Cystine Lithiasis: Combined Extracorporeal and Litholytic Treatment

Rigatti, Patrìzio; Francesca, F.; Ronchi, F.; Girolamo, V. Di; Grasso, Marco; Colombo, R.; Maffezzini, Massimo

doi:10.1159/000414533

Cited by 3 publications

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“…Local alkalinization by tromethamine, a buffer solution, pH 8.2, effective both in vitro [10] and in vivo [11], was utilized to dissolve residual fragments resulting after the primary procedure. The alkalinizing solution could reach the renal collecting system by means of either a transureteral catheter (angiographic pigtail) or through PCN, and it was administered by slow-drop infusion of 500 mL/24 hr according to the patient's tolerance (pain caused by stretching of the renal pelvis) and urinary pH.…”

Section: Resultsmentioning

confidence: 99%

“…A cystine stone submitted to ESWL generates large fragments that can rarely be spontaneously discharged. By combining ESWL with either systemic or in situ chemolysis, we have been previously able to achieve the volumetric decrease of the fragments that could be consequently discharged by the patient [11]. In the case of cystine stones larger than 2 cm, we now submit the patient to PNL.…”

Section: Discussionmentioning

confidence: 99%

“…Cystine stones do not respond successfully to shock waves due to their high elasticity [10,11]. A cystine stone submitted to ESWL generates large fragments that can rarely be spontaneously discharged.…”

Section: Discussionmentioning

confidence: 99%

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Extracorporeal lithotripsy and combined surgical procedures in the treatment of renoureteral stone disease: Our experience with 2,955 patients

et al. 1989

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From May, 1985 to August, 1987, a total of 2,955 patients with renoureteral stone disease presented at our institution and were treated either by extracorporeal lithotripsy alone or combined with percutaneous nephrolithotomy, ureteroscopy, or open surgery. Seventy-three percent of patients were stone-free at the 3 month follow-up date while 22% presented with negative urine culture and small (less than 5 mm) asymptomatic fragments deemed susceptible to spontaneous discharge. The rate of major complications was extremely low (sepsis, 0.03% and major renal bleeding, 1.55%). The application of this multimodal therapeutic strategy allowed successful treatment in almost every case of renoureteral lithiasis with minor iatrogenic damage to the renal parenchyma.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Extracorporeal lithotripsy and combined surgical procedures in the treatment of renoureteral stone disease: Our experience with 2,955 patients

et al. 1989

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The Use of Chemical Treatments for Improved Comminution of Artificial Stones

et al. 2004

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Treatment of Cystine Stones: Combined Approach using open Pyelolithotomy, Percutaneous Pyelolithotripsy, Extracorporeal Shock Wave Lithotripsy and Chemolysis

Aabech

Andersen

1993

Scandinavian Journal of Urology and Nephrology

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Treatment of cystine stones in the urinary tract can be difficult because of a high frequency of recurrence, resistance to Extracorporeal Shock Wave Lithotripsy (ESWL), difficulty in localization and access to peripheral stones during Percutaneous Nephrolithotripsy (PCNL), and the insufficient effect of oral chemolysis. We present two cases of urinary cystine calculi treated with a combination of pyelolithotomy, PCNL, ESWL and percutaneous irrigation chemolysis, using N-acetylcysteine and Tromethamine-E.

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Cystine Lithiasis: Combined Extracorporeal and Litholytic Treatment

Cited by 3 publications

References 0 publications

Extracorporeal lithotripsy and combined surgical procedures in the treatment of renoureteral stone disease: Our experience with 2,955 patients

Extracorporeal lithotripsy and combined surgical procedures in the treatment of renoureteral stone disease: Our experience with 2,955 patients

The Use of Chemical Treatments for Improved Comminution of Artificial Stones

Treatment of Cystine Stones: Combined Approach using open Pyelolithotomy, Percutaneous Pyelolithotripsy, Extracorporeal Shock Wave Lithotripsy and Chemolysis

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