多发性尿酸膀胱结石：临床表现与内镜治疗

Multiple Uric Acid Bladder Stones: Clinical Presentation and Endoscopic Management.

作者信息

Torricelli Fabio Cesar Miranda, Chueh Shih-Chieh Jeff, Shen Shujane, Monga Manoj

机构信息

University of Sao Paulo Medical School , Sao Paulo, Brazil .

Cleveland Clinic Glickman Urological and Kidney Institute , Cleveland, Ohio.

出版信息

J Endourol Case Rep. 2017 Feb 1;3(1):21-23. doi: 10.1089/cren.2016.0134. eCollection 2017.

DOI:10.1089/cren.2016.0134

PMID:28265592

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5314972/

Abstract

Bladder urinary calculi occur in 3%-8% of men with bladder outlet obstruction, and although most of them are composed of calcium, in a few cases uric acid bladder stones are diagnosed. We present clinical images and therapeutic management of a 65-year-old diabetic man with significant prostate enlargement and >30 bladder stones, the largest being 17 mm. Despite the large stone burden, the patient was managed by cystolithotripsy. Remarkably, stone composition analysis revealed 100% uric acid stone. Intraoperative and postoperative course were uneventfully. Uric acid bladder stone pathogenesis seems to be multifactorial with local and systemic factors contributing in different manners and even large stone burdens may be cystoscopically managed.

摘要

膀胱尿路结石在膀胱出口梗阻的男性中发生率为3% - 8%，尽管大多数结石由钙组成，但少数情况下会诊断出尿酸膀胱结石。我们展示了一名65岁糖尿病男性的临床影像及治疗情况，该患者前列腺显著增大且有30余颗膀胱结石，最大的结石为17毫米。尽管结石负荷量大，但患者通过膀胱碎石术进行治疗。值得注意的是，结石成分分析显示为100%尿酸结石。术中及术后过程顺利。尿酸膀胱结石的发病机制似乎是多因素的，局部和全身因素以不同方式起作用，即使结石负荷量大，也可通过膀胱镜进行处理。