URINARY STONE DISEASE
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1 URINARY STONE DISEASE
2 CURRENT CLINICAL UROLOGY Eric A. Klein, MD, SERIES EDITOR Female Urology: A Practical Clinical Guide, edited by Howard Goldman and Sandip P. Vasavada, 2007 Urinary Stone Disease: The Practical Guide to Medical and Surgical Management, edited by Marshall L. Stoller and Maxwell V. Meng, 2007 Peyronie s Disease: A Guide to Clinical Management, edited by Laurence A. Levine, 2006 Male Sexual Function: A Guide to Clinical Management, Second Edition, edited by John J. Mulcahy, 2006 Advanced Endourology: The Complete Clinical Guide, edited by Stephen Y. Nakada and Margaret S. Pearle, 2005 Oral Pharmacotherapy of Male Sexual Dysfunction: A Guide to Clinical Management, edited by Gregory A. Broderick, 2005 Urological Emergencies: A Practical Guide, edited by Hunter Wessells and Jack W. McAninch, 2005 Management of Prostate Cancer, Second Edition, edited by Eric A. Klein, 2004 Essential Urology: A Guide to Clinical Practice, edited by Jeannette M. Potts, 2004 Management of Benign Prostatic Hypertrophy, edited by Kevin T. McVary, 2004 Pediatric Urology, edited by John P. Gearhart, 2003 Laparoscopic Urologic Oncology, edited by Jeffrey A. Cadeddu, 2004 Essential Urologic Laparoscopy: The Complete Clinical Guide, edited by Stephen Y. Nakada, 2003 Urologic Prostheses: The Complete Practical Guide to Devices, Their Implantation, and Patient Follow-Up, edited by Culley C. Carson, III, 2002 Male Sexual Function: A Guide to Clinical Management, edited by John J. Mulcahy, 2001 Prostate Cancer Screening, edited by Ian M. Thompson, Martin I. Resnick, and Eric A. Klein, 2001 Bladder Cancer: Current Diagnosis and Treatment, edited by Michael J. Droller, 2001 Office Urology: The Clinician s Guide, edited by Elroy D. Kursh and James C. Ulchaker, 2001 Voiding Dysfunction: Diagnosis and Treatment, edited by Rodney A. Appell, 2000 Management of Prostate Cancer, edited by Eric A. Klein, 2000
3 URINARY STONE DISEASE THE PRACTICAL GUIDE TO MEDICAL AND SURGICAL MANAGEMENT Edited by MARSHALL L. STOLLER, MD MAXWELL V. MENG, MD Department of Urology University of California, San Francisco, School of Medicine San Francisco, CA
4 2007 Humana Press Inc. 999 Riverview Drive, Suite 208 Totowa, New Jersey humanapress.com For additional copies, pricing for bulk purchases, and/or information about other Humana titles, contact Humana at the above address or at any of the following numbers: Tel.: ; Fax: , or visit our Website: All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher. All articles, comments, opinions, conclusions, or recommendations are those of the author(s), and do not necessarily reflect the views of the publisher. Due diligence has been taken by the publishers, editors, and authors of this book to assure the accuracy of the information published and to describe generally accepted practices. The contributors herein have carefully checked to ensure that the drug selections and dosages set forth in this text are accurate and in accord with the standards accepted at the time of publication. Notwithstanding, as new research, changes in government regulations, and knowledge from clinical experience relating to drug therapy and drug reactions constantly occurs, the reader is advised to check the product information provided by the manufacturer of each drug for any change in dosages or for additional warnings and contraindications. This is of utmost importance when the recommended drug herein is a new or infrequently used drug. It is the responsibility of the treating physician to determine dosages and treatment strategies for individual patients. Further it is the responsibility of the health care provider to ascertain the Food and Drug Administration status of each drug or device used in their clinical practice. The publisher, editors, and authors are not responsible for errors or omissions or for any consequences from the application of the information presented in this book and make no warranty, express or implied, with respect to the contents in this publication. Cover design by Karen Schulz Cover illustrations: Staghorn calculus. This publication is printed on acid-free paper. ANSI Z (American National Standards Institute) Permanence of Paper for Printed Library Materials. Photocopy Authorization Policy: Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Humana Press Inc., provided that the base fee of US $30.00 per copy is paid directly to the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA For those organizations that have been granted a photocopy license from the CCC, a separate system of payment has been arranged and is acceptable to Humana Press Inc. The fee code for users of the Transactional Reporting Service is: [ /07 $30.00]. Printed in the United States of America eisbn Library of Congress Cataloging-in-Publication Data Urinary stone disease : the practical guide to medical and surgical management / edited by Marshall L. Stoller, Maxwell V. Meng. p. ; cm. -- (Current clinical urology) Includes bibliographical references and index. ISBN (alk. paper) 1. Urinary organs--calculi--treatment. [DNLM: 1. Urinary Calculi--etiology. 2. Urinary Calculi--surgery. 3. Urologic Surgical Procedures--methods. WJ 168 U ] I. Stoller, Marshall L. II. Meng, Maxwell V. III. Series. RC916.U '22--dc
5 Preface Urinary stone disease has afflicted mankind for centuries and continues to be a significant medical ailment throughout the world. Contemporary management reflects the changes and evolution that have occurred in both medicine and, specifically, urology. Traditional open surgery has been nearly replaced by minimally invasive techniques, the result of technologic innovations, miniaturization of instruments, and interdisciplinary collaboration. Nevertheless, nephrolithiasis remains a chronic disease and our fundamental understanding of the pathogenesis, and molecular and genetic basis of stones as well as their prevention, remains rudimentary. All large calculi were once small calculi. Where do stones originate and what facilitates their retention, allowing them to grow? Although we rely on 24-hour urinary collections, clearly our current methods of directing medical therapy have limitations. In addition, interest in disease prevention continues to grow and understanding basic questions and the underlying pathophysiology of stone disease will help optimize management strategies. Future advances in urinary stone disease will be the result of collaboration among urologists, nephrologists, radiologists, dieticians, scientists, and partners in industry. Physicians must not be complacent with the current status quo or be overly eager to intervene because techniques are less invasive; rather, the goals should be a better understanding of the underlying disease process in order to identify those at risk, prophylax against stone development and recurrence, and improved nonsurgical therapies. Urinary Stone Disease: The Practical Guide to Medical and Surgical Management puts together our contemporary views on the development, treatment, and prevention of urinary stone disease. We hope that the book helps improve the current care of patients but more importantly highlights areas of potential research and inspires novel approaches that will ease the burden of this disease. Marshall L. Stoller, MD Maxwell V. Meng, MD v
6 Contents Preface... v Contributors... xi About the Editors... xv I. BACKGROUND 1 Stone Nomenclature and History of Instrumentation for Urinary Stone Disease Viraj A. Master, Maxwell V. Meng, and Marshall L. Stoller Epidemiology and Incidence of Stone Disease Joseph E. Dallera and Paramjit S. Chandhoke The Genetics of Stone Disease Berenice Y. Reed and William L. Gitomer Theories of Stone Formation Hsiao-Jen Chung, Harrison M. Abrahams, Maxwell V. Meng, and Marshall L. Stoller Structure and Compositional Analysis of Kidney Stones Ian Mandel and Neil Mandel II. METABOLISM 6 Calcium Physiology G. Bennett Stackhouse and Marshall L. Stoller Management of Patients With Hyperoxaluria Ojas Shah, Ross P. Holmes, and Dean G. Assimos Renal Acid Base Balance and Renal Tubular Acidosis Andrew I. Chin Urinary Stone Inhibitors: Citrate and Magnesium Harrison M. Abrahams, Maxwell V. Meng, and Marshall L. Stoller Modulators of Crystallization of Stone Salts Saeed R. Khan and Dirk J. Kok Hormonal Influences on Nephrolithiasis Colonel Noah S. Schenkman and Major C. Gerry Henderson Associated Systemic Disease: Bowel and Bones Michael E. Moran vii
7 viii Contents 13 Medical Evaluation of Stone Disease Clarita V. Odvina and Charles Y. C. Pak Pharmacologic Prophylaxis of Calcium Stones Yeh Hong Tan and Glenn M. Preminger Diet and Urolithiasis William K. Johnston, III and Roger K. Low Uric Acid Urolithiasis Bodo E. Knudsen, Darren T. Beiko, and John D. Denstedt Struvite Stones D. Brooke Johnson and Margaret S. Pearle Cystine Stone Disease Bijan Shekarriz Urinary Stones of Unusual Etiology Patrick S. Lowry and Stephen Y. Nakada III. PRESENTATION AND EVALUATION 20 Imaging of Urinary Stone Disease Richard S. Breiman and Fergus V. Coakley Physician Safety Ronald M. Yang and Gary C. Bellman Treatment of Acute Renal Colic Albert M. Ong and Thomas W. Jarrett Anatomical Considerations in Urinary Stone Disease Louis Eichel and Ralph V. Clayman IV. TREATMENT 24 Conservative Management of Ureteral Calculi Christopher J. Kane Ureteral Stents John S. Lam and Mantu Gupta Anesthetic Considerations for Extracorporeal Shockwave Lithotripsy, Percutaneous Nephrolithotomy, and Laser Lithotripsy Mark Ancheta and Daniel Swangard Complications of Urinary Stone Surgery Ruben Urena, Freddy Mendez-Torres, and Raju Thomas Extracorporeal Shockwave Lithotripsy: Patient Selection and Outcomes Christopher S. Ng, Gerhard J. Fuchs, and Stevan B. Streem
8 Contents ix 29 Indications and Outcomes of Ureteroscopy for Urinary Stones Matthew T. Gettman and Joseph W. Segura Ureteroscopy: Technical Aspects Assaad El-Hakim, Beng Jit Tan, and Arthur D. Smith Percutaneous Nephrolithotomy: Indications and Outcomes Paul K. Pietrow Percutaneous Nephrolithotomy: Technical Aspects Sangtae Park, Maxwell V. Meng, and Marshall L. Stoller Open Stone Surgery Elizabeth J. Anoia and Martin I. Resnick Laparoscopic Approach to Urinary Stone Disease Anup P. Ramani and Inderbir S. Gill Stones of the Urethra, Prostate, Seminal Vesicle, Bladder, and Encrusted Foreign Bodies Bradley F. Schwartz Index
9 Contributors HARRISON M. ABRAHAMS, MD Endourology Center, Urology Associates of North Texas, Arlington, TX MARK ANCHETA, MD Resident in Anesthesia, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, CA ELIZABETH J. ANOIA, MD Resident in Urology, Department of Urology, Case Western Reserve University, Cleveland, OH DEAN G. ASSIMOS, MD Professor, Department of Urology, Wake Forest University Health Sciences Center, Winston-Salem, NC DARREN T. BEIKO, MD Assistant Professor, Department of Urology, Queen s University, Kingston, Ontario Canada GARY C. BELLMAN, MD Department of Urology, Kaiser Permanente Medical Center, Los Angeles, CA RICHARD S. BREIMAN, MD Associate Clinical Professor, Department of Radiology, University of California, San Francisco, School of Medicine, San Francisco, CA PARAMJIT S. CHANDHOKE, MD, PHD Professor, Division of Urology and Renal Diseases, University of Colorado Health Sciences Center, Denver, CO ANDREW I. CHIN, MD Assistant Professor, Division of Nephrology, Department of Medicine, University of California Davis, Sacramento, CA HSIAO-JEN CHUNG, MD Division of Urology, Taipei-Veterans General Hospital, Taipei, Republic of China RALPH V. CLAYMAN, MD Professor and Chair, Department of Urology, University of California Irvine, Orange, CA FERGUS V. COAKLEY, MD Associate Professor, Department of Radiology, University of California San Francisco, School of Medicine, San Francisco, CA JOSEPH E. DALLERA, MD Division of Urology, University of Colorado Health Sciences Center, Denver, CO JOHN D. DENSTEDT, MD Professor of Urology, Division of Urology, The University of Western Ontario, London, Ontario Canada LOUIS EICHEL, MD Clinical Assistant Professor of Urology, University of Rochester; Director of Minimally Invasive Surgery, The Center for Urology, Rochester General Hospital, Rochester, NY ASSAAD EL-HAKIM, MD Department of Urology, Long Island Jewish Medical Center, New Hyde Park, NY GERHARD J. FUCHS, MD Director, Minimally Invasive Urology Institute, Cedars Sinai Medical Center, Los Angeles, CA MATTHEW T. GETTMAN, MD Department of Urology, Mayo Clinic Rochester, Rochester, MN INDERBIR S. GILL, MD, MCH Director, Minimally Invasive Surgery Center, Glickman Urological Institute, The Cleveland Clinic Foundation, Cleveland, OH WILLIAM L. GITOMER, PHD Renal Division, Department of Medicine, University of Colorado Health Sciences Center, Denver, CO MANTU GUPTA, MD Associate Professor of Urology, Department of Urology, Columbia University College of Physicians and Surgeons; Director, Stone Center, Squier Urological Clinic, New York Presbyterian Hospital, Columbia Presbyterian Medical Center; Director, Endourology and Minimally Invasive Urology, Saint Luke s Roosevelt Hospital Center and New York Presbyterian Hospital, Columbia Presbyterian Medical Center, New York, NY xi
10 xii Contributors MAJOR C. GERRY HENDERSON, MD Department of Urology, Walter Reed Army Medical Center, Washington, DC ROSS P. H OLMES, PHD Associate Professor, Department of Urology, Wake Forest University Health Sciences Center, Winston-Salem, NC THOMAS W. JARRETT, MD Professor and Chairman, Department of Urology, The George Washington University School of Medicine, Washington, DC D. BROOKE JOHNSON, MD Attending Urologist, Department of Urology, Dean West Clinic, Madison, WI WILLIAM K. JOHNSTON, III, MD Assistant Professor, Feinberg School of Medicine, Northwestern University; Director of Laparoscopy and Minimally Invasive Urology, Evanston Northwestern Hospital, Evanston, IL CHRISTOPHER J. KANE, MD Associate Professor and Vice Chair of Urology, Department of Urology, University of California, San Francisco, San Francisco, CA SAEED R. KHAN, PHD UFRF Professor, Department of Pathology, Immunology and Laboratory Medicine, Director, Center for the Study of Lithiasis, University of Florida, Gainesville, FL BODO E. KNUDSEN, MD Assistant Professor, Division of Urologic Surgery, The Ohio State University Medical Center, Columbus, OH DIRK J. KOK, PHD Department of Pediatric Urology, Josephine Nefkens Institute, Erasmus University Rotterdam, Rotterdam, The Netherlands JOHN S. LAM, MD Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY ROGER K. LOW, MD Associate Professor, Department of Urology, University of California Davis, Sacramento, CA PATRICK S. LOWRY, MD Assistant Professor, Head of Endourology, Scott and White Program, Temple, TX IAN MANDEL Department of Medicine, Medical College of Wisconsin, Milwaukee, WI NEIL MANDEL, PHD Professor, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI VIRAJ A. MASTER, MD Assistant Professor, Department of Urology, Emory University, Atlanta, GA FREDDY MENDEZ-TORRES, MD Department of Urology, Tulane University School of Medicine, New Orleans, LA MAXWELL V. MENG, MD Assistant Professor, Department of Urology, University of California San Francisco, San Francisco, CA MICHAEL E. MORAN, MD Clinical Associate Professor, Albany Medical College, Director of St. Peter s Kidney Stone Center, Albany, NY STEPHEN Y. NAKADA, MD Associate Professor and Chairman, Division of Urology, The University of Wisconsin Medical School, Madison, WI CHRISTOPHER S. NG, MD Minimally Invasive Urology Institute, Cedars Sinai Medical Center, Los Angeles, CA CLARITA V. ODVINA, MD Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX ALBERT M. ONG, MD Instructor in Urology, Fellow in Endourology, The Brady Urological Institute, Johns Hopkins Hospital, Baltimore, MD CHARLES Y. C. PAK, MD Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX SANGTAE PARK, MD, MPH Acting Assistant Professor, University of Washington, Department of Urology, Seattle, WA MARGARET S. PEARLE, MD, PHD Professor of Urology and Internal Medicine, Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX
11 Contributors xiii PAUL K. PIETROW, MD Director of Minimally Invasive Urology, Hudson Valley Urology, Poughkeepsie, NY GLENN M. PREMINGER, MD Professor, Division of Urology, Director, Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, NC ANUP P. R AMANI, MD Assistant Professor, Director of Laparoscopy, Department of Urology, University of Minnesota Medical School, Minneapolis, MN BERENICE Y. REED, PHD Renal Division, Department of Medicine, University of Colorado Health Sciences Center, Denver, CO MARTIN I. RESNICK, MD Lester Persky Professor and Chairman, Department of Urology, Case Western Reserve University, Cleveland, OH COLONEL NOAH S. SCHENKMAN, MD Chief, Department of Urology, Director, Endourology and Urology Stone Center, Walter Reed Army Medical Center, Washington, DC BRADLEY F. SCHWARTZ, DO, FACS Director, Center for Urologic Laparoscopy and Endourology, Associate Professor of Urology, Southern Illinois University School of Medicine, Springfield, IL JOSEPH W. SEGURA, MD Department of Urology, Mayo Clinic, Rochester, MN (Deceased) OJAS SHAH, MD Assistant Professor, Director, Endourology and Stone Disease, Department of Urology, New York University Medical Center, New York, NY BIJAN SHEKARRIZ, MD Associate Professor, Director of Laparoscopy and Minimally Invasive Surgery, Department of Urology, Upstate Medical University, State University of New York, Syracuse, NY ARTHUR D. SMITH, MD Chairman, Professor of Urology, Department of Urology, Long Island Jewish Medical Center, New Hyde Park, NY G. BENNETT STACKHOUSE, MD Clinical Instructor, Department of Urology, University of California, San Francisco, San Francisco, CA MARSHALL L. STOLLER, MD Professor, Department of Urology, University of California, San Francisco, San Francisco, CA STEVAN B. STREEM, MD Glickman Urological Institute, The Cleveland Clinic Foundation, Cleveland, OH (Deceased) DANIEL SWANGARD, MD Director, PREPARE, Assistant Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, CA BENG JIT TAN, MD Department of Urology, Long Island Jewish Medical Center, New Hyde Park, NY YEH HONG TAN, MD Consultant, Department of Urology, Singapore General Hospital, Singapore RAJU THOMAS, MD Professor and Chairman, Department of Urology, Tulane University School of Medicine, New Orleans, LA RUBEN URENA, MD Department of Urology, Tulane University School of Medicine, New Orleans, LA RONALD M. YANG, MD Resident in Urology, Department of Urology, Kaiser Permanente Medical Center, Los Angeles, CA
12 About the Editors MARSHALL L. STOLLER Dr. Stoller is currently Professor and Vice-Chairman in the Department of Urology at the University of California San Francisco. He is an expert in the management of urinary stone disease and has made numerous contributions to both the fundamental understanding of urolithiasis as well as advancing the standards of care for patients with the disease. In addition, he has been a pioneer in minimally invasive surgical techniques, neural modulation of voiding dysfunction, and holds multiple patents with medical as well as nonmedical applications. Dr. Stoller received his undergraduate degree from the University of California at Berkeley and medical degree from the Baylor College of Medicine. His surgical and urologic training was obtained at the University of California San Francisco and with a fellowship at the University of New South Wales in Sydney, Australia. MAXWELL V. MENG Dr. Meng is currently Assistant Professor of Urology at the University of California San Francisco. He received his training in urologic surgery, laparoscopy and endourology, and urologic oncology at UCSF. Prior to this, he studied biochemical sciences at Harvard College and received his medical degree from the Johns Hopkins School of Medicine. His primary areas of interest are minimally invasive surgery, urologic cancers, and the combination of the two disciplines. In addition, he is investigating prostate cancer biomarkers and the utility of decision analysis for a variety urologic questions. Dr. Meng has received numerous teaching awards and is actively involved with the American Urological Association and American College of Surgeons. xv
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