Résumé:
Objective:
To provide correlations between crystalluria and chemical structure of calculi
in situ
to help making decision in the use of the extracorporeal shock wave lithotripsy (
ESWL
).
Methods:
A crystalluria study was carried out on 644 morning urines of 172 nephrolithiasis
patients (111 males and 61 females), and 235 of them were
in situ
stone carriers. After treating
by
ESWL
, the recovered calculi have been analyzed by Fourier transform infrared spectroscopy
and their compositions were correlated to the nature of urinary crystals.
Results:
We obtained successful treatment for 109 patients out of 157 and 63 patients out of 78
with stones had a treatment failure (33.2%). The correlations showed that for the overwhelming
crystalluria containing calcium oxalate dihydrate (
COD
) with mixed crystals without calcium
oxalate monohydrate, we should have 68% to 88 % success rate. However, the obtained result
was 79%. Similarly, for crystalluria with
COD
+ calcium oxalate monohydrate ± carbapatite,
the prediction was 11% to 45% and the result was approximately 39%. When the majority
of crystalluria was calcium phosphate, the prediction of 50% to 80% was confirmed by 71%
success rate. For those majority containing magnesium ammonium phosphate hexahydrate
(struvite) ± diammonium urate ±
COD
, we predicted between 80% to 100%, and the result
gave a success rate of 84%.
Conclusions:
The analysis of crystalluria of morning urine can help to know the composition
of calculi
in situ
and can predict the success rate of
ESWL
for maximum efficiency.
