Influence of alkaline solutions on chemolitholysis and lithotripsy of uricacid stones - An in vitro study

Objectives: Th is study was performed to look for an improvement of therape utic strategies with regard to the treatment of uric acid stones using arti ficial stones made of uric acid (BON(N)-STONES) which are comparable to the ir natural counterparts. Materials and Methods: Using an experimental arrangement simulating the phy siological conditions in the upper urinary tract the efficacy of different alkaline solutions and artificial urine in dissolving artificial uric acid stones (BON(N)-STONES) was investigated. The dissolution of natural uric ac id stones was measured and investigations on shock wave lithotripsy (SWL) c ombined with initial chemolytic treatment of the stones were performed. Results: The efficacy of alkaline solutions, especially THAM at a pH of 10, in dissolving artificial uric acid stones was demonstrated. The investigat ions on SWL showed a significant improvement on stone comminution of artifi cial uric acid stones after initial chemolytic treatment with THAM, Conclusions: New basics to improve dissolution of uric acid stones have bee n developed by performing standardized in vitro investigations. The suggest ion was confirmed that stone fragility and thus SWL can be improved by vary ing the physical properties of uric acid stones th rough initial treatment with THAM solution. Copyright (C) 2000 S. Karger AG, Basel.