Beltrami Paolo, Ruggera Lorenzo, Guttilla Andrea, Iannetti Alessandro, Zattoni Fabio, Gigli Francesca, Bernich Patrizia, Zattoni Filiberto
Urology Clinic, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy.
Urol Int. 2014;93(4):394-8. doi: 10.1159/000357624. Epub 2014 Jun 20.
To report our experience with the endourological treatment of renal matrix stones, an infrequent form of urinary calculi whose diagnosis and treatment are often difficult.
From 1990 to 2010 we treated 9 female patients with matrix calculi using the endourological approach; 4 presented with renal colics, 3 with symptomatic urinary tract infection and 2 with asymptomatic bacteriuria. Six patients underwent percutaneous lithotripsy and 3 retrograde intrarenal surgery as first-line therapy. Three cases needed a multidisciplinary approach.
The six percutaneous procedures were successful after a single session, while the retrograde approach required multiple treatments; a single case needed a shock wave session to complete the fragmentation, in another one a percutaneous lithotripsy was necessary after the first procedure, and a third case needed multidisciplinary treatment.
Percutaneous lithotripsy has been confirmed as the first option for matrix stones. The retrograde approach - by confirming the suspected diagnosis and being minimally invasive - may be employed to treat either lower-size stones or stones at high risk of recurrence.
报告我们采用腔内泌尿外科治疗肾基质结石的经验，肾基质结石是一种罕见的尿石症形式，其诊断和治疗通常具有挑战性。
1990年至2010年，我们采用腔内泌尿外科方法治疗了9例女性基质结石患者；4例表现为肾绞痛，3例有症状性尿路感染，2例有无症状菌尿。6例患者接受经皮碎石术，3例接受逆行肾内手术作为一线治疗。3例患者需要多学科方法治疗。
6例经皮手术单次治疗成功，而逆行方法需要多次治疗；1例患者需要冲击波治疗以完成结石破碎，另1例患者在首次手术后需要经皮碎石术，第3例患者需要多学科治疗。
经皮碎石术已被确认为基质结石的首选治疗方法。逆行方法——通过证实疑似诊断且微创——可用于治疗较小尺寸的结石或复发风险高的结石。
