Skip to main content
Log in

Percutaneous chemolysis of renal calculi

  • Published:
Urologic radiology

Abstract

Certain types of pyeloureteral calculi can be treated by chemolytic drug irrigation through a percutaneous nephrostomy catheter. Struvite, apatite, and carbonate stones can be dissolved with an acidic solution (hemacidrin, Suby solution G). An alkaline agent (Tham-E®, acetylcysteine) will dissolve cystine calculi. While most uric acid stones are managed by oral alkalinization with sodium bicarbonate or potassium citrate, there are occasions (cardiac, metabolic conditions) where treatment via percutaneous nephrostomy is preferable. Successful nonoperative management of symptomatic calculi has been obtained in 85% of cases with chemolysis of more than 150 stones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Dretler SP, Pfister RC, Newhouse JH: Renal stone dissolution via percutaneous nephrostomy.N Engl J Med 300:341–343, 1979

    CAS  PubMed  Google Scholar 

  2. Smith AD, Lange PH, Miller RP, Reinke DB: Dissolution of cystine calculi by irrigation with acetylcysteine through percutaneous nephrostomy.Urology 13:422–423, 1979

    Article  CAS  PubMed  Google Scholar 

  3. Spataro RF, Linke CA, Barbaric ZL: The use of percutaneous nephrostomy and urinary alkalinization in the dissolution of obstructing uric acid stones.Radiology 129:629–632, 1978

    CAS  PubMed  Google Scholar 

  4. Newhouse JH, Pfister RC: Therapy for renal calculi via percutaneous nephrostomy: dissolution and extraction.Urol Radiol 2:165–170, 1981

    CAS  PubMed  Google Scholar 

  5. Tseng CH, Talwalkar YB, Tank ES, Hatch T, Alexander SR: Dissolution of cystine calculi by pelviocalyceal irrigation with thromethamine-E.J Urol 128:1281–1284, 1982

    CAS  PubMed  Google Scholar 

  6. Strijk SP, Boetes C, Froeling P: Dissolution of bilateral renal calculi via percutaneous nephrostomy.Acta Radiol Diagn 23:599–603, 1982

    CAS  Google Scholar 

  7. Dretler SP, Pfister RC: Percutaneous dissolution of renal calculi.Annu Rev Med 34:359–366, 1983

    Article  CAS  PubMed  Google Scholar 

  8. Dretler SP, Pfister RC, Newhouse JH, Prien EL Jr: Percutaneous catheter dissolution of cystine calculi.J Urol 131:216–219, 1984

    CAS  PubMed  Google Scholar 

  9. Sheldon CA, Smith AD: Chemolysis of calculi.Urol Clin North Am 9:121–130, 1982

    CAS  PubMed  Google Scholar 

  10. Newhouse JH, Prien EL Jr, Amis ES Jr, Dretler SP, Pfister RC: CT analysis of urinary tract stones.AJR 142:545–548, 1984

    CAS  PubMed  Google Scholar 

  11. Mulvaney WP: A new solvent for certain urinary calculi: a preliminary report.J Urol 82:546–548, 1959

    CAS  PubMed  Google Scholar 

  12. Nemoy NJ, Stamey TA: Use of hemiacidrin in management of infection stones.J Urol 116:693–695, 1976

    CAS  PubMed  Google Scholar 

  13. Suby HI, Albright F: Dissolution of phosphatic urinary calculi by the retrograde introduction of a citrate solution containing magnesium.N Engl J Med 228:81–91, 1943

    Article  Google Scholar 

  14. Pfister RC, Newhouse JH: Percutaneous nephrostomy and other procedures.Radiol Clin North Am 17:351–363, 1979

    CAS  PubMed  Google Scholar 

  15. Gunther R, Aiken P, Altwein JE: Percutaneous nephropyelostomy using a fine needle puncture set.Radiology 132:228–230, 1979

    CAS  PubMed  Google Scholar 

  16. Ho PC, Talner LB, Parsons CL, Schmidt JD: Percutaneous nephrostomy: experience in 107 kidneys.Urology 16:532–535, 1980

    Article  CAS  PubMed  Google Scholar 

  17. Pollack HM, Banner MD: Percutaneous nephrostomy and related pyeloureteral manipulative techniques.Urol Radiol 2:147–154, 1981

    CAS  PubMed  Google Scholar 

  18. Newhouse JH, Pfister RC: Percutaneous catheterization of the kidney and perinephric space: trocar technique.Urol Radiol 2:157–164, 1981

    Article  CAS  PubMed  Google Scholar 

  19. Cunningham JJ, Friedland GW, Stamey TA: Radiologic changes in the urothelium during Renacidin irrigation.J Urol 109:556–558, 1973

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pfister, R.C., Dretler, S.P. Percutaneous chemolysis of renal calculi. Urol Radiol 6, 138–143 (1984). https://doi.org/10.1007/BF02923712

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02923712

Key words

Navigation