Analysis of Urinary Tract Stones

Today, the prevalence of urinary tract stones between 5 to 12% with the prevalence and recurrence rates levels increased remarkably in recent years indicated. Stone disease within one year after the first admission of 10%, 35% within 5 years and 10 years, 50% repeats. However, the 1980's, after the expansion of a pulsed, solid device technology in addition to the methods of endoscopic lithotripsy is a minimally invasive method, the body outside the shock waves to break stones in the treatment of urological disease in the introduction of a fundamental progress has been made ​​of stone. But the underlying reason for the non-recurrence rates of these treatments have no effect. Today, as surgical treatment of the stone, then the second step, in order to prevent recurrences do. With the underlying metabolic-anatomic causes of these studies, the introduction and then start the appropriate prophylactic treatment for the patient is an absolute necessity to know the analysis of the stone. Stone analysis, urinary tract, "biochemical biopsy" is sometimes defined as the identification of specific components and custom stone may indicate a metabolic diagnosis.


For example, cystine stones as a result of analysis to arrive, pre-diagnosis of hereditary cystinuria or calcium oxalate stones determination, related to the metabolism of calcium and oxalate in primary hyperparathyroidism, hypercalciuria, renal tubular acidosis, primary hyperoxaluria, in many disorders such as gastro-intestinal diseases. Many of these crystalline form. According to the results of stone analysis is the most common components, respectively, of calcium oxalate (monohydrate or dihydrate-Wheweelite-Weddellite), calcium hydrogen phosphate (Brushite), calcium phosphate (hydroxyapatite / Dahllite), cystine, magnesium ammonium phosphate (struvite) and uric acid building blocks. Many of the stone in the mucopolysaccharide and proteins are usually found in small amounts. However, their clinical significance is still understood. Urinary system stones natural as long a grows and shows the time period itself. Some crystalline forms, appears as the product of reduction of other forms. For example, calcium monohydrate, dihydrate form is the product of dehydration. Therefore, close to the kernel at the periphery of the stone has a higher incidence of monohydrate form. There are many different methods the study of urinary tract stones. These X-ray diffraction crystallography, infrared spectroscopy, electron microscopy, thermogravimetric analysis, polarizing microscopy and chemical spot tests. Compared to these methods, the methods by about 30% of all the stone was the wrong diagnosis was obtained.



Chemical analysis, is still the most widely used today, but also has the highest error rate methods. These methods provide insufficient results, especially for small amounts of stone and blends. Most of error are cystine stones. If it contains phosphate in detection rate of cystine stones than 70% to 58% may go up.


In all methods of analysis for both common and rare components of the most accurate results were given by the infrared spectroscopy.


Stone analysis is done correctly is very important to assess the changing risk factors. Stone analysis indicates that within the urinary environment. For example, as a result of the analysis in a patient with magnesium ammonium phosphate, with the start of crystallization and stone formation, urinary tract infection, followed by secondary, resulting in storage of magnesium ammonium phosphate. These results suggest that infected urinary environment. Similarly, recurrent stones, each time changes occur in the composition of the stone. For example, cystine, or uric acid stone was originally a combination of stone, and then be sent for example as a result of magnesium ammonium phosphate. At this point, stone analysis, the presence of intercurrent infection, pointing to a urology specialist treatment plan may require making changes. Depending on the treatment given the observed changes in the composition of the stone is in the same patient. Cystine, or uric acid stones in patients with calcium phosphate stones may occur after the alkali treatment. In recent years, increasing the pre-operative analysis of the components of the stone and the treatment plan according to the results of various studies that are done.


Urate, calcium oxalate monohydrate, calcium phosphate stones and cystine stones ESWL for the treatment at the first step to answer in general is lower.


Tested different methods for prediction of the possible components of the stone before surgery. Among these, according to the results of the previous stone analysis to determine the treatment plan, urinary pH, urine microscopy, KUB, conventional and spiral CT, magnetic resonance, X-ray diffraction and is located in bone mineral densitometry.


In one study, X-rays have been reported with the 39% accuracy.

In another study conducted in-vivo with spiral CT as the only correct analysis be made ​​of calcium oxalate and uric acid stones have been reported.

T1-weighted magnetic resonance imaging studies done in the separation of struvite and apatite stones have been reported.


Although promising, even though some of these studies, yet there is a method to ensure an accurate assessment of the stone exactly as in vivo.


Today, analysis of urinary tract stones in each stone must be done for patients and to determine the treatment plan as well as an overview of which is very important in the prevention of duplication. Currently, many different techniques used in the laboratory are often not reliable, and working with high error rates. Therefore, especially in reference to some of the advanced centers should be preferred. Analysis of the foundation stone is connected to the correct diagnosis and treatment of high-quality stone, but the analysis can assist the clinician.