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Jack D. Francis, M.D., F.A.C.S.
Many stone patients will only experience stones once in their lives, so most urologists will check only the stone analysis, and blood levels of calcium and uric acid. All stone patients should maintain a permanent high urine output by drinking lots of water a daily, which reduces the ability of crystals and stones to form. One way to judge hydration is by examining the color and odor of the urine. With good hydration the urine should be a pale yellow, or white with little odor. If the uric acid is high, or the stone contains uric acid, then Allopurinol, a drug that prevents the formation of uric acid in the body will be started, frequently with an attempt to make the urine slightly alkaline to keep uric acid crystals from forming. Similarly if a cysteine stone is present, Cystinuria may be treated with D-penicillamine or tiopronin, but these medications have significant side effects. If a patient has a second stone, a stone work up is indicated. This consists of several blood tests and a 24 hour urine collection for several chemical components. For the most common calcium oxalate stones, treatment is centered around correcting any demonstrated abnormalities such as excess calcium or oxalate excretion in the urine. High urinary calcium can frequently be reduced by using a thiazide diuretic. Sometimes it is appropriate to decrease high intake of calcium in the diet, (dairy products especially), but other times it may be inappropriate. Other treatments may include citrate, which is a known inhibitor of stone formation. Lemonade is high in citrate and there are also pharmaceutical preparations available. If the patient is a hyperabsorber of calcium from the intestines, treatment with sodium cellulose phosphate may correct this. There are other treatments for this too. For high excreters of oxalate, reduction in leafy, dark green vegetables, colas, beer and tea my be helpful. After infection stones have been successfully removed, prevention of infection is critical to prevention of recurrence of stones. Your doctor may want you to take long term antibiotics to achieve this goal. Stone disease continues to be a major problem for patients, but newer techniques have certainly lessened its severity. Hopefully, in the future newer preventive treatments will be discovered. |
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[Home] Werner - Francis Urology Associates llc - Mid Atlantic Urology Associates llc Greenbelt - Bowie - Laurel Maryland (301) 441-8900 Fax (301) 982 0453 7500 Hanover Parkway Suite 206 Greenbelt, MD 20770
Rev:03/08 |