Identifying Struvite Kidney Stones
Doctors classify kidney stones based on what substance they are composed of. Struvite kidney stones, as it name suggests, are composed of the substance struvite, which is another term for magnesium ammonium phosphate, plus calcium carbonate apatite.
The main cause of struvite kidney stones are urinary tract infections, hence, they are commonly known as infection kidney stones. A main element of struvite is ammonia, the level of which in the urine can increase with there is an infection in the urinary tract. The bacteria that cause increased ammonia in urine are the same bacteria that commonly cause urinary tract infections. A high pH level in the urine also contributes to the growth of struvite kidney stones. Even though there are numerous antibiotics available to treat urinary tract infections, about twenty percent of kidney stone patients are classified to have struvite stones.
Struvite kidney stones can develop quickly over several weeks to become what is known as staghorn stones, which can affect a large portion of or the entire kidney. Staghorn stones also lead to much worse and persistent infections or even acute failure of the kidney.
That is why recognizing the symptoms of struvite kidney stones and getting prompt and proper diagnosis is very important to avoid complications. Unfortunately, struvite kidney stones have few direct symptoms including blood in urine and/or mild side pains. Usually, a patient learns of the disorder incidentally, for instance, during a checkup for a recurring urinary tract infection. An x-ray exam, CT scan and a urine test are required to diagnose struvite kidney stones.
One treatment for struvite kidney stones is a non-surgical procedure called shock wave lithotripsy or ESWL, which is performed if the stone/stones are small enough and located in the upper part of the ureter. If the struvite kidney stones have developed into staghorn stones or if shock wave lithotripsy failed, the doctor may perform percutaneous nephrolithotomy. This may be followed by shock wave lithotripsy to remove remaining stone fragments. Doctors will only resort to an open surgical procedure if the struvite kidney stones are larger than usual, if there is chronic infection and shrinking of the kidneys, or if the patient is severely obese.
After the treatment procedure, it is important that the patient's condition is monitored closely through regular follow-up assessments to check for any complication or re-growth of stones.
If all the fragments of the struvite kidney stones are removed entirely, the patient has a ninety percent chance of being free from kidney stones and infections for a period of three years. However, if some fragments remain and these are half a centimeter or larger in size, the patient is highly likely to develop kidney stones again within the following 3 months after the removal procedure. If this is the case, there may be a need for the patient to undergo another treatment procedure.
To prevent the re-occurrence of struvite kidney stones, complete removal of existing stones is necessary as well as aggressive treatment of the patient's urinary tract infections.
