Radiological morphology of calcium oxalate stones and their fragility in relation to their mono and dihydrate content

ABSTRACT

Eighty patients were treated for calcium oxalate urolithiasis with a diameter between 10 and 22 mm were subjected to a radiomorphological study of the surgically or endourologically extracted stones. X-ray densitometry of the stones and infrared spectroscopic urolith analysis were also performed. Sixty patients were treated with ESWL monotherapy. The success rate of stone fragmentation was determined by the total energy required in joules to fragment the stones. A definite radiological pattern was illustrated for the monohydrate, dihydrate and the mixed stones. Also, calcium oxalate monohydrate, stones acquired the highest optical density and required the highest energy for complete fragmentation. There was also an insignificant difference in the optical density regarding the different diameters of the oxalate stones. Therefore, calcium oxalate monohydrate stones are characterized by particular hardness and might not be recommended for ESWL monotherapy even in the 10-20 mm diameter zone