Struvite Stones - Symptoms, Causes, Diagnosis, and Treatment

Introduction:

Struvite was discovered in 1845 by the German chemist Georg Ludwig Ulex. Struvite (magnesium ammonium phosphate) is a phosphate mineral composed of magnesium ammonium phosphate. It is very easy for struvite urinary stones and crystals to form in the urine of animals and humans who have been infected with ammonia-producing microbes. Stones made of struvite have also been referred to as infection stones and triple phosphate stones.

What Are Struvite Stones?

Struvite stones, or infection stones, are kidney stones composed of magnesium ammonium phosphate and are found in the urinary tract. They are frequently found in patients suffering from urinary tract infections and other disorders. They can develop at an alarming speed and have the potential to obstruct the kidney, ureter, or bladder, causing kidney damage over time.

What Are the Symptoms of Struvite Stones?

The presence of struvite kidney stones can cause the following signs and symptoms:

• Infection of the urinary tract.

• Kidney damage: As struvite kidney stones can grow to be extremely large and fill the kidneys, the patient may suffer from kidney damage. The bacterium that causes struvite stones can also infect other types of calcium kidney stones, resulting in the formation of mixed stones that cause additional damage.

• Sharp, throbbing pain below the ribcage, in the side, and back.

• The sensation of burning or pain during urinating.

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• Pain that radiates to the groin and lower abdomen.

• Urine that is red, pink, or brown in color.

• Frequent urination.

• Urinating in small amounts at a time or in larger amounts than normal.

• Chills and fever.

• The severity of the pain caused due to a struvite stone may fluctuate as the stone passes through the urinary tract.

What Causes Struvite Stones?

Urine pH is raised to neutral or alkaline levels due to bacterial infection, which hydrolyzes urea to ammonium and raises the pH of urine to neutral or alkaline levels. Proteus, Xanthomonas, Pseudomonas, Klebsiella, Staphylococcus, and Mycoplasma are some microbes that break down urea. Urine becomes alkaline when the patient has UTI (urinary tract infection). Struvite stones are frequently formed in the urinary tracts of women who have urinary tract infections.

How Are Struvite Stones Diagnosed?

The following tests are done to diagnose the cause of the symptoms and to determine whether or not the patient has struvite stones:

• Imaging Studies: Radiology techniques such as X-rays, computerized tomography (CT) scans, MRI (magnetic resonance imaging), and ultrasounds can detect a kidney stone's size and location.

• Urine Collection Tests: These tests are performed 24 hours a day. These can assist in determining if the patient is creating too few stone-preventing ingredients or too many stone-forming minerals in the production. The doctor may instruct to collect two urine samples over the course of two consecutive days.

• Stone Examination: An examination of the stones that have passed is done. This test includes passing urine through a filter to detect if any stones are present. Following that, laboratory tests will be performed to determine the composition of kidney stones.

• Blood Tests: A high quantity of waste products, such as uric acid, which can result in kidney stones, can be detected using these tests.

• Intravenous Urography: Intravenous urography is a procedure in which a catheter is inserted into a vein. This examines the kidneys, ureters, and bladder using X-rays and a specific dye to detect any issues with them.

How Are Struvite Stones Treated?

As struvite stones can harm the kidneys and create life-threatening infections if they grow large enough, it is essential to treat them as soon as possible. Shock wave lithotripsy (SWL) or percutaneous nephrolithotomy (PNL) are two treatments used to remove these stones (PNL).

• Shock Wave Lithotripsy (SWL): Intense shock waves from a device outside the body are used to break up the stones into small fragments, which can then be removed. Urine will eventually contain the bits of the stone that will be passed through the urinary tract. If the stones are large or many, one may require treatment more than once.

• Percutaneous Nephrolithotomy (PNL): PNL is the therapy of choice for those with large stones that SWL cannot break up. A small incision is made in the back, and a scope and other small instruments are inserted. Then, the stone is extracted through the cut in the skin. The patient will be in sedation during the procedure. After the procedure, he may need to stay a few days in the hospital for recovery.

• Open Surgery: Although it was once the gold standard, open surgery for the removal of struvite stones is no longer used as frequently as it was. Currently, this procedure is only used if no alternative method is possible because of the anatomy of the intrarenal space or if the goal is to remove the kidney entirely.

After struvite stone surgery, patients should have follow-up imaging and periodic urine cultures every six to 12 months. However, this can be done more frequently every three to six months in patients with rapid or frequent stone recurrences.

How to Prevent the Recurrence of Struvite Stones?

Struvite stones can be prevented from recurring with the use of drugs prescribed by doctors. Dietary modifications can help only to a certain extent but cannot have a great impact.

Drugs Commonly Prescribed:

• Acetohydroxamic acid.

• Pyrophosphate.

• Trisodium citrate.

• Disodium EDTA.

Diet: As struvite stones are caused by infections, diet may not be able to prevent them. However, there are some fluids that can make the urinary tract less conducive to stone formation. These are only a few examples

• Lemonade
• Orange juice.
• Citrus-infused water.
• Tea and coffee.

Fluid Intake: In addition, try to drink a lot of water. Diluted (watery) urine has a lower crystal formation risk. Two quarts of urination each day is the standard recommendation from certain doctors. Consult the physician to determine an appropriate fluid intake.

Conclusion:

If the patient is experiencing back and side pain, fever, and frequent urine, he may have a kidney stone. Urinary tract pain, nausea, vomiting, and blood in the urine are signs of a kidney stone. Consult the physician right away if there are any of these symptoms. For any further assistance and support, please do reach out to icliniq.

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