Cystinuria
Alternative names:
cystine stones; stones - cystine
Treatment:
Treatment goals include relief of symptoms and preventing the development of further stones. Hospitalization may be required if symptoms are severe.
Stones are usually passed spontaneously. The urine should be strained and the stone saved for analysis of the type of stone. The patient should drink enough fluid to produce large amounts of urine. Water is encouraged, usually at least 6 to 8 glasses per day. Consistently high liquid intake is the mainstay of treatment. Intravenous fluids may be required.
Cystine is more soluble in alkaline solution, so sodium bicarbonate or sodium citrate (or similar medications) may be used to alkalinize the urine (see sodium bicarbonate and sodium citrate and sodium). Other medications (penicillamine) may be used to increase the solubility of cystine.
Analgesics may be needed to control renal or ureteric colic (pain associated with the passage of stones).
If the stone is not excreted spontaneously, surgical removal.
Lithotripsy may be an alternative to surgery. In this procedure, ultrasonic waves or shock waves are used to break up stones so that they may be expelled in the urine (extracorporeal shock wave lithotripsy) or removed with an endoscope that is inserted into the kidney via a small flank incision (percutaneous nephrolithotomy).
Expectations (prognosis):
Cystinuria is a chronic and life long condition. The incidence of symptomatic stone formation is variable but recurrence of stones is common. The disorder seldom results in kidney failure and does not affect other organs.
Complications:
Calling your health care provider:
Call your health care provider if symptoms indicate urinary tract stones are present.
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