Structures of the types of stone
Calcium oxalate stones: The most common of all stones are stones and an average of 1 / 3 of the pure oxalate stones, and an average of 1 / 3 of a mixture of calcium oxalate and apatite stones creates. In this case, approximately 70% of urinary oxalate in the blocks of stones. Calcium oxalate stones, calcium phosphate and calcium carbonate stones are stones after the intense third-degree beam.
The formation of calcium oxalate stones are usually more than one risk factor effect. Risk factors of calcium oxalate in the urine by increasing, crystallization inhibitory activity are effective in reducing or increasing the crystallization promoter activity.
Metabolic risk factors, hypercalciuria, hyperoxaluria, hypocitraturia, can be considered as hypo magnesium. In addition, macromolecules, several microorganisms and diet play a role as risk factors for stone formation. Calcium oxalate stones in 50% of patients with hypercalcemia, hypercalciuria and unbound (idiopathic hypercalciuria) has. This is more than most of the patients intestinal calcium absorption and urinary excretion of more calcium is available. Excessive release of calcium from the bones more or less a part of the primary calcium excretion by the kidneys and monitored.
Hypercalcemia and hypercalciuria seen in 10% of patients with calcium oxalate stones. Hyperparathyroidism, sarcoidosis, vitamin D intoxication, diseases such as Cushing's syndrome arises as a consequence. 20% of patients with calcium oxalate stones hyperuricosuria, hyperoxaluria was found in 5%, 15% in 20, not available with any metabolic disorder. Calcium oxalate stones CaOMNH (Whewellite) or CaODH (Weddellite) can be structured. Weddellite stones, according to those who Whewellite structure, better stone-free rates with ESWL and intracorporeal lithotripsy techniques can be obtained from fragmentation can be achieved more easily. Calcium oxalate monohydrate or dihydrate structure, the formation of stones is not fully understood causes. Building stones, the stones, hyperoxaluria, hypercalciuria with Weddelite Whewellite structure, and these stones are shown to be associated with differences in patient groups that have been reported.
Objective in the treatment of recurrent urinary stone disease by correcting the risk factors to eliminate disturbances in the structure, thus to prevent new stone formation and growth of existing stones.
Calcium phosphate stones: calcium phosphate, calcium phosphate stones most common causes of balance disorders, renal tubular acidosis and urinary tract infection. Urine pH of calcium phosphate stones are two main types depending on. These brushite (calcium hydrogen phosphate trihydrate) and carbonate apatite (oxalate triphosphate) blocks. And the risk of recurrence of stones is a very fast Brushite high (30-60%) (13). Brushite stones, the pH of acidic urine ranging between 6.5 and 6.8, occurs in the presence of high amounts of calcium and phosphate.
Carbonate apatite stones in the urine alkaline (pH> 6.8), develops in the presence of high calcium and low citrate concentration.
Carbonate apatite, or infection is easy to break stones with ESWL. However, monotherapy with the stone-free rates and low risk of recurrence is high. Brushite stones in the phosphate stones are stones with the most intense and hard. ESWL is very difficult with the fragmentation and stone-free rate is low.
Therefore, percutaneous procedures are often applied, and in some cases, open surgery would be preferable.
Magnesium ammonium phosphate (MgNH3PO4) stones (struvite, infection) stones: Mixed or pure variety. Ray density is lower than that of calcium in the stones. Phosphate containing stones, urinary tract stones is 15%. Chief among these are struvite. Chronic infections, especially urinary pH and ammonium concentrations of urea-splitting bacteria such as Proteus, can cause an increase in the formation of struvite stones may prepare the ground. Is the rapid growth of phosphate stones tend to fill the entire renal pelvis and calyceal system. This type of deer horn, stone formation resembles "staghorn" is defined as a stone.
Proteus species of microorganisms that break down urea and the urine becomes alkaline, magnesium ammonium phosphate stones occur. More women appear. The main reason for this less than bacterial infection, struvite stones in women. There are bacteria living in the stones.
The main aim of treatment of infection stones in the urinary system is to purify these stones. Conservatively while monitoring the reported mortality of up to 28%
Stones of the urinary tract will serve arınmasına methods ESWL, percutaneous nephrolithotomy, open nephrolithotomy or ESWL and percutaneous nephrolithotomy include combined. The first step is composed of staghorn stone treatment with percutaneous nephrolithotomy.
Calcium carbonate stones: Usually found in combination with phosphate stones. Light intensity is very high.