Struvite stones (Infection stones)

💠 Composition & Risk Factors -

📌 Composed of Calcium, Ammonium, Magnesium Phosphate (Triple Phosphate stones)

📌 Mostly grows in alkaline urine, especially with Proteus infection

📌 Forms Staghorn Calculi (S for Struvite & S for Staghorn)

📌 Formed in high urinary concentration of ammonia

📌 More common in women (due to UTI)

📌 Increased chances to form struvite calculi is seen in -

👉 Foreign body in the urinary tract (Foley’s catheter)

👉 Neurogenic bladder/Bladder dysfunction/Bladder outlet obstruction

 

💠 Diagnosis -

👉 Urine Microscopy - Coffin Lid Shaped Crystals

Attribution - Wikimedia Commons

👉 Radio Opaque stone seen in X - Ray KUB & Non Contrast Spiral CT

Attribution - Wikimedia Commons

💠 Management -

👉 Complete stone removal + Treatment of a metabolic abnormality + Correction of any anatomic abnormalities contributing to stasis

👉 Antibiotics to prevent recurrences

👉 Acetohydroxamic acid (irreversible inhibitor of urease) decreases likelihood of precipitation

👉 Low calcium, low phosphorus diet

👉 PCNL + ESWL (Best treatment option) - PCNL first then ESWL

#Urology #Surgery

#The_Conceptual_Codon