UroToday - This poster section contained 30 abstracts on the subjects of medical treatment of stone disease and metabolic evaluation. Findings from the abstracts as a whole suggests an increasing popularity in the use of alpha-blockers in the medical management of distal ureterolithiasis and the benign effect of common soft drinks on 24-hour urine parameters.

Dr. E.N. Liatsikos from Patras, Greece evaluated the efficacy of doxazosin in spontaneous passage of distal ureteral stones in a controlled trial. Sixty patients were randomized to four groups: A. Distal stone < 5mm, no alpha blocker, B. Distal stone 5-10mm, no alpha blocker, C. Distal stone < 5mm, 4 mg Doxazosin qd and D. Distal stone 5-10 mm, 4 mg Doxazosin qd. When compared to controls, treatment groups (those treated with Doxazosin 4mg qd) spontaneously passed their stones in a significantly shorter time frame. In addition, those with stones > 5mm were able to pass their stones with less painful episodes.

Very little is known about normal 24-hour urine parameters in the pediatric population. A multi-institutional study headed by Dr. GM Preminger from Duke University Medical Center sought to determine what the normal 24-hour urine values would be in the non-stone forming pediatric population. Samples from forty six children and teenagers were collected, adjusted for body weight and creatinine and the stratified into four age groups separated by 5 years. The range of urinary parameters (Oxalate, uric acid, citrate, Ca+, Mg+, Na+, P+, and K+) were shown to decrease as age increased. Those in the youngest age group (0-5 yrs) had the most marked difference from all other age groups. This is the first time that a stratified relationship between age and urinary values in non-stone forming pediatric population has been demonstrated.

Dr. K. Ogan's group from Emory University School of Medicine evaluated the effects of cola consumption on stone risk in a controlled metabolic environment. Six Patients underwent three phase concluding 24-hour urine collections: 1. Controlled metabolic diet + 1 L cola qd for 6 days, 2. Washout period of 3 weeks and 3. Controlled metabolic diet + 1 L de-ionized water for 6 days. It was found that cola ingestion exerted minimal and insignificant changes in urinary risk factors associated with calcium oxalate stone formation. Similarly, Dr. T. Averch's study from the University of Pittsburgh Medical Center, prospectively evaluated effect of carbohydrate-electrolyte beverages (i.e Gatorade) on urinary stone risk factors in 12 non-stone formers vs 10 hypercalcuric stone formers. After patients underwent phase concluding 24-hour urine collections, no significant differences amongst measured parameters were found between normal subjects and stone formers in response to Gatorade. It was concluded that consumption of carbohydrate-electrolyte sports beverages neither increases nor decreases urinary stone risk factors.

By Michael C. Ost, MD (University of Pittsburgh Medical Center)

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