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Difficult Renal Stones
Stones
in Patients with Augmentation
cystoplasty
For patients with small contracted bladders, bowel segments can
be used to increase the bladder capacity for storage purposes. One
of the major complications of bladder augmentation is the formation
of bladder calculi. The incidence of calculus formation in augmentative
bladders is between 18-50%. Possible metabolic causes implicated
in the formation of stones in these patients include intestinal
mucus as a lithogenic agent and altered levels of inhibitors. Citrate,
a known inhibitor of crystallization, works by its ability to chellate
calcium, thereby reducing calcium salt formation. Therefore, reduced
citrate levels in the urine are implicated in bladder stone formation.
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