The Litholyse - the dissolution of stones by administration of drugs - may be performed only when uric acid stones and cystine stones little. The principle is to change the pH of the urine so as to dissolve the stones again and can be washed away with the urine. This can be done with the help of medication or be occupied by a locally applied irrigation.
The success rate is 70 percent
In oral Litholyse to uric acid stone removal are recommended for neutralizing urine at a pH from 6.2 to 6.8 the following measures:
Potassium citrate to enhance the solubility of uric acid.
Increase in urinary excretion of 2 liters per day, and
Allopurinol to reduce uric acid concentration in urine.
In 70 percent of cases, this therapy is successful in uric acid stones.
Cystine stones dissolve poorly
With much less chance of success may be tempted to dissolve cystine stones little about oral Litholyse.
Potassium citrate to improve the solubility of cystine
Increase in urinary excretion of 3 liters per day, and
Alpha-mercaptopropionylglycine to reduce cystine concentration in urine.
The local Litholyse is applied only under special conditions
A local Litholyse, rinsed, with the help of a catheter directly into the kidney or the ureter is only useful if the stones are a few millimeters in size and if there is direct contact between the stone and rinse solution can be made. Uric acid stones are treated in this way only when oral Litholyse has no success. In this case, is flushed with a locally-bicarbonate or tromethamine-E solution. This solution should have a pH of 8, to improve the solubility of uric acid. For cystine stones is the lavage solution (pH = 8) of N-acetyl-cysteine in sodium bicarbonate. The Improves cystine solubility and reduces the free cystine. Infection stones are flushed with Suby G solution or Renacidin solution. The solutions have a pH of 4 which improves Phosphate solubility.
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