The pathogenesis of calyceal diverticular calculi

Controversy exists over whether metabolic factors or urinary stasis predominate in the pathogenesis of calyceal diverticular calculi. We performed a study to better define the effects urinary stasis and metabolic abnormalities have in the pathogenesis of calyceal diverticular stones. Twenty-nine patients who underwent percutaneous treatment of calyceal diverticular calculi were studied. All patients underwent 24 h urine collection to evaluate metabolic risk factors. In three patients, urine was sampled directly from the diverticulum for metabolic studies. The urinary stone risk parameters of the patients with calyceal diverticular stones (Tic SF) were similar to those of a well-characterized cohort of calcium oxalate stone formers (CaOx SF). When compared to a group of normal people, the Tic SF and CaOx SF were significantly more hypercalciuric and their urine was significantly more supersaturated with calcium oxalate. Urine aspirated directly from the diverticulum had the lowest SSCaOx when compared to ipsilateral and contralateral renal pelves. The urinary risk profiles of patients with diverticular calculi are similar to those of CaOx SF, suggesting a metabolic etiology of diverticular stones. However, the SS CaOx of urine aspirated directly from the diverticula is significantly lower than that of the renal pelves; these data support the hypothesis that urinary stasis significantly contributes to the pathogenesis of calyceal diverticular calculi. Taken together, it seems likely that calyceal diverticular calculi arise from a combination of metabolic abnormalities and urinary stasis.     

Metabolic abnormalities associated with renal calculi in patients with horseshoe kidneys

BACKGROUND AND PURPOSE: Horseshoe kidneys are a complex anatomic variant of fused kidneys, with a 20% reported incidence of associated calculi. Anatomic causes such as high insertion of the ureter on the renal pelvis and obstruction of the ureteropelvic junction are thought to contribute to stone formation via impaired drainage, with urinary stasis, and an increased incidence of infection. In this multi-institutional study, we evaluated whether metabolic factors contributed to stone development in patients with horseshoe kidneys. PATIENTS AND METHODS: A retrospective review of 37 patients with horseshoe kidneys was performed to determine if these patients had metabolic derangements that might have contributed to calculus formation. Stone compositions as well as 24-hour urine collections were examined. Specific data points of interest were total urine volume; urine pH; urine concentrations of calcium, sodium, uric acid, oxalate, and citrate; and number of abnormalities per patient per 24-hour urine collection. These data were compared with those of a group of 13 patients with stones in caliceal diverticula as well as 24 age-, race-, and sex-matched controls with stones in anatomically normal kidneys. RESULTS: Eleven (9 men and 2 women) of the 37 patients (30%) with renal calculi in horseshoe kidneys had complete metabolic evaluations available for review. All patients were noted to have at least one abnormality, with an average of 2.68 abnormalities per 24-hour urine collection (range 1-4). One patient had primary hyperparathyroidism and underwent a parathyroidectomy. Low urine volumes were noted in eight patients on at least one of the two specimens (range 350-1640 mL/day). Hypercalciuria, hyperoxaluria, hyperuricosuria, and hypocitraturia were noted in seven, three, six, and six patients, respectively. No patients were found to have gouty diathesis or developed cystine stones. Comparative metabolic analyses of patients with renal calculi in caliceal diverticula or normal kidneys revealed a distinct profile in patients with horseshoe kidneys, with a higher incidence of hypocitraturia. CONCLUSIONS: All patients with renal calculi in horseshoe kidneys were noted to have metabolic abnormalities predisposing to stone formation. In this initial series of 11 patients, hypovolemia, hypercalcuria and hypocitraturia were most common metabolic defects. These findings suggest that metabolic derangements play a role in stone formation in patients with a horseshoe kidney. Patients with calculi in anatomically abnormal kidneys should be considered for a metabolic evaluation to identify their stone-forming risk factors in order to initiate preventative selective medical therapy and reduce the risk of recurrent calculus formation.     

Comparison of renal function and metabolic abnormalities of cystine stone patients and calcium oxalate stone patients in China

Purpose

To compare renal function and metabolic abnormalities of cystine stone patients and calcium oxalate stone patients in China.

Methods

Between 2008 and 2011, thirty cystine stone patients were involved in our study, and an equal number of age- and gender pair-matched patients with calcium oxalate stones. Non-stone forming individuals were elected as controls. The evaluation included blood chemistry studies and 24-h urine collection in both groups of patients.

Results

The cystine stone patients had higher mean values of serum blood urea nitrogen, urate and creatinine levels than patients in other two groups. With respect to urine risk factors, cystine stone patients had higher urinary citrate and lower urinary oxalate and creatinine than calcium oxalate stone patients. When compared to non-stone forming individuals, cystine stone patients had higher urinary urate excretion and lower urinary creatinine excretion. Metabolic abnormalities could be demonstrated in 80 % of the cystine stone patients and in 100 % of the calcium oxalate stone patients. We also compared urine risk factors among cystine stone patients with different urine cystine excretion (<1 mmol/24 h, 1–2 mmol/24 h and >2 mmol/24 h). No significant difference was found in urine risk factors among three groups.

Conclusions

This study suggested that cystine stone patients were at greater risk for the loss of renal function than calcium oxalate stone patients, but the risk of the formation of calcium oxalate stones was lower. Our results also indicated that urinary cystine had little or no impact on the excretion of urine chemistries in cystine stone patients.     

METABOLIC URINARY CORRELATES OF CALCIUM OXALATE DIHYDRATE IN RENAL STONES

Purpose

We determined what metabolic features of the 24-hour urine predict calcium oxalate dihydrate in kidney stones. Prior studies have suggested that low urine magnesium, high urine calcium, high calcium-to-oxalate ratio and high urine supersaturation with respect to calcium oxalate monohydrate predict calcium oxalate dihydrate.

Materials and Methods

Stone analyses and results from 2, 24-hour pretreatment urine collections from 96 patients with nephrolithiasis were drawn from 3 kidney stone prevention centers. Standard stone risk measurements were made on the urine, including supersaturation for calcium oxalate monohydrate, brushite and uric acid.

Results

The main differences in metabolic urine findings were between patients with no calcium oxalate dihydrate and those with any calcium oxalate dihydrate in stones. Percent calcium oxalate dihydrate itself did not correlate with urine findings. Patients with no calcium oxalate dihydrate in stones showed a biphasic pattern of urine calcium oxalate monohydrate supersaturation, about half had values below almost any found among patients with calcium oxalate dihydrate in stones (less than 7) and the rest overlapped with the calcium oxalate dihydrate group. Except for higher calcium oxalate monohydrate supersaturation, patients with calcium oxalate dihydrate in stones had higher urine calcium excretion and lower urine citrate concentrations, even after calcium oxalate monohydrate supersaturation was considered.

Conclusions

Patients with low calcium oxalate monohydrate supersaturation (less than 7) are unlikely to have calcium oxalate dihydrate in renal stones. However, many patients with no calcium oxalate dihydrate have higher calcium oxalate monohydrate supersaturation values, and so prediction of calcium oxalate dihydrate or its absence from urine findings is imperfect. Urine magnesium and the calcium-to-oxalate ratio are unrelated to calcium oxalate dihydrate.     

Percutaneous Endoscopic Treatment for Calyceal Diverticular Calculi

A 29-year-old man complaining of gross hematuria was referred to our department. DIP demonstrated calyceal diverticular calculi of the left kidney. The patient requested ESWL, but the stone had not been discharged after two treatments. He then underwent PNL with dilation of the narrow neck of the calyceal diverticulum under fluoroscope. The neck of the diverticulum was dilated using an amplats dilator. Three months after the surgery, DIP demonstrated that the diverticulum was completely free from calculi and the size of the diverticulum was reduced. He was doing well 24 months after the operation. Calyceal diverticular calculi should be managed not only with ESWL and PNL but also with dilation of the narrow neck of the calyceal diverticulum.     

Predisposing factors in bladder calculi. Review of 100 cases

One hundred patients, aged twenty to ninety-two years, underwent 111 procedures for removal of bladder calculi. Most patients (88) had some type of bladder outlet obstruction. Two types of stones were identified: those that had apparently formed in the upper tract and been trapped in the bladder (17 cases) and those that appeared to have formed in the bladder in the presence of various types of outlet obstruction. Stone analysis revealed uric acid stones in 50 percent, calcium oxalate stones in 19 percent, and stones of mixed composition in 31 percent. Five patients had metabolic abnormalities predisposing to stone formation; in 2 cases, these abnormalities were discovered during the evaluation for stone disease. Treatment depended on stone characteristics, associated pathology, and the general health of the patient. A review of the literature with regard to the morbidity and mortality of combining treatment of vesical calculi and bladder outlet obstruction secondary to prostatic obstruction is included.     

Detection of Proteus mirabilis Urease Gene in Urinary Calculi by Polymerase Chain Reaction

Background: Urea-splitting microorganisms cannot always be detected by stone or urine culture in patients with infection stones. Detection of genetic elements within the calculi by the polymerase chain reaction (PCR) may be a useful alternative. In this study, we assessed the usefulness of the PCR method in detecting the urease gene specific to Proteus mirabilis in urinary calculi.
Methods: Thirty-eight metabolic stones (calcium oxalate and/or calcium phosphate, uric acid, or cystine) and 49 struvite stones were examined. The PCR was applied with DNA extracted by boiling pulverized stone pieces.
Results: Of the 87 stones, PCR demonstrated the presence of the P. mirabilis urease elements ureC1 and ureC2 in 1 7, all of which were struvite. Stone culture and urine culture had been performed in 22 and 46 struvite stone cases, respectively, and the PCR was positive in all of the 10 culture-positive calculi and also in two calculi from which P. mirabilis was not isolated.
Conclusion: PCR was reliable and convenient for detecting P. mirabilis in desiccated struvite calculi. Study to detect other species such as Ureaplasma or Corynebacterium would be useful in elucidating the role of bacterial infection in the formation of these stones.     

Nephrolithiasis in identical twins: the impact of nature vs nurture

OBJECTIVE: To assess possible underlying metabolic abnormalities in three sets of monozygotic twins, to evaluate the interplay among the factors of kidney stone formation, a complex multifactorial process influenced by environmental, genetic and anatomical factors. PATIENTS AND METHODS: Three sets of identical twins with either cystine or calcium oxalate stones were identified. Demographic data, medical histories and the results of 24-h urine testing, with samples collected on self-selected diets, were reviewed and analysed. RESULTS: The cystinuric twins had very similar cystine excretion rates, while stone activity was significantly more pronounced in one. Metabolic abnormalities were concordant in one set of twins with calcium oxalate stones, both being hypercalciuric and hyperuricosuric. However, metabolic abnormalities were discordant in the other pair, one twin with hypercalciuria and the other with hypocitraturia. Two of the three pairs had low urinary volume. CONCLUSIONS: These results support previous observations that environmental, genetic and potentially, anatomical factors play roles in kidney-stone formation. Additional controlled studies of monozygotic stone-forming twins might help to define the interplay between environmental and genetic factors, and allow the identification of susceptibility genes involved in stone generation.     

Formation of the staghorn calculi

To study the process of formation of staghorn calculi, 58 patients with staghorn calculi were evaluated clinically and the removed stones were studied architecturally. Of 35 patients with infection stones composed of struvite and/or apatite in the nuclei as well as peripheral layers, 18 had identified predisposing factors related to infection. Of 13 patients with infection stones containing calcium oxalate in the nuclei, 7 had predisposing factors of infection but only 2 had metabolic disorders. The patients with infection stones who had no predisposing factors may have transient or subclinical abnormalities. Initial stone formation of oxalate may also be one of the predisposing factors of infection. Most of the patients with staghorn calculi composed of uric acid, oxalate and cystine, had metabolic disorders related to these substances. Large numbers of bacteria and large amounts of organic matrix were found extensively within infection stones and were thought to be important components as well as crystals. Metabolic stones contained little matrix. In this case crystal aggregation is thought to play the most important role in stone formation.     

Urine risk factors in children with calcium kidney stones and their siblings

Calcium nephrolithiasis in children is increasing in prevalence and tends to be recurrent. Although children have a lower incidence of nephrolithiasis than adults, its etiology in children is less well understood; hence, treatments targeted for adults may not be optimal in children. To better understand metabolic abnormalities in stone-forming children, we compared chemical measurements and the crystallization properties of 24-h urine collections from 129 stone formers matched to 105 non-stone-forming siblings and 183 normal, healthy children with no family history of stones, all aged 6 to 17 years. The principal risk factor for calcium stone formation was hypercalciuria. Stone formers have strikingly higher calcium excretion along with high supersaturation for calcium oxalate and calcium phosphate, and a reduced distance between the upper limit of metastability and supersaturation for calcium phosphate, indicating increased risk of calcium phosphate crystallization. Other differences in urine chemistry that exist between adult stone formers and normal individuals such as hyperoxaluria, hypocitraturia, abnormal urine pH, and low urine volume were not found in these children. Hence, hypercalciuria and a reduction in the gap between calcium phosphate upper limit of metastability and supersaturation are crucial determinants of stone risk. This highlights the importance of managing hypercalciuria in children with calcium stones.     

The etiology of urolithiasis in HIV infected patients

PURPOSE: It is commonly thought that urinary lithiasis in HIV infected patients on protease inhibitor therapy is composed primarily of the protease inhibitor itself. Since many HIV infected patients on protease inhibitors presenting to our institution had nonprotease inhibitor stones, we investigated potential underlying metabolic abnormalities that may account for the lithogenesis. MATERIALS AND METHODS: We retrospectively reviewed all HIV infected patients on protease inhibitors with renal colic and evidence of nephrolithiasis who presented to our institution between June 1996 and January 2001. Patients were evaluated for stone composition and metabolic abnormalities of blood and urine when possible. RESULTS: A total of 24 patients were identified, and all were or had been on protease inhibitors (indinavir 14, ritonavir 3, nelfnavir 2, unspecified 5). Of the 14 patients on indinavir only 4 (28.6%) had indinavir containing stones. The remaining stones in this group and in those not on indinavir contained various amounts of calcium oxalate monohydrate and dihydrate, ammonium acid urate and uric acid. Of 10 patients who underwent 24-hour urine collection for metabolic evaluation 8 (80%) had abnormalities, including hypocitraturia in 5, hyperoxaluria in 4, hypomagnesuria in 4, hypercalciuria in 3, increased supersaturation of calcium oxalate in 3 and hyperuricosuria in 2. Abnormalities in the levels of urinary phosphate and sodium were also observed. CONCLUSIONS: HIV infected patients form many types of stones, which probably are attributable to underlying metabolic abnormalities rather than the use of protease inhibitors. A complete metabolic evaluation is warranted in these patients, as a means of guiding treatment to prevent future stone episodes, while avoiding the need to alter antiretroviral regimens.     

上海市浦东新区泌尿系结石患者与健康体检者结石相关因素的对照研究

目的：探讨泌尿系结石患者与健康体检者结石相关因素。方法：对300例泌尿系结石患者的结石成分进行分析,并结合血生化及24h尿液分析结果,与300例健康体检者进行对照研究。结果：尿石症患者中,草酸钙结石232例（77．3％）,磷酸盐结石50例（16．7％）,感染性结石9例（3％）,尿酸结石9例（3％）。结石患者血清镁、钙、磷及24h尿氯、钙、镁、磷、尿酸显著高于健康体检者（P〈0．05）,而血钾、尿枸橼酸则显著低于健康体检者（P〈0．05）。结论：尿结石与多种代谢异常关系密切,结石成分及代谢评估对泌尿系结石的成因、治疗和预防有重要临床指导意义。     

The increased risk of urinary stone disease in betel quid chewers

The chewing of betel quid is a common practice in many countries of the world, particularly in Southeast Asia. The quid consists of a preparation of areca nut, betel leaf and calcium hydroxide “lime” paste (“chuna”). For the first time, we present a study that links its use to urinary stone disease. Eight patients (seven male and one female) who presented to our Stone Unit with recurrent urinary stones were included in the study. All were from the Indian subcontinent and were found to regularly chew betel. The patients underwent metabolic screening including blood, random urine and 24-h urine tests, quantitative chemical analysis of their calculi (where possible) and each completed a 7-day Diet Diary on his/her free, home diet. The study demonstrated a high incidence of hypercalciuria, a tendency to pass an alkaline urine and low urinary citrate excretion among the patients. Together these urinary risk factors increase the probability of developing both calcium phosphate-containing and calcium oxalate-containing stones. In support of this hypothesis, the patients were found to form stones consisting mainly of calcium phosphate but mixed with calcium oxalate. It is concluded that the use of calcium hydroxide “chuna” in the betel quid is the major contributor to the cause of urinary stones in its users. Moreover, the development of urinary lithiasis in such patients may be a precursor to milk-alkali syndrome in those individuals whose chewing habit is more extensive than in the patients in this study and who do not seek to decrease their habit over the long term.     

Metabolic and urinary risk factors associated with Randall's papillary plaques

BACKGROUND AND PURPOSE: Increasing evidence suggests that Randall's plaques contribute to the pathogenesis of urinary stone formation. The purpose of our study was to evaluate the urinary risk factors of stone patients who underwent endoscopic mapping of their calices for Randall's plaques. PATIENTS AND MATERIALS: Patients (N = 143) having endoscopic procedures to remove upper tract calculi or for other purposes underwent mapping of their calices for Randall's plaques. Plaque incidence and pattern were correlated with the stone composition and urinary risk factors found on subsequent metabolic evaluation. RESULTS: Papillary plaques were found more commonly in patients having calcium oxalate stones than in patients with other stone types and patients without a history of stones. Papillary plaque incidence and pattern did not correlate with any specific urinary risk factor; however, patients with plaques tended to exhibit a higher incidence of all risk factors. Plaque severity tended to be greater in patients exhibiting hypercalciuria. CONCLUSIONS: Randall's plaques are found most frequently in patients with calcium oxalate stones and are most important in the pathogenesis of calcium oxalate nephrolithiasis. Stone patients with papillary plaques are more likely to exhibit abnormalities in their urinary milieu than are patients without papillary plaques.     

Percutaneous nephrolithotomy for caliceal diverticular calculi: a novel single stage approach

PURPOSE: Current percutaneous treatment of symptomatic caliceal diverticular calculi involves renal access, stone removal, dilation of the diverticular communication, fulguration of the cavity and placement of a nephrostomy tube. We reviewed the outcomes of patients undergoing a novel single stage percutaneous nephrolithotomy technique for radiopaque caliceal diverticular stones that eliminates ureteral catheterization and entry into the renal collecting system. MATERIALS AND METHODS: A total of 21 patients (8 male and 13 female including 1 bilateral) with a mean age of 42.4 years underwent percutaneous nephrolithotomy for caliceal diverticular stones from February 2001 to May 2003. Of the diverticula 12 were upper pole, 4 were interpolar and 6 were lower pole. Infracostal access was established by the urologist directly onto the radiopaque stones without the aid of a ureteral catheter. After balloon tract dilation a 30Fr Amplatz sheath was placed and following stone removal the diverticulum was fulgurated. The infundibulum was neither cannulated nor dilated. A 20Fr red rubber catheter or an 8.5Fr Cope loop was placed into the diverticulum. Stone-free status was assessed by noncontrast computerized tomography on postoperative day 1 (POD1). The drainage tube was removed if there was no urine drainage and the kidney was stone-free. Excretory urography was performed at 3 months to evaluate diverticular resolution. RESULTS: Of 21 patients 20 were discharged home tubeless on POD1 and 18 of 21 (85.7%) renal units were stone- free on POD1 noncontrast computerized tomography. Mean operative time was 58.5 minutes and mean stone burden was 138.9 mm. Mean stone diameter was 11.6 mm and mean diverticular diameter was 15.3 mm. Of 22 renal units 16 had followup excretory urography. All diverticula decreased in size and 14 (87.5%) had complete resolution. CONCLUSIONS: In patients with symptomatic radiopaque caliceal diverticular stones, a single stage procedure without the need for ureteral catheterization combined with direct infracostal diverticular puncture allows for a rapid procedure with little morbidity.     

Bacteriology of upper urinary tract stones

Extensive cultures of stones and urine were performed in 215 patients who underwent an operation for upper urinary tract calculi. Microorganisms could be cultured from the stone in 1 of every 3 patients. Despite the extended culture technique urease-producing microorganisms could be cultured from the stone in only 48% of the patients with calculi that contained magnesium ammonium phosphate. This finding suggests that an infection with urease-producing microorganisms is not obligatory for the formation of this type of stone. Of the patients with calcium oxalate phosphate stones 32% had positive stone cultures, which distinguished them from patients with pure calcium oxalate stones, only 8% of whom had a positive stone culture (p less than 0.001).     

Hydronephrosis caused spontaneous evacuation of many small calculi in a caliceal diverticulum: a case report

We experienced a curious case that hydronephrosis had caused spontaneous evacuation of calculi in a caliceal diverticulum. A 50-year-old woman was visited to our department complaining of right lower abdominal pain. Several right ureteral stones, right hydronephrosis and a great numbers of small round-shaped calculi in a right caliceal diverticulum were diagnosed. Many of the calculi moved from the diverticulum to ureter, and were evacuated spontaneously. The month after, the right hydronephrosis had already subsided and almost all of the calculi had disappeared. It was supposed that a hydronephrosis had widened the narrow channel between the diverticulum and the calyx and enabled the small calculi to pass through. Recent reports show that effectiveness of ESWL for symptomatic caliceal diverticular calculi is doubtful, because the narrow channel hinders the passage of stone fragments. However, this case suggests that an artificial hydronephrosis created by retrograde occlusion ureteral balloon catheter may lead to good drainage of gravel and better stone-free rate of caliceal diverticular calculi treated by ESWL.     

SEQUENTIAL ANALYSIS OF RECURRENT CALCIUM CALCULI BY INFRARED SPECTROSCOPY

Background: While the incidence of calcium urolithiasis increases, the precise mechanism of calcium oxalate stone formation is still controversial. Is the composition of a recurrent calcium oxalate stones always the same as previous ones? There are few reports that specifically address the question by study of sequential changes of the composition of recurrent calcium calculi. Method: From our medical records 70 patients with a history of two or more recurrent episodes of calcium oxalate stone disease were selected and the analyses of 190 stones were reviewed. Infrared spectroscopic analysis was done using a Perkin Elmer 1740 spectrophotometer. Results: Calcium oxalate monohydrate were detected in 63 stones, calcium oxalate dihydrate in 12, calcium oxalate monohydrate mixed with dihydrate in 28, calcium oxalate monohydrate mixed with calcium phosphate in 30, calcium oxalate dihydrate mixed with calcium phosphate in 20, calcium oxalate monohydrate mixed with dihydrate and calcium phosphate in 20, calcium oxalate monohydrate mixed with dihydrate and calcium phosphate in 37. Alterations of stone components during follow-up were found in 43 stones from 40 patients. The shift of a main composition from calcium oxalate monohydrate to calcium oxalate dihydrate was found in 24 stones and vice versa in 19 stones. Conclusions: Sequential changes of the compositions of recurrent calcium calculi are highly likely to occur with time in individual recurrent calcium stone formers. Calcium oxalate monohydrate was a most common component of the studied recurrent calcium stones.     

Kidney stones during pregnancy: an investigation into stone composition

Kidney stones can be a source of considerable morbidity for pregnant women. Although there is a body of literature confirming that different stone compositions predominate for different age and sex cohorts, there have been no similar reports characterizing the nature of stone disease during pregnancy. We performed a multi-institutional study to define the composition of renal calculi diagnosed during pregnancy. We retrospectively reviewed the records from two stone referral centers of all patients diagnosed with a de novo kidney stone during pregnancy who underwent a procedure for the purpose of stone removal from June 2001 through September 2007. A total of 27 patients were identified, with a mean age of 26.8 years (range, 21-34). Twenty patients (74%) had no history of prior stone formation. Seven patients (26%) had previously formed stones, although none of these patients had a known kidney stone at the time they became pregnant. Stones were removed in the first, second, third trimester and immediately post-partum in 4, 52, 22, and 22% respectively. Stone removal was performed without complication in all cases. Analysis found that in 74% of all cases (20 patients) stones were composed predominantly of calcium phosphate (hydroxyapatite). In 26% of cases, (7 patients) the stones were composed predominantly of calcium oxalate. Of the seven patients with prior stone history, three patients had previously formed calcium phosphate stones and four patients had previously formed calcium oxalate stones. Calcium oxalate calculi are the most common stone in non-pregnant women of a comparable age as our subjects. However, our present data suggest that stones detected during pregnancy are most commonly composed of calcium phosphate (hydroxyapatite). Indeed, it is the minority of stones that are composed of calcium oxalate. Although the reason for this unusual preponderance of calcium phosphate calculi is unclear, physiologic alterations that occur during pregnancy may be influential.     

输尿管软镜钬激光碎石术治疗24例肾盏憩室结石

目的 探讨输尿管软镜钬激光碎石治疗肾盏憩室结石的临床治疗效果.方法 2011年3月至2013年1月收治肾盏憩室结石24例,均行输尿管软镜钬激光碎石治疗,对碎石成功率、手术时间、并发症及复发等情况进行分析.结果 一次性碎石成功19例,碎石成功率为79.1％,20例患者症状消失,平均手术时间（80±21）mm,结石直径平均为（11.5±4.1）mm.分析24例患者的结石成分,其中草酸钙＋碳酸磷灰石结石占50.0％（12例）,草酸钙结石占41.7％（10例）,六水磷酸镁铵结石占8.3％（2例）.所有患者术后均无并发症发生.随访1～6个月,未见结石复发及其他症状出现.结论 输尿管软镜钬激光碎石是治疗肾盏憩室结石安全、有效的方法之一.