Physico-biochemical parameters of urine and blood and biominerology of urinary bladder stones in patients with bladder outlet obstruction
Tairhon H. NazarovVladimir A. NikolaevI. V. RychkovК. Е. ТрубниковаAlina R. IzatulinaU. V. AbulboqievDilmurod N. Madumarov
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Abstract:
BACKGROUND: Bladder outlet obstruction is one of the main factors leading to the formation of stones in the urinary bladder. Understanding of the physico-biochemical processes in urine and blood, as well as the biomineralogy of urinary bladder stones, will make it possible to determine the pathogenetically justified treatment of such patients.
AIM: The aim of the study was to identify and study the relationship between the physico-biochemical parameters of urine and blood and the biomineralogical composition of urinary bladder stones in patients with bladder outlet obstruction.
MATERIALS AND METHODS: A comprehensive examination of 76 patients at the age of 37 to 89 years with urinary bladder stones occurred against the background of bladder outlet obstruction was carried out. A comprehensive diagnosis, including an assessment of the physico-biochemical parameters of urine and blood, bacteriological urine tests, radiological diagnostics, as well as biomineralogical studies of concretions, was carried out.
RESULTS: The data obtained show that not all physicochemical parameters of blood and urine of the subjects are comparable with the data of patients with nephrolithiasis. In the vast majority of the studied kidney calculi were not detected, in addition, blood biochemical parameters, including the level of stone-forming substances were within the reference values. In urine tests an increase in some lithogenic substances is detected. Urinary stones in patients with bladder outlet obstruction had a mixed composition, more often phosphates and uric acid salts were detected (75 and 54% of cases, respectively). Considering the nature of metabolism and the increase in uric acid excretion with age, as well as the presence of residual urine in case of bladder outlet obstruction, it can be assumed that uric acid is the primary matrix in cystolithiasis. The data obtained indicate a connection between the infectious process in the bladder and the composition of urinary stones. Against this background, there is a more intensive process of cystolithogenesis.
CONCLUSIONS: The algorithm for the diagnosis of urinary bladder stones secondary to bladder outlet obstruction should include not only the collection of anamnesis and the performance of routine blood and urine tests, but also specific physical and biochemical studies, as well as assess the biomineralogy of urinary stones, which will make it possible to choose an adequate tactics for the pathogenetic treatment of patients and effective metaphylaxis of stone formation.Keywords:
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You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy II1 Apr 2018MP31-20 BLADDER STONE RECURRENCE IN PATIENTS THAT DO NOT UNDERGO OUTLET PROCEDURES Julio Chong, Stephanie Purnell, William Atallah, Julie Thai, Blair Gallante, and Mantu Gupta Julio ChongJulio Chong More articles by this author , Stephanie PurnellStephanie Purnell More articles by this author , William AtallahWilliam Atallah More articles by this author , Julie ThaiJulie Thai More articles by this author , Blair GallanteBlair Gallante More articles by this author , and Mantu GuptaMantu Gupta More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1049AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Bladder stones have been linked to stasis of urine from bladder outlet obstruction (BOO) due to benign prostatic enlargement (BPE). Many of these patients have been found to make kidney stones and have metabolic disturbances on 24-hour urine analysis. Moreover, many bladder stone patients refuse an outlet procedure. We evaluated bladder stone recurrence rates in patients refusing an outlet procedure comparing results between those compliant versus noncompliant with their BPE and stone prevention medical regimens. METHODS A database of patients undergoing bladder stone procedures without an outlet procedure (n=66) from 2012-2017 at a tertiary referral center was retrospectively analyzed to assess for differences in clinical features between individuals who did or did not form recurrent bladder stones (n= 19 vs 47, respectively) with particular attention to compliance with BPE and kidney stone medical regimens. RESULTS Mean prostate size, presence of intraprostatic protrusion, post void residual, flow rate, stone burden and follow-up were similar between groups. In the non-recurrent group, 72 % (34/47) were compliant with BPE medications and 71% (5/7) were compliant with stone prevention regimens compared to 63% (12/19) and 39% (5/13) in the recurrent group (p=0.038 and <0.0001). Recurrent bladder stone formers were more likely to be prescribed two or more medications (p = 0.008). Moreover, recurrent stone formers were found to have lower urine volume (1.5 vs 1.99, p = 0.048) and urine pH (5.64 vs 6.04, p = 0.050) (Table 1). CONCLUSIONS The etiology of bladder stone formation is multifactorial with BOO and metabolic disturbances as major contributors. In patients who do not undergo an outlet procedure, both factors must be addressed and treated accordingly. Prostate size and voiding dynamics do not predict for recurrence; compliance with medical regimens does predict for recurrence. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e419 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Julio Chong More articles by this author Stephanie Purnell More articles by this author William Atallah More articles by this author Julie Thai More articles by this author Blair Gallante More articles by this author Mantu Gupta More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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Gallstones and kidney stones are two types of stone diseases that are very afflictive and often fatal. Biological studies in this field have primarily aimed to discover what causes gallstones formation in the urinary tract and gallbladder. Many ideas have been put forward to explain how stones form and how they grow, but the entire pathogenesis cycle is still being debated. A combination makes stones of different things, but much attention is paid to finding what elements and molecules are in them. In this review article, we talk about spectroscopic techniques and show how they can be used to study the diseases of stones. To better understand the subject, we also went over the basics of how stones form inside the body and how complicated they can be.
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Studies show that the incidence of kidney stones are common and urinary tract stones occur after urinary tract infections and prostate disorders, are the third most common disease of the urinary tract.Developing kidney stones cause severe pain and colic in patients which conventional drugs in most cases will not disappear the pain. The consumption traditional medicinal plants include the most basic methods of dealing with the disease. In Iran, since ancient times, medicinal plants have been used to treat the urinary stones. The aim of this study is identifying medical plants in different parts of Iran in traditional medicine for the treatment of stones. After collecting medicinal plants used in different parts of Iran ,68 medicinal plants was determined in Iran which published on the resources of traditional medicine for the treatment of kidney stones are used. Ethnobotanical studies led to the creation of new original ideas, which in laboratory studies and pharmacological treatment effects can be checked and evaluated and if so they be effective on urinary stone can produced natural remedies against urolithiasis.
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Stones (calculi) in the urinary tract (urolithiasis) or kidney (nephrolithiasis) occur in 5% of the population. The lifetime risk of passing a stone is 8-10%. Men are twice as likely to develop stones, with the first episode occurring before 30 years of age. Stones are caused by the aggregation of crystalline mineral deposits in the urine. Calcium stones are the most common type of stone. Investigations for stone disease include plain X-ray, X-ray with contrast media, ultrasound imaging, and computed tomographic (CT) scanning. Treatment of stones is dependent on the size and location, e.g. lithotripsy is used to break down stones in the ureter or kidney, whereas litholapaxy is used for stones in the bladder that are too large to be passed urethrally. Alpha-blocker medication (e.g. tamsulosin) can facilitate spontaneous passing of a stone. Nurses have a crucial role in assessment, management and provision of discharge advice for patients. Strategies for preventing stones include increasing the urine output (by giving 2-3 litres of fluid per day) and dietary modification, particularly reduction in animal protein and salt content.
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INTRODUCTION Bladder stones have historically been associated with urinary stasis secondary to bladder outlet obstruction (BOO). Recent studies indicate that the role of BOO in bladder stone formation is minor. We evaluate the role of urinary lithogenic factors in bladder stone formation by comparing the compositions of bladder stones and kidney stones in patients with multi-site urinary calculi. MATERIALS AND METHODS We identified patients who were treated for concomitant bladder stones and kidney stones between 2008-2019, and had both stone compositions available. Patients with bladder stone size < 10 mm, urinary foreign bodies, encrusted stents or tumors were excluded. Data regarding urinary symptoms, residual volumes, stone composition and 24-hours urine data were collected. RESULTS We identified 40 males with a median age of 72 years (IQR 6-14), median residual volume of 76 mL (IQR 41-200), and a median prostate volume of 52 mL (IQR 32-102). Bladder outlet procedures were performed concomitantly with cystolitholapaxy in 21 (53%) patients. The most common bladder stone and kidney stone compositions were CaOx (47.5% and 65%), uric acid (32.5% and 22.5%), calcium phosphate (15% and 10%), and struvite (5% and 2.5%), respectively. Bladder stone and kidney stone compositions were identical in 70% of patients. Bladder stone composition was predictive of kidney stone composition, regardless of the PVR, bladder stone size, or whether an outlet procedure was performed. CONCLUSION We found a high concordance between bladder stone and kidney stone composition, suggesting that metabolic abnormalities have a significant role in bladder stone formation. Bladder stone composition can be used to guide surgical and medical treatment for kidney stones in metabolically active stone patients.
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A stone, also known as a renal calculus (from the Latin ren, kidney and calculus, pebble) is a solid concretion or crystal aggregation formed in the kidneys from dietary minerals in the urine. Stone formation in the is one of the oldest and most wide spread diseases known to man. Urinary stone disease has afflicted humankind since antiquity and can persist, with serious medical consequences, throughout a patient's lifetime. In addition, the incidence of stones has been increased in western societies in the last five decades, in association with economic development. Most calculi in the urinary system arise from a common component of urine, e.g. calcium oxalate (CaOx), representing up to 80% of analyzed stones. The problem of urinary stones or calculi is a very ancient one and many remedies have been employed during the ages these stones are found in all parts of the urinary tract, the kidney, the ureters and the urinary bladder and may vary considerably in size. The present day medical management of lithiasis includes lithotripsy and surgical procedures. Unfortunately, these techniques do not correct the underlying risk factors. Also, the overuse of synthetic drugs, which results in higher incidence of adverse drug reactions, has motivated humans to return to nature for safe remedies. Many plants conveniently available in India are used in traditional folklore medicine for the treatment of lithiasis (kidney stone).Herbs and herbal drugs have created interest among the people by its clinically proven effects like immunomodulation, adaptogenic and antimutagenic. In the present article, an attempt has been made to emphasis on herbal option for urinary stone.
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