Dissolution of Phosphate Stones by Percutaneous Nephrostomy and Local Irrigation

A high urine pH plays a critical role in the origin and growth of phosphate-containing calculi. Conversely, phosphate stones may be dissolved in more acid solutions. In 1943, Suby and Albright1 reported the dissolution of phosphatic calculi in situ by the retrograde introduction of a citrate solution containing magnesium (Suby’s solution or Solution G). Chemolysis of renal calculi by local irrigation has been used as postoperative adjuvant treatment but may also be considered as an alternative to the surgical removal of the stones, especially in patients who are poor surgical risks or when surgical removal is no longer possible2.