Urinary Stone Disease
Urinary calculi are the third most common affliction of the urinary tract, exceeded only by urinary tract infections and pathologic conditions of the prostate. They are common in both animals and humans. The nomenclature associated with urinary stone disease arises from a variety of disciplines. Struvite stones, for example, composed of magnesium ammonium phosphate hexahydrate, are named in honor of H.C.G. von Struve (1772-1851), a Russian naturalist.
Before the time of von Struve, the stones were referred to as guanite, because magnesium ammonium phosphate is prominent in bat droppings. Calcium oxalate dihydrate is frequently referred to as weddellite, because it was commonly found in floor samples collected from the Weddell Sea in Antarctica. The history of the nomenclature associated with urinary stone disease is as intriguing as that of the development of the interventional techniques used in their treatment.
Urinary stones have plagued humans since the earliest records of civilization. The etiology of stones remains speculative. If urinary constituents are similar in each kidney and if there is no evidence of obstruction, why do most stones present in a unilateral fashion? Why don't small stones pass uneventfully down the ureter early in their development? Why do some people form one large stone and others form multiple small calculi? There is much speculation concerning these and other questions. Advances in the surgical treatment of urinary stones have outpaced our understanding of their etiology. As clinicians we are concerned with an expedient diagnosis and efficient treatment.
Equally important is a thorough metabolic evaluation directing appropriate medical therapy and lifestyle changes to help reduce recurrent stone disease. Without such follow-up and medical intervention, stone recurrence rates can be as high as 50% within 5 years. Uric acid calculi can recur even more frequently. Physicians look forward to gaining a better understanding of this multifactorial disease process in hopes of developing more effective prophylaxis.***
Marshall L. Stoller, MD
Ions In Urinary Stone Formation
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Preputial calculi are rare and usually occur in adults. They develop secondary to a severe obstructive phimosis.
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Matrix Urinary Calculi
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Urinary Stone Inhibitors
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Orthophosphates & Pyrophosphates
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2, 8-Dihydroxyadenine Urolithiasis
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Renal Tubular Acidosis
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Urinary Stone Disease in Uncommon Situations
Spinal Cord Dysfunction
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Anatomic Renal Anomalies
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Extracorporeal Shock Wave Lithotripsy
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