Dissolution of cystine stones by irrigated tiopronin solution.

A new method involving the introduction of tiopronin solution directly into the renal pelvis or bladder has been developed for the treatment of cystine stones. Therapeutic irrigation by tiopronin solution was done in 4 cases of residual cystine kidney stones using a nephrostomy tube, and in an infant with bladder cystine stones using a Foley 3-way catheter. In every case all of the cystine stones were dissolved completely. During the course of the treatment no abnormality was noted on blood, liver function or immunological tests. Neither have there been any negative side effects, such as eruption, anorexia, nausea, diarrhea or general fatigue. The significance of this irrigation process is that whereas nephrectomy, heminephrectomy or nephrolithotomy was necessary previously to remove kidney cystine stones, now only pyelolithotomy and nephrostomy tube insertion are necessary. Furthermore, an operation is unnecessary in cases of bladder cystine stone dissolution by tiopronin irrigation.