05 ). The intraoperative blood loss and the duration of hematuria in the PCNL group were significantly shorter than those in the FURL group, and the operation time and postoperative hospital stay in the FURL group were longer than those in the FURL group. The postoperative VAS score in the study group was significantly lower than that in the control group ( P < 0.05 ). The levels of CRP, IL-1, TNF-α, and NF-κB in both groups decreased after operation, and the level of inflammatory factors in the PCNL group was significantly lower than that in the FURL group ( P < 0.05 ). The indexes of IPSS and Q max in the PCNL group were significantly lower than those in the control group 3 months after operation. The index of micturition function in the PCNL group was significantly lower than that in the FURL group. Preoperative use of immunosuppressant, preoperative stone fever, positive preoperative urine culture, preoperative urinary leukocyte count ≥ 544 × L , intraoperative urinary opacity, and pus fur were significantly correlated with poor prognosis of ureteral patients ( P < 0.05 ). Preoperative stone fever, high preoperative urinary leukocyte count, intraoperative urinary turbidity, and suppurative fur were independent risk factors for postoperative SIRS in patients with ureteral calculi. Conclusion. PCNL is effective when treating complex upper urinary tract renal calculi. Compared with FURL, PCNL can remarkably reduce intraoperative blood loss and hematuria duration, can enhance micturition function, and will not remarkably increase the incidence of intraoperative and postoperative complications, high safety. High white blood cell count in urine before operation, fever due to stone before operation, turbid urine, and purulent fur during operation are independent risk factors for postoperative adverse outcome in patients with complex upper urinary tract renal calculi. Patients should be fully treated before surgery.

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“…Urinary calculi are an obvious urinary system disease, and the incidence of urinary calculi in my country is 1% to 5% [ 1 ]. Its incidence is about 4% to 15% worldwide [ 2 ]. Urinary calculi mostly occur in young adults, more men than women, and the incidence is basically the same on the left and right sides [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Application of CTU-Assisted Doppler Ultrasound Puncture in Nontube Percutaneous Nephrolithotomy, Its Effect on Patients’ Complications, and Its Clinical Value

Xu

¹

,

Liu

²

,

Jia

³

et al. 2022

BioMed Research International

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Objective. To research the application of CTU-assisted Doppler ultrasound puncture in uncatheterized PCNL, its influence on patients’ complications, and its clinical value in a case-control study. Methods. One hundred and forty-four patients who went through percutaneous nephrolithotomy (PCNL) from March 2019 to June 2021 in our hospital were arbitrarily assigned into the CTU group ( n = 72 ) and CT plain scan group ( n = 72 ). CTA+CTU was adopted to determine the puncture passage in the CTU group, and CT scan was employed in the CT group. The intraoperative blood loss, postoperative blood loss, operation time, hospital stay, primary stone removal rate, and the incidence of intraoperative and postoperative complications were compared. The visual analogue score (VAS) was employed to assess the degree of postoperative wound pain. Results. The first-stage stone removal rate in the CTU group was 95.83% (69/72), which was remarkably higher compared to the CT plain scan group, which was 81.94% (59/72), and the difference was statistically significant ( P < 0.05 ). The overall rates of intraoperative complications were 6.94% (5/72) in the CTU group and 18.06% (13/72) in the CT plain scan group, respectively, which exhibited great differences ( P < 0.05 ). In addition, the overall rates of intraoperative complications were 2.78% (2/72) in the CTU and 13.89% (10/72) in the CT plain scan group, respectively, and the difference was statistically significant ( P < 0.05 ). The operation time and postoperative hospital stays in the CTU group were remarkably shorter compared to the CT group, and the difference was statistically significant ( P < 0.05 ). The intraoperative and postoperative blood loss of CTU group displayed obvious less than that of the CT group, and the difference was statistically significant ( P < 0.05 ). The VAS were compared 24 hours after surgery. After operation, the VAS of 24 hours after operation in the CTU group ( 0.92 ± 0.12 ) were remarkably lower compared to the CT group ( 1.22 ± 0.15 ), and the difference was statistically significant ( P < 0.05 ). Discussion. PCNL is constantly being optimized by CTU-assisted Doppler ultrasound puncture to improve stone clearance rates, reduce postoperative bleeding, be less painful, provide rapid recovery, and provide safe and feasible results. It is therefore worthwhile to standardize and then widely promote it in clinical practice.

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“…Microorganisms can survive in already formed stone by building into its structure. When stones are crushed, for example with high-energy ultrasound waves, microorganisms are released into the urinary tract, which causes disease recurrence after treatment up to 50% of cases 19 . The results to date indicate that even dead microorganisms can be centres of heterogeneous nucleation, accelerating the recrystallization.…”

Section: Introductionmentioning

confidence: 99%

Consumption of soft drinks rich in phosphoric acid versus struvite crystallization from artificial urine

Skubisz

¹

,

Torzewska

²

,

Mielniczek‐Brzóska

³

et al. 2022

Sci Rep

3

0

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In recent years, there has been a continuous increase in the incidence of urolithiasis, especially in highly developed countries. Therefore, the question arises which factors specific to these countries may be responsible for the increase in the incidence of this disease. In this article, we try to assess the effect of phosphoric acid, a component of various carbonated drinks, including Coca-Cola, on the nucleation and growth of struvite crystals, which are the main component of infectious urinary stones. The research was carried out in the environment of artificial urine with and without the presence of Proteus mirabilis bacteria. In the latter case, the activity of bacterial urease was simulated by adding an aqueous ammonia solution. The obtained results indicate that phosphoric acid present in artificial urine causes the nucleation of struvite to shift towards a lower pH, which means that struvite nucleates earlier in artificial urine compared to the control test. The amount of struvite formed is the greater the higher the concentration of phosphoric acid. At the same time, as the concentration of phosphoric acid increases, the growing struvite crystals are larger, which is disadvantageous because they are more difficult to remove from the urinary tract along with the urine. For the highest levels of phosphoric acid tested, large dendrites are formed, which are particularly undesirable as they can damage the epithelium of the urinary tract. The effect of phosphoric acid on the nucleation and growth of struvite is explained in base of chemical speciation analysis. This analysis indicates that the MgHCit and MgCit− complexes have the main influence on the nucleation and growth of struvite in artificial urine in the presence of phosphoric acid. It should be keep in mind that all these effects of phosphoric acid are possible when the urinary tract is infected with urease-positive bacteria. In the absence of infection, phosphoric acid will not cause struvite to crystallize.

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Study of risk factor of urinary calculi according to the association between stone composition with urine component

Cited by 14 publications

References 36 publications

Efficacy of Flexible Ureteroscopic Lithotripsy and Percutaneous Nephrolithotomy in the Treatment of Complex Upper Urinary Tract Nephrolithiasis

Efficacy of Flexible Ureteroscopic Lithotripsy and Percutaneous Nephrolithotomy in the Treatment of Complex Upper Urinary Tract Nephrolithiasis

Application of CTU-Assisted Doppler Ultrasound Puncture in Nontube Percutaneous Nephrolithotomy, Its Effect on Patients’ Complications, and Its Clinical Value

Consumption of soft drinks rich in phosphoric acid versus struvite crystallization from artificial urine

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