How about struvite stones?
What do we need to consider in
that particular patient population?
So struvite stones are also called triple
phosphate stones or infections stones.
They are large in size, they're difficult to eradicate
and they oftentimes will form a staghorn calculus
meaning that they fill up the
entire renal pelvis in those calyces.
They are composed of magnesium ammonium phosphate
and triple phosphte and calcium carbonate apatite.
They are associated with urease-producing bacteria,
that includes Proteus, Pseudomonas, Klebsiella,
Serratia, Ureaplasma and Citrobacter.
So some of the risks of forming struvite stones are
going to be when patients have urinary tract infections.
There's an increase in propensity to
form these struvite stones particularily
with those urease-producing
organisms that we talked about.
Women tend to have more struvite stones
than men and having a high urinary pH,
again with those urease-producing
organisms really puts that patient at risk.
How do we treat struvite stones?
Antibiotic therapy is key, remember these are infection-related
stones so we have to eradicate that infection.
Oftentimes unfortunately, that is not enough and
our patients will actually require urological intervention.
So we call our urology colleagues and
they can do a complete stone removal.
For small stones, they can come in and they
can do extracorporeal shock wave lithotripsy.
So basically, they can actually use a shock
wave to break up those stones and let them pass
or if it's a larger stone, particularly staghorn calculi or
others, they can do a percutaneous nephrolithotomy.
That's what's shown in this image over here.
This patient actually has multiple tracks where
they've entered percutaneously right into the renal pelvis
in order to retrieve the stone.