Crystalluria: A Means To Avoid A High-Risk Extra Corporeal Lithotripsy

A. Driouch¹, Z. Kaid-Omar¹, D. H. Taleb-bendiab² , M. Daudon³, A. Semmoud⁴ ,  A. Addou⁴

¹Laboratoire STEVA, Facult? des Sciences, University of Mostaganem (Algeria). ²Service d’Urologie, Centre Hospitalier Universitaire, Oran, (Alg?rie). ³Laboratoire de Biochimie A, H?pital Necker, Paris, (France). ⁴Laboratoire de Spectroscopie Infrarouge et Raman, Universit? des Sciences et Technologies, Villeneuve d’Ascq, (France).

ABSTRACT: For about ten years, several research teams have been seeking means to predict the impact resistance of the in situ stones basing their argument on the radiological aspect, composition of previously collected stones from patients as well as biological anomalies characterised in urine. In the present study, the workers compared the nature of the urinary crystals of the first morning urine after storing at +4°C, to the composition of the stones surgically removed or spontaneously evacuated or after treatment by E.C. L. The results have shown that the frequency of crystalluria was very high (92.6%). The crystalline species that was the most frequent was weddellite (46.7%) followed by amorphous complex urates (20.3%), calcic phosphates (12.5%), dihydrated uric acid (7.1%) and struvite (6.8%). The comparison between crystalluria and stone composition has shown that the dominant or pure weddellite crystalluria was associated with stones where weddellite was the major or pure constituent in 49% of the cases. Crystalluria cases where whewellite was found whether pure or major, were associated with stones where whewellite was the major constituent in 83.6% of the cases. On the other hand, crystalluria of complex amorphous urates was rarely associated with uric acid stones (5.7%) and that of dihydrated uric acid was in 38.1% of the cases. Struvite crystalluria was observed in the urine of patients that presented an infection lithiasis mainly composed of struvite in 62.9% of the cases.

KEYWORDS: Crystalluria; Urinary stones; Whewellite; Weddellite; extra-corporeal lithotripsy

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