Percutaneous chemolysis of renal calculi.

Certain types of pyeloureteral calculi can be treated by chemolytic drug irrigation through a percutaneous nephrostomy catheter. Struvite, apatite, and carbonate stones can be dissolved with an acidic solution (hemiacidrin, Suby solution G). An alkaline agent (Tham-E, acetylcysteine) will dissolve cystine calculi. While most uric acid stones are managed by oral alkalinization with sodium bicarbonate or potassium citrate, there are occasions (cardiac, metabolic conditions) where treatment via percutaneous nephrostomy is preferable. Successful nonoperative management of symptomatic calculi has been obtained in 85% of cases with chemolysis of more than 150 stones.