Abstract
Struvite kidney stones are rare but may cause significant morbidity and mortality. Therapy remains primarily surgical, but combined treatment with antibiotics is now common. Pharmacologic dissolution therapy has been applied successfully, but the side effects of currently available drugs are significant, limiting their use. Struvite stones are strongly associated with genitourinary infection and urinary stasis, but metabolic abnormalities may coexist and formal metabolic evaluation may be useful in some cases. New treatments with a renewed emphasis on hybrid and non-surgical dissolution therapies are being investigated.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Griffith DP. Struvite stones. Kidney Int. 1978;13(5):372–82.
Jaskowiec TC, et al. No stone unturned: the presence of kidney stones in a skeleton from 19th century Peoria, Illinois. Int J Paleopathol. 2017;19:18–23.
Wall I, et al. Biochemical risk factors in patients with renal staghorn stone disease. Urology. 1986;28(5):377–80.
Healy KA, Ogan K. Pathophysiology and management of infectious staghorn calculi. Urol Clin North Am. 2007;34(3):363–74.
Viprakasit DP, et al. Changing composition of staghorn calculi. J Urol. 2011;186(6):2285–90.
Resnick MI, Boyce WH. Bilateral staghorn calculi--patient evaluation and management. J Urol. 1980;123(3):338–41.
Preminger GM, et al. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol. 2005;173(6):1991–2000.
Cohen TD, Preminger GM. Struvite calculi. Semin Nephrol. 1996;16(5):425–34.
Bichler KH, et al. Urinary infection stones. Int J Antimicrob Agents. 2002;19(6):488–98.
Rodman JS. Struvite stones. Nephron. 1999;81(Suppl 1):50–9.
Schwaderer AL, Wolfe AJ. The association between bacteria and urinary stones. Ann Transl Med. 2017;5(2):32.
Parkhomenko E, et al. A multi-institutional study of struvite stones: patterns of infection and colonization. J Endourol. 2017;31(5):533–7.
Singh P, et al. Stone composition among first-time symptomatic kidney stone formers in the community. Mayo Clin Proc. 2015;90(10):1356–65.
Flannigan R, et al. Renal struvite stones--pathogenesis, microbiology, and management strategies. Nat Rev Urol. 2014;11(6):333–41.
Gnessin E, et al. Changing composition of renal calculi in patients with musculoskeletal anomalies. J Endourol. 2011;25(9):1519–23.
Akagashi K, et al. Characteristics of patients with staghorn calculi in our experience. Int J Urol. 2004;11(5):276–81.
Lingeman JE, Siegel YI, Steele B. Metabolic evaluation of infected renal lithiasis: clinical relevance. J Endourol. 1995;9(1):51–4.
Kristensen C, et al. Reduced glomerular filtration rate and hypercalciuria in primary struvite nephrolithiasis. Kidney Int. 1987;32(5):749–53.
Diri A, Diri B. Management of staghorn renal stones. Ren Fail. 2018;40(1):357–62.
Blandy JP, Singh M. The case for a more aggressive approach to staghorn stones. J Urol. 1976;115(5):505–6.
Koga S, et al. Staghorn calculi--long-term results of management. Br J Urol. 1991;68(2):122–4.
Deutsch PG, Subramonian K. Conservative management of staghorn calculi: a single-centre experience. BJU Int. 2016;118(3):444–50.
Iqbal MW, et al. Contemporary management of struvite stones using combined endourologic and medical treatment: predictors of unfavorable clinical outcome. J Endourol. 2016;30(7):771–7.
Williams JJ, Rodman JS, Peterson CM. A randomized double-blind study of acetohydroxamic acid in struvite nephrolithiasis. N Engl J Med. 1984;311(12):760–4.
Rodman JS, Williams JJ, Jones RL. Hypercoagulability produced by treatment with acetohydroxamic acid. Clin Pharmacol Ther. 1987;42(3):346–50.
Pearle MS, et al. Medical management of kidney stones: AUA guideline. J Urol. 2014;192(2):316–24.
Iqbal MW, et al. Should metabolic evaluation be performed in patients with struvite stones? Urolithiasis. 2017;45(2):185–92.
Chamberlin JD, Clayman RV. Medical treatment of a Staghorn calculus: the ultimate noninvasive therapy. J Endourol Case Rep. 2015;1(1):21–3.
Smith LH. New treatment for struvite urinary stones. N Engl J Med. 1984;311(12):792–4.
Sant GR, Blaivas JG, Meares EM Jr. Hemiacidrin irrigation in the management of struvite calculi: long-term results. J Urol. 1983;130(6):1048–50.
Dretler SP, Pfister RC. Primary dissolution therapy of struvite calculi. J Urol. 1984;131(5):861–3.
Tiselius HG, et al. Minimally invasive treatment of infection staghorn stones with shock wave lithotripsy and chemolysis. Scand J Urol Nephrol. 1999;33(5):286–90.
Houston DM, et al. A diet with a struvite relative supersaturation less than 1 is effective in dissolving struvite stones in vivo. Br J Nutr. 2011;106(Suppl 1):S90–2.
Chauhan CK, Joshi MJ. Growth inhibition of struvite crystals in the presence of juice of Citrus medica Linn. Urol Res. 2008;36(5):265–73.
Manzoor MAP, et al. Vitamin C inhibits crystallization of struvite from artificial urine in the presence of Pseudomonas aeruginosa. Int Braz J Urol. 2018;44(6):1234–42.
Thalji NK, et al. Enzymatic dissolution of calcium and struvite crystals: in vitro evaluation of biochemical requirements. Urology. 2011;78(3):721 e13–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Mutter, W.P. (2019). Struvite Stones. In: Han, H., Mutter, W., Nasser, S. (eds) Nutritional and Medical Management of Kidney Stones. Nutrition and Health. Humana, Cham. https://doi.org/10.1007/978-3-030-15534-6_11
Download citation
DOI: https://doi.org/10.1007/978-3-030-15534-6_11
Published:
Publisher Name: Humana, Cham
Print ISBN: 978-3-030-15533-9
Online ISBN: 978-3-030-15534-6
eBook Packages: MedicineMedicine (R0)