Urinary Matrix Calculi: Our Experience at a Single Institution

Bani-Hani, Ahmad H.; Segura, Joseph W.; LeRoy, Andrew J.

doi:10.1097/01.ju.0000145868.18824.25

Cited by 32 publications

(34 citation statements)

References 11 publications

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“…If suspicious for these stone compositions based on prior history or crystal presence on urinalysis, SWL is best avoided and another treatment selected. Matrix stones, while not dense, are made of organic matter and do not break with SWL [25] . Ureteroscopy or percutaneous nephrolithotomy should be used to treat this rare stone type if known.…”

Section: Patient Selectionmentioning

confidence: 99%

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

Semins

Matlaga

2015

WJN

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Shock wave lithotripsy (SWL) was introduced in 1980, modernizing the treatment of upper urinary tract stones, and quickly became the most commonly utilized technique to treat kidney stones. Over the past 5-10 years, however, use of SWL has been declining because it is not as reliably effective as more modern technology. SWL success rates vary considerably and there is abundant literature predicting outcome based on patient-and stone-specific parameters. Herein we discuss the ways to optimize SWL outcomes by reviewing proper patient selection utilizing stone characteristics and patient features. Stone size, number, location, density, composition, and patient body habitus and renal anatomy are all discussed. We also review the technical parameters during SWL that can be controlled to improve results further, including type of anesthesia, coupling, shock wave rate, focal zones, pressures, and active monitoring. Following these basic principles and selection criteria will help maximize success rate. Core tip: Shock wave lithotripsy is a commonly utilized technology for kidney stone treatment that has declining efficacy over the past decade. The paper outlines how to optimize outcomes with proper patient selection and control of treatment parameters.

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Section: Patient Selectionmentioning

confidence: 99%

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

Semins

Matlaga

2015

WJN

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“…The radiological appearance of these stones can be variable. Bani-Hani et al [4] reported the presence of gas in the renal pelvis, probably secondary to active infection. Intravenous urography in these patients is often of poor diagnostic value due to impaired renal function, which makes the contrast medium inadequate to outline the filling defects.…”

Section: Discussionmentioning

confidence: 99%

“…Histological examination shows laminar concentric rings of organized matrix with an orderly, layered deposition of mineral. Bani-Hani et al [4] believe that reduced urinary excretion of calcium by the affected kidney is responsible for the lack of calcifications, but it is possible that the normal calcium excretion by the contralateral kidney compensates for the 24-hour urinary calcium amount. Indeed, all our patients were normocalciuric and we did not find any alteration at metabolic screening.…”

Section: Discussionmentioning

confidence: 99%

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The Endourological Treatment of Renal Matrix Stones

Beltrami

Ruggera²,

Guttilla

et al. 2014

Urol Int

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Objective: To report our experience with the endourological treatment of renal matrix stones, an infrequent form of urinary calculi whose diagnosis and treatment are often difficult. Methods: From 1990 to 2010 we treated 9 female patients with matrix calculi using the endourological approach; 4 presented with renal colics, 3 with symptomatic urinary tract infection and 2 with asymptomatic bacteriuria. Six patients underwent percutaneous lithotripsy and 3 retrograde intrarenal surgery as first-line therapy. Three cases needed a multidisciplinary approach. Results: The six percutaneous procedures were successful after a single session, while the retrograde approach required multiple treatments; a single case needed a shock wave session to complete the fragmentation, in another one a percutaneous lithotripsy was necessary after the first procedure, and a third case needed multidisciplinary treatment. Conclusions: Percutaneous lithotripsy has been confirmed as the first option for matrix stones. The retrograde approach - by confirming the suspected diagnosis and being minimally invasive - may be employed to treat either lower-size stones or stones at high risk of recurrence.

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“…Therefore, brushite stone formers should be treated with a paradigm similar to cystine stone formers, and only those patients with small stone burdens should undergo SWL. Finally, matrix calculi, which are composed of as much as 65% organic matter, also respond very poorly to SWL, and should generally be approached through endoscopic means [Bani-Hani et al 2005].…”

Section: Patient Selectionmentioning

confidence: 99%

How to improve results with extracorporeal shock wave lithotripsy

Semins

Matlaga

2009

Therapeutic Advances in Urology

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Abstract:Objective: Shock wave lithotripsy (SWL) has greatly revolutionized the treatment of patients suffering from stone disease. There are a number of patient-and device-specific factors that can affect treatment outcome. Herein, we review practices that can increase the likelihood of SWL treatment success. Methods: A systematic literature review was performed to identify studies of SWL treatment parameters. Results: Among the factors affecting the outcome of SWL were patient selection criteria, such as stone burden, stone location, and anatomic features. Additionally, technical aspects of the SWL procedure also can affect outcome; these factors include the acoustic output of the lithotripter, the coupling of the lithotripter to the patient, and the power, total number, and rate of shock wave delivery. Conclusions: The outcome of SWL can be optimized with close attention to patient selection criteria as well as the manner in which the treatment is performed.

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Urinary Matrix Calculi: Our Experience at a Single Institution

Cited by 32 publications

References 11 publications

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

The Endourological Treatment of Renal Matrix Stones

How to improve results with extracorporeal shock wave lithotripsy

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