The Management of Infection Stones

  • Manoj Monga
  • Sarah Tarplin


“Infection stones,” or stones formed as a result of urinary tract infection (UTI) with a urease-producing organism, are more common in women and those with functional or anatomic abnormalities of the urinary tract. Infection stones may form staghorns and the prognosis is poor if left untreated. The primary therapeutic goal should be that the patient is stone-free. To that end, percutaneous nephrolithotomy (PCNL) or other modern endoscopic interventions, in addition to culture-specific antimicrobial therapy are required. Hydroxamic acid and long-term antibiotic therapy may be useful adjuncts in some patients. Sepsis following PCNL is an ongoing challenge and can occur despite prophylactic antibiotic administration and treatment of a positive pre-operative urine culture. Recent studies suggest that a longer course of antibiotics prior to PCNL may be beneficial in some patients. Stones formed due to a metabolic derangement can lead to infection by providing a nidus for bacterial growth or by causing obstruction. After collecting system decompression and delayed stone removal, it is important to identify and manage all risk factors for infection in patients with stones and concomitant infection.


Spinal Cord Injury Neurogenic Bladder Asymptomatic Bacteriuria Percutaneous Nephrolithotomy Nephrostomy Tube 
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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of UrologyStevan Streem Center for Endourology & Stone Disease, Glickman Urological & Kidney Institute, Cleveland Clinic FoundationClevelandUSA

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