Local chemolysis of obstructive uric acid stone with 0.1 M THAM and 0.02% chlorhexidine.
We used a modified chemolytic solution by combining 0.1 M THAM (tris[hydroxymethyl] aminomethane) with 0.02% chlorhexidine to treat 10 obstructive uric acid stone patients. A total of 23 local chemolysis sessions were performed. Five patients received 13 sessions (average: 2.6) as an adjuvant chemolysis after extracorporeal shock wave lithotripsy 5 patients received 10 sessions (average: 2) as a primary treatment. The average time of local chemolysis was 2.3 days, ranging from 1 to 4 days. In the 23 local chemolysis sessions, only one patient developed two episodes of fever (8.7%), which were managed successfully by conservative treatment. The mean values of effective renal plasma flow of treated kidney was increased from 108.2 to 155.6 ml/min (p < 0.05). The stone-free rate assessed by IVP and ultrasonography at 3 months follow-up was 80%. Our results indicate that the combined use of 0.1 M THAM and 0.02% chlorhexidine is an effective and safe method to treat obstructive uric acid stones.
Lee
Y H
YH
Department of Surgery, Kaohsiung Veterans General Hospital, Taiwan, ROC.
Chang
L S
LS
Chen
M T
MT
Huang
J K
JK
D000368:Aged; D002710:Chlorhexidine / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000737:chemistry / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D012079:Renal Circulation; D012996:Solutions; D013997:Time Factors; D016896:Treatment Outcome; D014325:Tromethamine / Q000627:therapeutic use*; D014514:Ureteral Calculi / Q000737:chemistry / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D014517:Ureteral Obstruction / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014527:Uric Acid / Q000032:analysis
D004338:Drug Combinations; D012996:Solutions; D014325:Tromethamine; D014527:Uric Acid; D002710:Chlorhexidine