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Management of uric acid stone
M N Chugtai1, F A Khan, M Kaleem
1Department of Urology, Postgraduate Medical Institute, Lahore.
Summary
Oral chemolysis effectively dissolves uric acid stones in most patients. This simple, safe, and inexpensive treatment requires patient compliance and regular monitoring for successful outcomes.
Area of Science:
- Nephrology
- Urology
- Biochemistry
Background:
- Uric acid stones are the most dissolvable urinary calculi.
- Effective dissolution strategies are crucial for patient management.
Purpose of the Study:
- To evaluate the efficacy of oral chemolysis in dissolving uric acid stones.
- To assess the safety and cost-effectiveness of this treatment modality.
Main Methods:
- A study involving 67 patients with 107 uric acid stones.
- Treatment involved maintaining urinary pH (6.2-6.8) with sodium acid citrate/uralyt-U and reducing serum uric acid with allopurinol.
Main Results:
- Ninety-three percent (86.9%) of stones dissolved within one year.
- Six percent (5.6%) passed spontaneously; 7.5% required surgical intervention or ESWL.
- Recurrence was observed in 7.5% of patients over 3 years.
Conclusions:
- Oral chemolysis is the preferred treatment for uncomplicated uric acid stones.
- The treatment is simple, safe, and inexpensive but demands strict patient compliance and ultrasonographic follow-up.