The risk of urolithiasis recurrence may be reduced with anti-nanobacterial therapy

Urolithiasis is a common disorder responsible for serious human suffering and economic cost to society. Approximately 13% of men and 7% of women in the United States will be diagnosed with urolithiasis at some time in their lives with a recurrence rate of more than 50% in 5 years. Even if some risk factors are defined for stone formation, none of them can fully explain the etiopathogenesis. A controversial pathogen bacteria called 'nanobacteria' (NB) has been associated with several diseases including stone formation in some studies. It is thought to be the nidi for the stone formation after its' isolation from the renal stones and the occurrence of the stone after the percutaneus renal injection of NB. The clinical trials demonstrated that the eradication of NB prevented the calcifications in coronary arteries and prostate with an acceptable level by performing a novel combination therapy called 'ComET' which comprises a tetracycline antibiotic, nutraceutical and EDTA. Based on these findings, we hypothesize that the risk of urolithiasis recurrence may be reduced with combined anti-nanobacterial therapy. Long term prospective studies should be designed for evaluating the patients with positive NB cultures. If our hypotheses can be further supported with clinical trials it may change the approach of the medical management for urolithiasis.