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Urinary Infection and Struvite Stones

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Urinary Tract Stone Disease

Abstract

Struvite stones, also known as infection stones, have a chemical composition of magnesium ammonium phosphate, with or without calcium carbonate. They are named “infection stones” due to their association with urea-splitting bacteria, which degrade urea into ammonium and carbon dioxide, thus providing a major substrate for the development of a large, branched renal calculus. The most important urease producers include Proteus, Pseudomonas, Klebsiella, and Staphylococcus species. Moreover, bacterial endotoxins produced by many of these organisms contribute to the formation of a biofilm, which can entrap cations and promote crystallization. Staghorn calculi have been known to grow rapidly, in some instances as quick as 4–6 weeks. In addition to urea breakdown, urinary stasis may also contribute to calculus formation as seen in patients with urinary diversion, ureteropelvic junction (UPJ) obstruction, bladder outlet obstruction, or neurogenic voiding dysfunction. The management of infection stones includes antibiotic administration and complete stone removal. Retained fragments have a propensity to be associated with regrowth of renal stones in the vast majority of patients, demonstrating the necessity for an aggressive therapeutic approach.

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Authors and Affiliations

  1. Department of Urology, Naval Medical Center San Diego, San Diego, CA, USA

    Sean P. Stroup

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  1. Sean P. Stroup
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  2. Brian K. Auge
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Correspondence to Sean P. Stroup .

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Editors and Affiliations

  1. Dept. Urology, Spire Manchester Hospital, Russell Road, Manchester, M16 8AJ, United Kingdom

    Nagaraja P. Rao

  2. Division of Urologic Surgery, Duke University Medical Center, Durham, 27710, North Carolina, USA

    Glenn M. Preminger

  3. Department of Urology, South Manchester University Hospitals, Manchester, M20 2LR, United Kingdom

    John P. Kavanagh

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Stroup, S.P., Auge, B.K. (2010). Urinary Infection and Struvite Stones. In: Rao, N., Preminger, G., Kavanagh, J. (eds) Urinary Tract Stone Disease. Springer, London. https://doi.org/10.1007/978-1-84800-362-0_18

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  • DOI: https://doi.org/10.1007/978-1-84800-362-0_18

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