[Urinary stones and urinary tract abnormalities. Is the stone composition independent of the anatomical abnormality?].

INTRODUCTION

More than ten per cent of stones are associated with a urinary tract abnormality. To verify whether the malformation influences stone composition, we studied the composition of stones observed in fifteen urological abnormalities.

MATERIAL AND METHOD: This study is based on 1,461 stones associated with a clearly defined malformation analysed by infrared spectroscopy plus 402 bladder stones in men with benign prostatic hyperplasia.

RESULTS

In this series of 1,863 abnormalities, 732 (39.3%) involved the kidney, 561 (30.1%) involved the ureter and 570 (30.6%) involved the lower tract. Whewellite stones were predominant in all renal abnormalities with the exception of cysts, which were mainly associated with uric acid. The main differences concerned the second constituent: weddellite in horseshoe kidneys, carbapatite in Cacchi-Ricci disease and caliceal abnormalities. Struvite was uncommon (<10%). Whewellite was the main component in ureteric abnormalities except for megaureter and reflux in which carbapatite was predominant. Struvite was present in 10% to 30% of stones. Vesicourethral abnormalities were accompanied by calcium and magnesium phosphate stones (90% of cases), and struvite was present in 58% to 90% of cases. The exception to this general rule was bladder stones associated with benign prostatic hyperplasia, in which the main component was uric acid.

CONCLUSION

Significant differences in stone composition were observed as a function of anatomical abnormalities reflecting the fact that some abnormalities add infectious or metabolic risk factors to anatomical factors.