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Multimodal treatments of cystine stones: an observational, retrospective single-center analysis of 14 cases.
[cystinuria]
To
document
the
experiences
of
a
single
institution
in
evaluating
the
clinical
courses
and
treatment
outcomes
of
patients
with
cystine
stones
.
The
clinical
data
of
14
patients
with
cystine
stones
who
were
treated
at
our
institution
from
March
1994
to
July
2012
were
reviewed
.
These
data
included
age
at
first
visit
,
gender
,
family
history
,
body
mass
index
,
presence
of
a
single
kidney
,
stone
locations
,
stone
burden
,
routine
urinalysis
,
and
culture
.
In
addition
,
we
also
analyzed
data
on
surgery
,
shock
wave
lithotripsy
,
medical
treatment
,
stone
recurrence
or
regrowth
,
and
overall
treatment
success
rates
.
The
mean
age
of
our
patients
at
their
first
visit
was
19
.
6
±
5
.
0
years
,
and
eight
patients
were
males
.
The
median
stone
burden
and
mean
urine
pH
before
each
surgery
were
6
.
5
cm
(
2
)
and
6
.
5
±
0
.
9
,
respectively
.
Two
patients
had
a
family
history
of
cystine
stones
.
Patients
underwent
surgery
an
average
of
2
.
7
times
.
The
median
interval
between
surgeries
was
27
.
3
months
,
and
1
open
surgery
,
12
percutaneous
nephrolithotomies
,
and
25
ureterorenoscopies
were
performed
.
Potassium
citrate
or
sodium
bicarbonate
was
used
in
nine
cases
.
D-Penicillamine
was
continuously
used
in
three
patients
.
Patients
had
an
average
incidence
of
3
.
2
recurrences
or
regrowth
of
stones
during
the
median
follow-up
period
of
60
.
5
months
.
Patients
with
cystine
stones
have
high
recurrence
or
regrowth
rates
and
relatively
large
stone
burdens
.
Adequate
treatment
schedules
must
therefore
be
established
in
these
cases
to
prevent
possible
deterioration
of
renal
function
.
Diseases
Validation
Diseases presenting
"also analyzed data on surgery"
symptom
cystinuria
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