Hinman F
J Urol. 1979 Jun;121(6):700-5. doi: 10.1016/s0022-5347(17)56962-1.
The forces involved in shaping urinary calculi reside in crystalline characteristics and especially in local influences. Box pleves may restrict passage and, by allowing mobility, help shape a round calculus. Fixation, occurring with a rapidly growing infection stone, facilitates initial growth on a matrix mold in a funnel pelvis, further aided by pelviocaliceal paralysis from bacterial endotoxins and later by stasis. Branched calculi are further shaped by contact with the pelvic and infundibular walls. Through pressure and mucous coating they grow only at the ends. Late caliceal obstruction frees the ends for clubbing. Consideration of these forces aids in prognosis and surgical removal, and may offer opportunities for prevention.
形成尿路结石的相关作用力存在于晶体特性中，尤其是局部影响因素。肾盂内陷可能会限制结石通过，并通过允许其移动来帮助形成圆形结石。快速生长的感染性结石发生固定，有利于在肾盂漏斗部的基质模具上开始生长，细菌内毒素导致的肾盂肾盏麻痹以及随后的尿液淤积会进一步促进其生长。分支状结石通过与肾盂和漏斗壁接触而进一步塑形。通过压力和黏液覆盖，它们仅在末端生长。晚期肾盏梗阻使末端得以游离而形成杵状。考虑这些作用力有助于预后评估和手术切除，并且可能提供预防的机会。
