NEW PROCEDURE FOR IMPROVED URINARY STONE PROGNOSIS

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NEW PROCEDURE FOR IMPROVED URINARY STONE PROGNOSIS
28 March 2007 - University of Bonn (Universität Bonn)

The symptoms are dramatic: unbearable pain, blood-red urine, and nausea. Approximately five percent of the German population suffer at least one episode of ureteral colic in their life. This is caused by stones which are dislodged from the renal pelvis and which then get stuck in the ureter.

Those who suffered from a urinary stone may soon be affected by the next colic. However, the risk can be drastically reduced by an appropriate change of diet or by medication. Scientists at the Urology Clinic of the University of Bonn have now developed a procedure for rapid and exact assessment of urinary stone risk. With this "BONN Risk Index" the success of a particular treatment strategy can be checked and therapy concepts optimised. This results in a drastic reduction of the risk of further urinary stones.

When the concentration of calcium and other substances in urine is too high, small crystals may be formed, which subsequently will grow into bigger and bigger "stones". Scientists usually determine a number of biochemical values from a urine sample of the patient, which allow a rough estimation of stone formation risk. However, this, indirect, method is not reliable: urine contains hundreds of substances which may influence crystal formation. "We have chosen a different approach", says Dr Norbert Laube from the Department of Experimental Urology. "We grow crystals from the urine sample. The more difficult this is, the lower the risk of stone formation".

A triggering solution is added drop by drop to the sample in order to stimulate stone formation. As soon as the first micro crystals are formed, the urine becomes cloudy. This process is almost invisible to the normal eye and the experts use a special device, a photometer, to exactly determine when crystal formation is taking place. The lower the amount of triggering solution added at that moment, the higher the risk of urinary stones. Dr Laube: "From this and from the concentration of calcium ions in urine, we calculate the BONN Risk Index, which determines the actual risk of the patient".

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