Primary dissolution therapy of struvite calculi

Area of Science:

• Urology
• Nephrology
• Medical Chemistry

Background:

• Magnesium ammonium phosphate (struvite) calculi pose a significant clinical challenge.
• Surgical intervention has traditionally been the primary treatment for these stones.
• Minimally invasive and non-surgical options are increasingly sought for urinary stone management.

Purpose of the Study:

• To evaluate the efficacy and safety of percutaneous nephrostomy combined with hemiacidrin infusion as a primary treatment for struvite calculi.
• To assess the rates of successful treatment and complete stone dissolution.
• To determine the complication profile and long-term outcomes of this therapeutic approach.

Main Methods:

• Percutaneous nephrostomy was performed in 32 surgical candidates.
• Hemiacidrin infusion was administered as the primary treatment to 28 of these patients.
• Patient outcomes, including stone dissolution and need for surgery, were monitored.
• Follow-up ranged from 3 months to 7 years.

Main Results:

• A high success rate of 85% (24 out of 28 patients) was achieved with hemiacidrin treatment, avoiding surgery.
• Complete stone dissolution occurred in 68% (19 out of 28 patients).
• No significant complications were reported during the study period.
• Long-term follow-up demonstrated sustained positive outcomes.

Conclusions:

• Percutaneous nephrostomy with hemiacidrin infusion is a viable and effective primary treatment for magnesium ammonium phosphate (struvite) calculi.
• This minimally invasive method offers a high success rate and significant stone dissolution, reducing the need for surgery.
• The treatment is well-tolerated, with a favorable safety profile and good long-term results, expanding treatment options for patients.