Experimental Observations on Dissolution of Uric Acid Calculi

No AccessJournal of Urology1 Sep 1985Experimental Observations on Dissolution of Uric Acid Calculi Marcus V. Sadi, Ned Saltzman, Guillermo Feria, and Ruben F. Gittes Marcus V. SadiMarcus V. Sadi More articles by this author , Ned SaltzmanNed Saltzman More articles by this author , Guillermo FeriaGuillermo Feria More articles by this author , and Ruben F. GittesRuben F. Gittes More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)47303-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail An in vitro model was devised to evaluate the efficacy of the different irrigating solutions utilized for local dissolution of uric acid stones. Tris (hydroxymethyl) aminomethane proved to be several times faster than sodium bicarbonate in dissolving uric acid calculi. The maximal dissolution rate was obtained when the highest pH (10.5) of Tris buffer was used in concentrations at or above 0.2M. This makes the commercially available THAM-E an optimal choice. Stones averaging 1cm. in diameter were dissolved in less than 48 hours when this compound was used. Sodium bicarbonate should only be used in solutions with concentrations lower than 0.2M and pH below 9, if some dissolution is to be attempted. Concentrations and pH’s above these levels will coat the stones with hard shells of sodium urate, making it impossible to dissolve them. The in vitro findings were confirmed in vivo in a limited study in pigs with human uric acid calculi surgically placed in their kidneys. Our results indicate how to make the best use of the solutions clinically available in order to obtain total dissolution of uric acid stones in short periods of time. We recommend the use of a 0.3 molar concentration of this buffer (THAM-E) at flow rates of about 50cc per hour. © 1985 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByRodman J (2018) Prophylaxis of Uric Acid Stones With Alternate Day Doses of Alkaline Potassium SaltsJournal of Urology, VOL. 145, NO. 1, (97-99), Online publication date: 1-Jan-1991.Iwata H, Nishio S, Yokoyama M, Matsumoto A and Takeuchi M (2018) Solubility of Uric Acid and Supersaturation of Monosodium Urate: Why is Uric Acid So Highly Soluble in Urine?Journal of Urology, VOL. 142, NO. 4, (1095-1098), Online publication date: 1-Oct-1989.Chernesky C, Rodman J, Reckler J, Rotterdam H, Marion D, Boolbol J and Vaughan E (2018) Urothelial Injury to the Rabbit Bladder From Alkaline Irrigants Useful in the Treatment of Uric Acid StonesJournal of Urology, VOL. 138, NO. 4 Part 1, (893-894), Online publication date: 1-Oct-1987. Volume 134Issue 3September 1985Page: 575-579 Advertisement Copyright & Permissions© 1985 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Marcus V. Sadi More articles by this author Ned Saltzman More articles by this author Guillermo Feria More articles by this author Ruben F. Gittes More articles by this author Expand All Advertisement PDF DownloadLoading ...