Treatment Options in Struvite Stones

Wang, Lester P.; Wong, Hoo Yin; Griffith, Donald P.

doi:10.1016/s0094-0143(05)70360-8

Cited by 35 publications

(15 citation statements)

References 118 publications

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“…Multimodality therapy is the key to a more successful removal of struvite stones, and the combination of open surgery and medical therapy is synergistic (436). Open surgery, while recommended for the complete removal of urinary stones, does not ensure complete removal, as the incidence of residual stone fragments is 12 to 36% (226).…”

Section: Diagnosis and Treatment Of Cautismentioning

confidence: 99%

“…The minimally invasive percutaneous nephrolithotomy, with or without extracorporeal shockwave lithotripsy (ESWL), is the preferred nonsurgical alternative (254,436), with stonefree rates that range from 23 to 86% (207). Percutaneous nephrolithotomy, performed under general anesthesia, involves an incision into the back and the insertion of an endoscope to remove stones from the kidney.…”

Section: Diagnosis and Treatment Of Cautismentioning

confidence: 99%

“…After either procedure, the insertion of an indwelling ureteral stent may be required to allow the proper drainage of urine. Medical therapy, such as culture-specific antibiotics, urease inhibitors, and urine acidification, complements these abovedescribed treatments to reduce the morbidity associated with persistent UTIs and stone recurrence (436). Acetohydroxamic acid (Lithostat) is the most commonly used urease inhibitor.…”

Section: Diagnosis and Treatment Of Cautismentioning

confidence: 99%

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Complicated Catheter-Associated Urinary Tract Infections Due toEscherichia coliandProteus mirabilis

et al. 2008

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SUMMARY Catheter-associated urinary tract infections (CAUTIs) represent the most common type of nosocomial infection and are a major health concern due to the complications and frequent recurrence. These infections are often caused by Escherichia coli and Proteus mirabilis. Gram-negative bacterial species that cause CAUTIs express a number of virulence factors associated with adhesion, motility, biofilm formation, immunoavoidance, and nutrient acquisition as well as factors that cause damage to the host. These infections can be reduced by limiting catheter usage and ensuring that health care professionals correctly use closed-system Foley catheters. A number of novel approaches such as condom and suprapubic catheters, intermittent catheterization, new surfaces, catheters with antimicrobial agents, and probiotics have thus far met with limited success. While the diagnosis of symptomatic versus asymptomatic CAUTIs may be a contentious issue, it is generally agreed that once a catheterized patient is believed to have a symptomatic urinary tract infection, the catheter is removed if possible due to the high rate of relapse. Research focusing on the pathogenesis of CAUTIs will lead to a better understanding of the disease process and will subsequently lead to the development of new diagnosis, prevention, and treatment options.

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Section: Diagnosis and Treatment Of Cautismentioning

confidence: 99%

Section: Diagnosis and Treatment Of Cautismentioning

confidence: 99%

Section: Diagnosis and Treatment Of Cautismentioning

confidence: 99%

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Complicated Catheter-Associated Urinary Tract Infections Due toEscherichia coliandProteus mirabilis

et al. 2008

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“…However in 17.4% (4/23) of kidneys, the irrigation had to be abandoned due to persistent pain. Citric acid is known to cause irritation of the urothelium, which is reduced by addition of magnesium [2, 6]. Compared to 10% hemiacidrin (renacidin) and Suby G solution, the concentration of citric acid used in the solution R (6%) is higher.…”

Section: Discussionmentioning

confidence: 99%

“…Dissolution treatment, either used in an adjuvant manner or administered alone, has been used in the management of these calculi. Citric acid, in various concentrations, has been used in the dissolution treatment of struvite renal stones [2]. Citric acid, being a urinary acidifier, inhibits formation and allows dissolution of calcium phosphate, calcium carbonate and magnesium ammonium phosphate.…”

Section: Introductionmentioning

confidence: 99%