All of calculus stones were complex in this study. CaOx and CaP were the main components with highest frequency in urolithiasis patients. The composition of calcium cation is of inverse proportion with magnesium cation
Urinary Calculi ; chemistry

OBJECTIVETo investigate the composition and morphology of the stones in the enlarged prostatic utricle (EPU).

METHODSWe took out 36 EPU stones from 11 patients by transurethral fenestration between 1992 and 2011, and analyzed the stones by scanning electron microscopy, x-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIS).

RESULTSUnder the scanning electron microscope, all the EPU stones were constituted of many intensive minicrystals and amorphous matrix. XRD and FTIS revealed that all were hydroxyapatite crystal.

CONCLUSIONEPU stones belong to the category of prostatic pseudo-calculi, whose formation is ascribed not to the abnormal change of urine composition, but to the continuous secretion, absorption and concentration of EPU liquid and ablated epithelial cells from the EPU.

Calculi ; chemistry ; Durapatite ; chemistry ; Humans ; Male ; Prostate ; chemistry ; pathology ; Prostatic Diseases ; pathology ; physiopathology

BACKGROUND: Studies that evaluate the effect of age on stone composition are scarce. The aim of this study was to highlight the changes in epidemiological characteristics (stone composition and location) of urolithiasis according to patients' age. METHODS: We studied 1,301 urolithiasis patients with age ranging from 6 months to 92 yr (781 males and 520 females). Stone analysis was performed using a stereomicroscope and infrared spectroscopy to determine the morphological type and molecular composition of each stone. RESULTS: The annual average incidence of new stone formation was 31.7 per 100,000 persons. In 71.8% of cases, calculi were located in the upper urinary tract. Compared to other age groups, children and old men were more affected by bladder stones. Calcium oxalate monohydrate was the most frequent stone component, even though its frequency decreased with age (59.5% in young adults and 43.7% in the elderly, P<0.05) in favor of an increase in uric acid stones (11.5% in young adults and 36.4% in the elderly, P<0.05). Struvite stones were rare (3.8%) and more frequent in children than in adults. CONCLUSIONS: The analysis of these data showed that urinary stones in Tunisian patients are tending to evolve in the same direction as the stones in patients from industrialized countries.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Calcium Oxalate/chemistry ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Kidney Calculi/chemistry/diagnosis/epidemiology ; Magnesium Compounds/chemistry ; Male ; Middle Aged ; Phosphates/chemistry ; Retrospective Studies ; Spectrophotometry, Infrared ; Tunisia/epidemiology ; Uric Acid/chemistry ; Urinary Bladder Calculi/chemistry/diagnosis/epidemiology ; Urinary Calculi/*chemistry/diagnosis/epidemiology ; Young Adult

PURPOSE: Recent studies have suggested an increased prevalence of urolithiasis with obesity. This study aimed to assess the influence of obesity on urinary metabolic abnormalities and the recurrence of stone. MATERIALS AND METHODS: We analyzed 802 consecutive stone formers(SF: first-time SF=501, recurrent SF=291) who underwent a comprehensive metabolic evaluation that included blood chemistry tests and a 24-hour urinary examination, as well as determining the body mass index(BMI). The BMI was categorized into the non-obese(BMI<25kg/m2) and obese(BMI>or=25kg/m2) according to the re-defined Western Pacific Region WHO criteria on obesity(WPRO). All possible risk factors such as age, gender, BMI, the clinical characteristics and the metabolic parameters were compared between both groups. Among them, 184(22.9%) patients had been followed up for more than 24 months or they recurred during the follow up(mean: 56.0, median: 58.5, range: 7.0-140.0) and they were examined for the risk of stone recurrence by performing multivariate Cox regression analysis. RESULTS: Obesity was significantly associated with the increased urinary excretion of sodium, calcium and oxalate(p<0.05, respectively). The urinary pH value showed inverse correlation with obesity(p=0.012). Urinary metabolic abnormalities were more common in the obese SF patients than the non-obese SF patients(p=0.003). Obesity was significantly associated with the stone recurrence rate(p=0.009). Cox regression analysis revealed that obesity was a strong predictor for recurrent stone formation(adjusted HR=2.384 95% CI: 1.372-4.143, p=0.002). CONCLUSIONS: Our results reveal that obesity is highly associated with metabolic alterations and urinary stone recurrence. Therefore, weight control might be considered as one of the preventive measures against recurrent stone formation.
Calcium ; Chemistry ; Humans ; Hydrogen-Ion Concentration ; Obesity ; Prevalence ; Recurrence* ; Risk Factors ; Sodium ; Urinary Calculi ; Urolithiasis*

Aged ; Aged, 80 and over ; Calculi ; chemistry ; diagnosis ; Genital Diseases, Male ; diagnosis ; Humans ; Male ; Scrotum

PURPOSE: Stone size and location are generally considered the most important factors associated with spontaneous ureter stone passage (SSP). Several parameters related to inflammatory changes have been identified as predictors associated with SSP. Our aim was to investigate the predictive role of neutrophil-to-lymphocyte ratio (NLR) for SSP. MATERIALS AND METHODS: A retrospective review was performed on 131 patients who were referred to the urology outpatient clinic and diagnosed with unilateral ureteral stones at our emergency department between July 2016 and December 2016. The presence of ureteral stones was confirmed with non-contrast-enhanced computed tomography (NCCT) for all patients. SSP was confirmed with either the patient collecting the stone during urination or by NCCT performed at 3 weeks from the first stone episode. Physical examination, urinalysis, complete blood count, serum chemistry and inflammatory markers, plain radiographs, and NCCT at initial presentation were reviewed to analyze predictors of future SSP. RESULTS: Of 113 patients included for analysis, 90 (79.6%) passed their stones spontaneously. The SSP rates within 3 weeks according to the stone's size (5–10 mm and ≤5 mm) were 62.2% and 88.2%, respectively. A lower stone location [odds ratio (OR), 11.54; p=0.001], smaller stone size (≤5 mm) (OR, 8.16; p=0.001), and NLR (<2.3) (OR, 9.03; p=0.003) were independent predictors of SSP. CONCLUSION: Low NLR (<2.3) may predict SSP in patients with ureter stones ×1.0 cm in size. Our results suggest that ureteral inflammation plays an important role in SSP. Early intervention may be considered for patients presenting with high NLR (≥2.3).
Ambulatory Care Facilities ; Blood Cell Count ; Calculi ; Chemistry ; Early Intervention (Education) ; Emergency Service, Hospital ; Humans ; Inflammation ; Physical Examination ; Prognosis ; Retrospective Studies ; Ureter* ; Urinalysis ; Urinary Calculi ; Urination ; Urology

PURPOSE: To assess the potential of dual-energy computed tomography (DECT) to identify urinary stone components, particularly uric acid and calcium oxalate monohydrate, which are unsuitable for extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: This clinical study included 246 patients who underwent removal of urinary stones and an analysis of stone components between November 2009 and August 2013. All patients received preoperative DECT using two energy values (80 kVp and 140 kVp). Hounsfield units (HU) were measured and matched to the stone component. RESULTS: Significant differences in HU values were observed between uric acid and nonuric acid stones at the 80 and 140 kVp energy values (p<0.001). All uric acid stones were red on color-coded DECT images, whereas 96.3% of the nonuric acid stones were blue. Patients with calcium oxalate stones were divided into two groups according to the amount of monohydrate (calcium oxalate monohydrate group: monohydrate> or =90%, calcium oxalate dihydrate group: monohydrate<90%). Significant differences in HU values were detected between the two groups at both energy values (p<0.001). CONCLUSIONS: DECT improved the characterization of urinary stone components and was a useful method for identifying uric acid and calcium oxalate monohydrate stones, which are unsuitable for ESWL.
Adult ; Aged ; Calcium Oxalate/analysis ; Female ; Humans ; Kidney Calculi/*chemistry/*radiography/therapy ; *Lithotripsy ; Male ; Middle Aged ; Patient Selection ; Radiography, Dual-Energy Scanned Projection ; Tomography, X-Ray Computed/*methods ; Ureteral Calculi/*chemistry/*radiography/therapy ; Uric Acid/analysis

To analyze types of urinary calculi and patients' clinical characteristics, and to explore the strategies for prevention and treatment of urinary calculi.
 Methods: A total of 1 849 patients with urinary calculi were treated in the Department of Urology, the Third Xiangya Hospital of Central South University. The components were analyzed by infrared spectroscopy. The relationship between stone composition and clinical parameters was analyzed according to the clinical characteristics of the patients.
 Results: The proportion of calcium oxalate stone or uric acid stone in male (84.1% or 7.7%) was higher than that in female (78.4% or 4.2%). The older patients were more likely to be diagnosed as uric acid stone. The proportions of uric acid stone in patients <18 years old, 18-<41 years old, 41-<66 years old, and ≥66 years old were 0.0%, 1.6%, 6.6%, and 12.4%, respectively. There was no significant difference in the proportion of stones in patients with different BMI. There were no significant difference in the stone composition between the patients with or without urinary tract infection, hypertension or diabetes. The proportion of uric acid stones in patients with acidic urine was higher than the other types. The proportion of uric acid stones in patients with elevated creatinine (12.1%) was higher than that in the patients with normal creatinine (4.5%).
 Conclusion: Elderly patients, or patients with high uric acid and renal insufficiency are more prone to uric acid stones. Regulation of urinary pH may be an important strategy for preventing and treating urinary calculi in Hunan Province.
Adolescent ; Adult ; Age Factors ; Aged ; Body Mass Index ; Calcium Oxalate ; analysis ; Creatinine ; urine ; Female ; Humans ; Hydrogen-Ion Concentration ; Kidney Calculi ; chemistry ; therapy ; Male ; Middle Aged ; Sex Factors ; Spectrophotometry, Infrared ; Uric Acid ; analysis ; Urinary Calculi ; chemistry ; therapy ; urine

A Clinical study was made on 41 cases of bilateral urinary stones who were admitted to Yonsei Medical Center, Severance Hospital during the period from January, 1962 to December, 1976. The results of this study may be summarized as follows: 1. During the period the total urinary stone patients were 997 and the ineidense of bilateral stone was 4.1 %. 2. 80 percents of the patients with bilateral stones were seen in 21-50 age groups. 3. Urinary infection was complicated in 63 % and staphylococcus coagulase positive was most common. 4. Urine acidity was over than pH 75 1n 6 patients and less than pH 5.5 in 2 patients. 5. In blood chemistry hypercalcemia was revaled in 7 patients. BUN was more than 20 mg % in 10 patients and creatinine was more than 2mg % in 7 patients. 6. The most common chief complaints were flank Pain which was in 31 patients. The next was gross hematuria which was in 21 patients. Total anuria was noted in 2 patients. 7. the location of bilateral urinary stone was most common in one kidney and one ureter which was in 15 cases. 8. The excretory urography revealed mild hydronephrosis in 21 cases, marked hydronephrosis in 9 cases, nonvisualization in 4 cases, delayed visualization in 19 cases and nephrogram only in 11 cases. 9. In the past history, immobilization and trauma was seen in 1 case respectively and the remaining cases there could not be noted the specific causative factors in the stone formation. 10. Operation was done in 33cases, endoscopic management in 7 cases, and kidney bisection in two cases.
Anuria ; Chemistry ; Coagulase ; Creatinine ; Flank Pain ; Hematuria ; Humans ; Hydrogen-Ion Concentration ; Hydronephrosis ; Hypercalcemia ; Immobilization ; Kidney ; Staphylococcus ; Ureter ; Urinary Calculi* ; Urography

PURPOSE: The purpose of the present study was to determine the risk factors for predicting the recurrence in first-time urinary stone formers. MATERIALS AND METHODS: A total of 121 patients, who presented at our hospital with first-time urinary stone episodes, between 1996 and 2005, and followed up for at least 3 years, were retrospectively evaluated. Of these, 65 patients (41 males, 24 females) recurred (R group) and 56 (38 males, 18 females) not (NR group) during the follow-up period. The blood chemistry and urinary analytes values, as well as the clinical characteristics between the NR and R groups were compared by gender. p-values less than 0.05 were used to indicate statistical significance. RESULTS: There were no differences in the clinical characteristics between the NR and R groups. A comparison of the blood chemistry showed differences in the phosphate and calcium in men and women (p=0.047 and 0.034), respectively. Greater urinary excretion of phosphates were found in the R group than in the NR group (p=0.018), but was more prominent in men (p=0.006). No significant differences were found between the two groups with regard to metabolic abnormalities. A multivariate analysis revealed that urinary phosphates excretion was the sole predictor for stone recurrence (Exp beta=8.347, p=0.033). CONCLISIONS: Our results suggested that the increased excretion of urinary phosphates was a significant risk factor for stone recurrence, which might be useful as a prognostic marker.
Calcium ; Chemistry ; Female ; Follow-Up Studies ; Humans ; Male ; Multivariate Analysis ; Phosphates ; Recurrence* ; Retrospective Studies ; Risk Factors ; Urinary Calculi