Urolithiasis following urinary diversion

Abstract

Urolithiasis is a well-known occurrence after cystectomy and urinary diversion. With high incidence and recurrence rates of urolithiasis, complex anatomy and associated morbidities, these patients remain a management challenge for urologists. The purpose of this review is to examine the literature and consider the risk factors for stone formation in this group of patients and reflect on the reported outcomes with the range of available treatment options.

Endourologic strategies for a minimally invasive management of urinary tract stones in patients with urinary diversion

“…El-Assmy et al ( 6 ) reported a 81.5% (22 of 27) overall success rate of SWL monotherapy in the treatment of upper urinary tract in this category of patients. On the other hand, Seth et al ( 12 ) reported higher rates of complications (such as steinstrasse) after SWL rather than other endourologic procedures. Furthermore, retreatment rates of SWL are considerably high ( 17 ).…”

“…With the rising prevalence of bladder cancer, many different forms of urinary diversions have been developed ( 2 , 12 ). Patients with urinary diversion have to face with an increased risk of long-term complications, including stone formation and recurrence.…”

Nastanak i liječenje gigantskih kamenaca ileocekalnog urinskog spremnika u pacijenta liječenog cistektomijom zbog intersticijskog cistitisa

“…Bakterije koje imaju enzim ureazu razlažu ureju na amonijak i hidroksilni ion koji pridonose alkalizaciji urina i formiranju struvitnih kamenaca 9 . Refluks koloniziranog urina u gornje urinarne puteve pogoduje razvoju kamenaca gornjeg mokraćnog sustava 10 . Strukturalni čimbenici koji pridonose nastanku litijaze su staza urina uzrokovana stenozom ili strikturom koja sprječava ispiranje spremnika te potiče agregaciju kristala u urinu, zatim prisustvo stranih tijela kao što su neresorptivni šavovi ili ureteralni stentovi, refluks sluzi ili nečista samokateterizacija [8][9][10] .…”

“…Refluks koloniziranog urina u gornje urinarne puteve pogoduje razvoju kamenaca gornjeg mokraćnog sustava 10 . Strukturalni čimbenici koji pridonose nastanku litijaze su staza urina uzrokovana stenozom ili strikturom koja sprječava ispiranje spremnika te potiče agregaciju kristala u urinu, zatim prisustvo stranih tijela kao što su neresorptivni šavovi ili ureteralni stentovi, refluks sluzi ili nečista samokateterizacija [8][9][10] . Istraživanje koje je uključivalo 401 pacijenta s Mainz-pouch I urinskim spremnikom pokazalo je kako učestalost nastanka litijaze ovisi i o vrsti upotrebljavanog kontinentnog mehanizma.…”

REPLY TO THE AUTHORS: Re: Endourologic strategies for a minimally invasive management of urinary tract stones in patients with urinary diversion

“…With the advancement of equipments and increasing experience, the surgical management of urolithiasis in patients with urinary diversion are varied, individualized consideration and comprehensive evaluation must be taken into account, which depending upon diversion type, patient fitness, stone size, stone location, available resource and surgeon experience ( 5 , 6 ).…”