Table 4.
Contemporary Renacidin Dissolution Cases
| Author, Year | N | Delivery method (n) | Stone composition (n) | Mean duration (d) | Dissolution responses | Reported complications | F/U (mos) | Notes |
|---|---|---|---|---|---|---|---|---|
| Blaivas et al 19753 | 9 | PNT | Struvite (8) Apatite (1) |
11 | Complete 6/9 Partial 2/9 Failure 1/9 |
UTI 4/19 Fever 3/9 Pain 3/9 |
12 | Intrapelvic pressure kept below 25 cm H2O by Y-tubing between nephrostomy, irrigation, and manometer; no recurrence during short follow-up |
| Fam et al 197636 | 11 | PNT after OL (6); UC (5) | Struvite/apatite | OL 12–120 UC 14–115 |
Complete: -UC 4/5 -PNT 4/6 |
Fever 4/11 Hematuria 3/11 Recurrence 2/11 |
12 | 10/11 patients had spinal cord injuries; stone sizes for UC and residual stones all <2 cm |
| Jacobs and Gittes 197637 | 11 | PNT after OL | Struvite (7) Calcium (2) |
7 | Complete 9/11 Failure 2/11 |
Fever 2/11 | 17 | Adjuvant therapy after open lithotomy in 11 patients; dissolution failed in calcium-based stones |
| Dretler et al 197928 | 8 | PNT | Struvite (presumed) | 16 | Complete 6/8 Partial 2/8 |
Flank pain 3/8 Fever 3/8 |
NR | Patient allowed to disconnect PNT; 2/8 patients needed additional PNT because of ureteral obstruction |
| Sant et al 198335 | 21 | PNT after OL (19); PNT (2) | Struvite | 13 | Complete 18/21 Partial 2/21 Failure 1/21 |
Back pain 9/21 Recurrence 2/21 |
66 | Consecutive open series with adjuvant Renacidin that included two patients with nonsurgical PNT dissolution; long follow-up |
| Silverman and Stamey 198340 | 46 | PNT after OL (46) | Struvite/apatite (46) | 4.5 | Complete 40/46 Failure 6/46 |
NR | 84 | All patients placed on Renacidin irrigation after OL regardless of stone status; 1/46 patients had documented stone recurrence in mean 7 years |
| Dretler and Pfister 198448 | 28 | PNT | Struvite (presumed) | 2–30 | Complete 19/28 Partial 6/28 Failure 3/28 |
Fever 8/28 Candiduria 6/28 Sepsis 1/28 |
3–84 | Hospital stay 5–60 days; stone recurrence documented in 3/19 patients complete stone clearance |
| Palmer et al 198746 | 15 | PNT (1); PNT after OL (6) or MIS (8) | Struvite (12); apatite (3) | 28 | Complete 11/15 Partial 1/15 Failure 3/15 |
Leakage 15/15 Fever 14/15 Admission 3/15 Pain 2/15 |
NR | Highly motivated patients who performed outpatient PNT irrigation after stone removal; stones recurred in 3/15; cost approximated a 1-day inpatient hospitalization |
| Spirnak et al 198845 | 11 | PNT after SWL | Struvite (presumed) | 6 | Complete 9/11 Partial 2/11 |
Pyelo 2/11 Candiduria 2/11 Edema and PNT 1/11 |
NR | Case series of complex struvite stone patients managed by irrigation after SWL; average 12-day hospital stay |
PNT=percutaneous nephrostomy tube; UTI=urinary tract infection; OL=open lithotomy; UC=ureteral catheter; NR=not recorded; MIS=minimally invasive surgery; SWL=shockwave lithotripsy.