Struvite is the crystal name for stones that form only in the presence of urease-producing bacteria (eg, Proteus mirabilis, Klebsiella pneumoniae, Corynebacterium species, Ureaplasma urealyticum) in the upper urinary tract.
Other names for this crystal type include "triple phosphate" and magnesium ammonium phosphate carbonate apatite. Struvite is found in approximately 1 percent of stones and is much more common in females than in males (due to the higher risk of urinary tract infections in females).
Struvite stones:
Struvite (magnesium ammonium phosphate) stones are often referred to as "infection stones" since they are strongly associated with urinary tract infections (UTIs) with urea-splitting organisms. They may grow rapidly over a period of weeks to months and, if not adequately treated, can develop into a staghorn or branched calculus that fills the entire kidney collecting system. If left untreated, this can lead to deterioration of kidney function and end-stage kidney disease. In addition, since the stones often remain infected, there is a risk of developing sepsis. Thus, most patients require definitive surgical treatment.
What does it mean if your Struvite result is too high?
What are the symptoms of struvite stones?
A stone that is small enough can pass through with no symptoms. However, a stone that is too large to pass through may cause significant pain, back-up of urine, and other health problems. Speak with a healthcare professional if you feel any of these symptoms:
- Severe pain on either side of your lower back
- Nausea or vomiting
- Fever and chills
- Frequent need to urinate
- Pain when you urinate
- Blood in the urine
- Urine that smells bad or looks cloudy
UTI symptoms:
Symptoms related to a UTI include a persistent urge to urinate, a burning sensation during urination, or passing frequent and small amounts of urine. Urine that looks red, pink or dark means there is blood in the urine.
How to treat struvite stones?
For many people with kidney stones, drinking more water may be the first recommendation. Medications can also be used either for pain or to help the stone pass. Medications can include thiazide diuretics (water pills) or tamsulosin (to relax the ureter and help the stone pass). Antibiotics are used to stop a bacterial infection causing a UTI.
However, in the case with struvite stones, passage of the stone is rare. In many cases, the stone is too large to pass through, and surgical procedures are needed to break down larger stones or remove them. A ureteroscopy uses a small scope to remove the stone. Shock wave lithotripsy (SWL) uses high-energy acoustic pulses to break up the stone into smaller pieces for passing. Percutaneous nephrolithotomy (PCNL) removes the stone surgically through the back. In the case with struvite stones, surgical management requires complete stone removal, usually with a procedure such as PCNL.
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