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Kidney Stones

Update in Diagnosis and Management



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Struvite Stones

Slide 26

February 2010

Finally, struvite stones require a unique set of urinary conditions to grow: a high urinary pH and high levels of ammonium. This occurs only when the urine is infected with a urease producing organism such as a proteus species.

Therefore, treatment starts with identification and treatment of the infection. The stones are colonized and usually cannot be sterilized with antibiotics alone. Therefore, all stones must be surgically removed. Quite often, these patients have an underlying stone disorder, and a preexisting calcium stone that became colonized with the urease positive organism that in turn led to overgrowth with struvite. Therefore, these patients should undergo metabolic workup for stone risk factors once the infected stone is removed. They often need suppressive antibiotics for 3-6 months postoperatively, with longer term follow-up to be sure they are clear of infection.

Struvite Stones

 


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