Of the commoner types of renal calculi, the phosphatic variety remains one of the most difficult to manage, as regards both the prevention of recurrences after operative removal and the inhibition of the further growth of stones in situ. Although the reported incidence of recurrence varies widely, it can be fairly estimatedto be approximately 40 per cent, on the basis of several of the more recent compilations.1
A number of factors apparently contribute to this high recurrence rate, quite apart from the difficulty in completely removing the entire mass of calculi at operation. Of major importance is the coexistence of urinary tract infection with organisms which are difficult to eliminate permanently even with modern chemotherapy.2 In addition to the pathological effects of bacterial infection on the renal pelvis, the urea-splitting properties possessed by the most frequent bacterial offenders result in a highly ammoniacal urine favorable to the precipitation
SHORR E, CARTER AC, Toscani V, Davis V, Stevens E. ALUMINUM GELS IN THE MANAGEMENT OF RENAL PHOSPHATIC CALCULI. JAMA. 1950;144(18):1549–1556. doi:10.1001/jama.1950.02920180013005
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