Kidney Stone Dissolution Therapy in Phosphate Stones: A Case Report

Phosphate stones can be divided into struvite (7%), apatite (20%), and brushite stones (2%). They often present as large staghorn calculi and, therefore, can be challenging to treat. Moreover, it is crucial to obtain a stone-free patient to prevent recurrence. Therefore, local chemolysis can be an interesting tool when complete surgical removal of the stone is impossible or as an adjuvant treatment for residual stone fragments after surgery. We present a case of an 84-year old Caucasian man in whom local chemolysis therapy with a citric acid solution resulted in a rapid reduction of the stone load, making less invasive therapy possible. We describe the procedure, (dis)advantages, and possible indications for local chemolysis.