Heimbach D, Jacobs D, Müller S C, Hesse A
Department of Urology, University of Bonn, Germany.
Urology. 2000 Jan;55(1):17-21. doi: 10.1016/s0090-4295(99)00386-6.
To perform an in vitro study analyzing the possibilities in therapeutic strategies for an effective treatment of cystine stones.
Artificial stones made of cystine [Bon(n)-Stones] with a ball-shaped size of 0.9 cm in diameter were used. Chemolysis of artificial cystine stones with different solvents (artificial urine, physiologic sodium chloride solution, acetylcysteine, tris-(hydroxymethylene)-aminomethane [THAM], and combinations of these) was investigated. An experimental arrangement with computer-assisted online measurement of data simulating the physiologic conditions in the upper urinary tract at varying pH values was used.
All solutions showed a statistical improvement in the solubility of cystine stones compared with artificial urine and physiologic sodium chloride solution. The combination of THAM (pH 10) and 2% acetylcysteine was most effective (1 3.91 +/- 1.73 mg/hr) and demonstrated a 41 -fold higher ability to dissolve cystine calculi compared with artificial urine.
Our data indicate that local chemolysis with special solutions is an effective treatment modality in cystine stone therapy.
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