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Struvite Stones, Diet and Medications

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Pocket Guide to Kidney Stone Prevention

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Abstract

Infection stones are caused by bacteria that possess the enzyme urease which increase the urine pH resulting in crystallization of carbonate apatite (with pH > 6.8) and magnesium ammonium phosphate (struvite) when the pH rises above 7.2. They account for 10–15 % of urinary calculi and carry significant morbidity and mortality if left untreated. Renal dysfunction from chronic obstruction and infection may occur if left untreated. The first principle of treatment is complete removal of all of the infected stone. Percutaneous nephrolithotomy is the treatment of choice for large stone burdens which are typical for infection stones. Secondly, antibiotics must be used pre- and post-operatively to sterilize the urine and ensure that the urine will remain sterile even after antibiotic therapy is completed. Lastly prevention of recurrent stones is key and is achieved by preventing infection and ensuring that all stones are removed. Routine imaging must be performed frequently as these stones may form rapidly even within 4–6 weeks.

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Author information

Authors and Affiliations

  1. Department of Urological Sciences, University of British Columbia, Level 6 – 2775 Laurel Street, Vancouver, BC, Canada, V52 1M9

    Ben H. Chew MD, MSc, FRCSC, Ryan Flannigan MD & Dirk Lange MD

Authors
  1. Ben H. Chew MD, MSc, FRCSC
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  2. Ryan Flannigan MD
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  3. Dirk Lange MD
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Corresponding author

Correspondence to Ben H. Chew MD, MSc, FRCSC .

Editor information

Editors and Affiliations

  1. Stevan Streem Center for Endourology & Stone Disease, The Cleveland Clinic, Cleveland, Ohio, USA

    Manoj Monga

  2. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA

    Kristina L. Penniston

  3. Nephrology Division, NYU Langone Medical Center, New York, New York, USA

    David S. Goldfarb

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© 2015 Springer International Publishing Switzerland

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Chew, B.H., Flannigan, R., Lange, D. (2015). Struvite Stones, Diet and Medications. In: Monga, M., Penniston, K., Goldfarb, D. (eds) Pocket Guide to Kidney Stone Prevention. Springer, Cham. https://doi.org/10.1007/978-3-319-11098-1_12

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  • DOI: https://doi.org/10.1007/978-3-319-11098-1_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-11097-4

  • Online ISBN: 978-3-319-11098-1

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