Chemolitholysis and lithotripsy of infectious urinary stones - an in vitro study.
OBJECTIVE
This study was performed to look for an improvement of therapeutic strategies with regard to the treatment of infectious urinary stones using artificial stones made of struvite and apatite ('Bon(n) stones') which are comparable to their natural counterparts.


METHODS
Using an experimental arrangement simulating the physiological conditions in the upper urinary tract, the efficacy of artificial urine (pH 5.7), Suby G solution (pH 3.6), mixtures of artificial urine with Suby G (pH 3.9 and pH 4.1) in dissolving artificial struvite and apatite stones (Bon(n) stones) was investigated. The dissolution of natural infectious urinary stones was also measured. Additionally, investigations on shock-wave lithotripsy (SWL) combined with initial chemolytic treatment of the stones were performed.


RESULTS
The efficacy of Suby G solution in dissolving artificial stones was demonstrated. Direct comparison of chemolysis of natural and artificial stones showed no statistical difference between infectious urinary stones and Bon(n) stones of the same material. The investigations on SWL showed a significant improvement on stone comminution, especially of artificial apatite stones after initial chemolytic treatment with Suby G.


CONCLUSIONS
New basics to improve dissolution of infectious urinary stones have been developed by performing standardized in vitro investigations. Local chemolysis with Suby G is an effective tool in the treatment of infectious stone disease. SWL can be improved by varying the physical properties of infectious stones through initial treatment with Suby G solution.
Heimbach
D
D
Department of Urology, Division of Experimental Urology, University of Bonn, Germany.
Jacobs
D
D
Müller
S C
SC
Hesse
A
A
D001031:Apatites / Q000737:chemistry; D004867:Equipment Design; D066298:In Vitro Techniques; D008096:Lithotripsy / Q000379:methods*; D017616:Magnesium Compounds / Q000737:chemistry; D008954:Models, Biological; D010710:Phosphates / Q000737:chemistry; D012680:Sensitivity and Specificity; D012997:Solvents / Q000494:pharmacology*; D018709:Statistics, Nonparametric; D000069877:Struvite; D014545:Urinary Calculi / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy*; D014552:Urinary Tract Infections / Q000628:therapy*
D001031:Apatites; D017616:Magnesium Compounds; D010710:Phosphates; D012997:Solvents; D000069877:Struvite