KIDNEY STONES MEDICAL AND SURGICAL MANAGEMENT
KIDNEY STONES MEDICAL AND SURGICAL MANAGEMENT
SECOND EDITION
Editors
Fredric L Coe MD
Professor Department of Medicine, Nephrology University of Chicago Chicago, Illinois, USA
Elaine M Worcester MD
Professor Department of Medicine, Nephrology University of Chicago Chicago, Illinois, USA
Andrew P Evan PhD
Professor Emeritus Department of Anatomy and Cell Biology Indiana University School of Medicine Indianapolis, Indiana, USA
James E Lingeman MD FACS
Professor Department of Urology Indiana University School of Medicine Indianapolis, Indiana, USA
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Kidney Stones: Medical and Surgical Management
First Edition: 1996
Second Edition: 2019
9789351529422
Printed at:
All patients that suffer from the stone, that what we have accomplished might comfort them and better their lives.
- Megan K Applewhite MD
- Assistant Professor of Surgery
- Albany Medical Center
- Albany, New York, USA
- John R Asplin MD FASN
- Medical Director
- Lintholink Corporation
- Chicago, Illinois, USA
- Dean G Assimos MD
- Professor and Chair
- Anton J Bueschen MD Endowed Chair
- in Urologic Surgery and Research
- Department of Urology
- University of Alabama at Birmingham
- Birmingham, Alabama, USA
- Aaron D Benson MD
- OSF Healthcare
- Peoria, Illinois, USA
- Kristin J Bergsland PhD
- Research Associate
- (Assistant Professor)
- Department of Medicine
- Nephrology Section
- University of Chicago Chicago,
- Illinois, USA
- Amit Bhattu MD
- Urologist
- Department of Urology
- Muljibhai Patel Urological Hospital
- Nadiad, Gujarat, India
- René JM Bindels PhD
- Professor
- Department of Physiology
- Radboud University Medical Center
- Nijmegen, The Netherlands
- Marc E De Broe MD PhD
- Emeritus Professor of Medicine
- Laboratory of Pathophysiology
- University of Antwerp
- Antwerp, Belgium
- David A Bushinsky MD
- Professor of Medicine Pharmacology
- and Physiology University of Rochester School of
- Medicine and Dentistry
- Rochester, New York, USA
- Fernando Cabrera MD
- Urologist
- Section of Endourology and Minimally
- Invasive Urology
- Department of Urology
- Cleveland Clinic Florida
- Weston, Florida, USA
- Aluizio Barbosa Carvalho MD PhD
- Bone Disease Unit Coordinator
- Affiliate Professor
- Nephrology Division
- Federal University of São Paulo
- São Paulo, Brazil
- Yew-Lam Chong
- MBBS MMed (Surgery) FAMS (Urology)
- Chairman, Division of Surgery
- Head, Department of Urology
- Tan Tock Seng Hospital
- Singapore
- Fredric L Coe MD
- Professor
- Department of Medicine, Nephrology
- University of Chicago
- Chicago, Illinois, USA
- William A Critchlow MD
- Urologist
- Department of Urology
- Mayo Clinic Arizona
- Phoenix, Arizona, USA
- Gary C Curhan MD ScD FASN
- Professor of Medicine
- Harvard Medical School
- Professor of Epidemiology
- Harvard School of Public Health
- Channing Division of Network
- Medicine/Renal Division
- Brigham and Women's Hospital
- Boston, Massachusetts, USA
- Mitra R de Cógáin MD
- Kaiser Permanente
- San Diego, California, USA
- Michel Daudon PhD
- AP-HP
- Department of Biochemistry
- A Necker-Entants Malades Hospital
- Paris, France
- Mahesh Desai MS FRCS FACS
- Medical Director
- Muljibhai Patel Urological Hospital
- Nadiad, Gujarat, India
- Mihir M Desai MD
- Professor of Clinical Urology
- Health Sciences Campus
- Los Angeles, California, USA
- Patrick C D’Haese PhD
- Professor
- Department of Biomedical Sciences
- Laboratory of Pathophysiology
- University of Antwerp Wilrijk, Belgium
- Andrew P Evan PhD
- Professor Emeritus
- Department of Anatomy and Cell
- Biology
- Indiana University School of Medicine
- Indianapolis, Indiana, USA
- Murray J Favus MD
- Professor
- Department of Urology
- Department of Medicine
- Endocrinology Section
- University of Chicago
- Chicago, Illinois, USA
- Kevin K Frick PhD
- Research Assistant Professor
- University of Rochester
- School of Medicine and Dentistry
- Rochester, New York, USA
- Daniel G Fuster MD
- Associate Professor of Nephrology
- University of Bern
- Bern, Switzerland
- Giovanni Gambaro MD PhD
- Professor of Nephrology
- Department of Internal Medicine
- Division of Nephrology
- Catholic University of the Sacred Heart
- Rome, Italy
- Arvind P Ganpule MS MNANS
- Consultant and Chief
- Division of Laparoscopy
- Muljibhai Patel Urological Hospital
- Nadiad, Gujarat, India
- David S Goldfarb MD FACP FASN FNKF
- Professor of Medicine and Physiology
- New York Harbor VA Healthcare System
- New York University School of Medicine
- New York, USA
- Laurie B Gower PhD
- Professor
- Department of Materials Science and
- Engineering
- University of Florida
- Gainesville, Florida, USA
- Joshua H Grimes PhD
- Clinical Medical Physics Resident
- Department of Radiology
- Mayo Clinic
- Rochester, Minnesota, USA
- Raymon H Grogan MD
- Professor of Surgery
- University of Chicago Medicine
- Chicago, Illinois, USA
- Mitchell L Halperin
- MDCM FRCP(C) FRS (Canada)
- Professor Emeritus
- Department of Medicine/Nephrology
- University of Toronto School of Medicine
- Toronto, Ontario, Canada
- Lee Hamm MD
- Senior Vice President and Dean
- James R Doty Distinguished Professor
- and Chair
- Tulane University School of Medicine
- New Orleans, Louisiana, USA
- Joe Harris PhD
- Post-doctoral Researcher
- Department of Materials Science and
- Engineering
- Friedrich-Alexander-University
- Erlangen-Nürnberg
- Erlangen, Germany
- Ita Pfeferman Heilberg Md PhD
- Kidney Stone Unit Coordinator
- Associate Professor
- Nephrology Division
- Federal University of São Paulo
- São Paulo, Brazil
- Kathleen S Hering-Smith MS PhD
- Associate Professor
- Department of Medicine
- Section of Nephrology
- Tulane University School of Medicine
- New Orleans, Louisiana, USA
- Joost GJ Hoenderop PhD
- Professor
- Department of Physiology
- Radboud University Medical Center
- Nijmegen, Netherlands
- Mitchell R Humphreys MD
- Professor and Fellowship Director
- Department of Urology
- Mayo Clinic Arizona
- Phoenix, Arizona, USA
- Edwin L Kaplan MD
- Professor
- Department of Surgery
- University of Chicago
- Chicago, Illinois, USA
- Amy E Krambeck MD
- Michael O Koch Professor of Urology
- Indiana University School of Medicine
- Indianapolis, Indiana, USA
- Nancy S Krieger PhD
- Research Associate Professor
- Department of Medicine
- University of Rochester School of
- Medicine
- Rochester, New York, USA
- Mohan Kumar MD
- Consultant Urologist
- Muljibhai Patel Urological Hospital
- Nadiad, Gujarat, India
- Anke L Lameris PhD
- Physiologist
- Radboud University Medical Center
- Nijmegen, Netherlands
- John C Lieske MD
- Professor of Medicine
- Division of Nephrology and Hypertension
- Mayo Clinic
- Rochester, Minnesota, USA
- James E Lingeman MD FACS
- Professor
- Department of Urology
- Indiana University School of Medicine
- Indianapolis, Indiana, USA
- Michael Lipkin MD MBA
- Associate Professor of Urology
- Duke University Medical Center
- Durham, North Carolina, USA
- Archana Lovett BS PhD
- Graduate Assistant
- Department of Materials Science and
- Engineering
- University of Florida
- Gainesville, Florida, USA
- Brian R Matlaga MD MPH
- Professor of Urology
- Johns Hopkins University School of
- Medicine
- Director
- Stone Disease
- The James Buchanan Brady Urological
- Institute
- Baltimore, Maryland, USA
- Jane S Matsumoto MD
- Assistant Professor
- Department of Radiology
- Mayo Clinic
- Rochester, Minnesota, USA
- Cynthia H McCollough PhD
- Professor
- Department of Radiology
- Mayo Clinic
- Rochester, Minnesota, USA
- Nicole L Miller MD
- Associate Professor
- Department of Urologic Surgery
- Vanderbilt University
- Nashville, Tennessee, USA
- Dawn S Milliner MD
- Professor of Medicine and Pediatrics
- Mayo Clinic
- Rochester, Minnesota, USA
- Orson W Moe MD
- Professor of Medicine
- Director, Charles and Jane Pak Center
- of Mineral Metabolism and Clinical
- Research
- Director
- O’Brien Kidney Research Core
- University of Texas Southwestern
- Medical Center
- Dallas, Texas, USA
- Lama Nazzal MD
- Assistant Professor of Medicine
- New York University School of Medicine
- New York City, New York, USA
- Craig A Peters MD
- Chief, Pediatric Urology
- Children's Health System Texas
- Professor of Urology
- University of Texas Southwestern
- Dallas, Texas, USA
- Keng-Siang Png MD FRCS (Urol)
- Consultant, Department of Urology
- Tan Tan Tock Seng Hospital
- Singapore
- Glenn M Preminger MD
- Professor of Urology
- Duke University School of Medicine
- Durham, North Carolina, USA
- Andrew D Rule MD
- Professor of Medicine
- Division of Nephrology and
- Hypertension
- Mayo Clinic
- Rochester, Minnesota, USA
- Khashayar Sakhaee MD
- Professor and Clinical Director
- Charles and Jane Pak Center for
- Mineral Metabolism and Clinical
- Research
- University of Texas Southwestern
- Medical Center
- Dallas, Texas, USA
- David J Sas DO
- Assistant Professor of Medicine
- Mayo Clinic
- Rochester, Minnesota, USA
- Daniel Schneider MD
- Urology Specialist
- Department of Urology
- Mayo Clinic Arizona
- Scottsdale, Arizona, USA
- Michelle Jo Semins MD
- Assistant Professor
- Department of Urology
- University of Pittsburgh
- Pittsburgh, Pennsylvania, USA
- Stephen Scott Sparks MD
- Assistant Professor
- Department of Urology
- Children's Hospital Los Angeles
- University of Southern California
- Los Angeles, California, USA
- Jubilee Tan MD
- Urologist
- Department of Urology
- University of Alabama
- Birmingham, Alabama, USA
- Yung-khan Tan MD
- Senior Consultant
- Department of Urology
- Tan Tan Tock Seng Hospital
- Singapore
- Eric N Taylor MD
- Associate Professor of Medicine
- Tufts University School of Medicine
- Boston, Massachusetts
- Division of Nephrology and
- Transplantation
- Maine Medical Center
- Portland, Maine, USA
- Anja Verhulst PhD
- Post-Doctoral Fellow
- Laboratory of Pathophysiology
- University of Antwerp
- Antwerp, Belgium
- Benjamin A Vervaet PhD
- Department of Biomedical Sciences
- University of Antwerp
- Antwerp, Belgium
- James C Williams Jr PhD
- Department of Anatomy and Cell Biology
- Indiana University School of Medicine
- Indianapolis, Indiana, USA
- Stephan E Wolf PhD
- Professor
- Department of Materials Science and
- Engineering
- Freidrich-Alexander University
- Erlangen-Nürnberg
- Erlangen, Germany
- Michael YC Wong MD
- Medical Director
- Urology and Fertility Center
- Mount Elizabeth Hospital
- Singapore
- Elaine M Worcester MD
- Professor
- Department of Medicine, Nephrology
- University of Chicago
- Chicago, Illinois, USA
The Plough and the Star
Fifty years have gone since I first came, and many who worked this field with me are gone. I have read or heard some say nothing alters, we are where we were before, have learned little we did not know. I say that is wrong, and they who have said it are wrong. Here is my evidence, this ample book filled with new knowledge, knowledge of what our senses show us and reasonable visions of how things came to be the way they are.
This field of mine—I lay some claims being an elder, though it is ours, of course—this field is like everywhere we do science. But, may be being so present, so undeniable, the stones themselves can make their causes seem, by contrast, gauzy dreamy things, and those who seek them dreamers. That is not new. The causes of stones have always been uncertain. But we care because of ancient distinctions, treatment by cause or treatment empiric, medicine of remedies or medicine of science.
This is a book for physicians and we all know how things are. Patients are ill and we seek in them a disease that causes their illness. Stones are a disease and their illnesses obvious. As if one satisfaction were not enough, surgeons can cure the disease. It is for them a kind of perfection: the stones so evident, and the result so much a cure, for a time.
But, what next? Stones recur. Surgeons tire of repetition, patients more so. Inevitably comes the question. We must treat by cause or by empirics, by science or by remedy, and as we do so judge this field of ours as to its fitness and maturity. Judge the work that came before us, and the work done now.
It is strange but true that a field matures by causes, by understanding things as they are in terms of things that made them be as they are. Yet those causes, those things that make the evident diseases be as they are, they are themselves impossibly distant gleaming brilliant things beyond our common ken. We can know what is there, but only imagine why.
So it is for stones. We observe them, catalog their crystals, perhaps the proteins of their matrix, study the patients who form them, and imagine. The word for our imaginings saves us from seeming dreamers. It means where we push off from. But hypotheses arise from dreams, from images, from imaginings. There is no other way, and we all know it.
Physicians have imagined the causes of disease forever. What changed things, perhaps five hundred years ago, was the deduction, the demand for the necessary prediction which would prove the imaginings false or not false as if each prophetess were tested by the happening.
Have we all not done this? Have we all not tested visions? Even in the microcosm of our practices, we imagine– illness comes from this disease, or that one, and we test if we are right, or wrong.
Surgeons, perhaps, least suffer from the enigma of imagination. Stones, as I have said, are remarkably present, and the purpose of the surgeon their extirpation—the success of which is rarely doubtful. They do research. But surgical research itself is not usually about causes. It is about remedy: better ways, better instruments. And the test gives a clear answer: better, no better, worse.
The rest of us, cognitive, and physically less inclined, care about remedies too, and test them with results, perhaps less clear, for we end up counting stones and bickering among ourselves about bias and sufficiency. Did this remedy slow their recurrence? Did we repeat the trials often enough to be done with them and simply use what we have?
Both enterprises, the hunt for better surgery, the hunt for better medicines, are often called technology research, practical research, pragmatic research, and the answers are more or less what one would find in testing refrigerators, or dishwashers, or automobiles: better, worse, no different, not good, good.
That is to say medicine is about the remedy. It is humble that way. Ultimately, we serve people who are ill because of disease, who want health and for us to restore it: rightly so. But we dream, sometimes, about the invisible causes of things and say with some reasons that treatment by cause is ultimately a grace because ultimately better than treatment by empirics, treatment by remedy.
We have examples.
Do you remember peptic ulcer?
It was the corrosive acid caused it, how could things be otherwise? Antacids helped them heal. When industry produced the acid blockers, they worked, they helped the ulcers heal. What more could we desire? What more should we desire? The remedy was workable, and based on an evident cause—a cause afloat on oceans of measurement, shielded by mountains of published papers, central to a universe of understanding.
The silly dream that bacteria could live in stomach acid and cause the ulcers was just that, silly and a dream, silk and gossamer in the stern winter of finished science, of working technology, but true even so. Those who dreamed were scorned and slighted, hardly thought of by working scientists who ruled the field—until the proof came, and everything altered. The remedy from the dream is more enduring and more efficient than any that had been before. Even more, somehow those bacteria cause cancer that can, one hopes, be avoided.
Do you want another?
Remember, then, when rising systolic blood pressure was natural, part of how we age, the way nature contrived to force blood through old and narrowed vessels. Lower it, and cause great harm. When that was first tried those who tried it feared. But they were right. To lower it staves off strokes, and heart attacks, and heart failure, and death. No one anymore thinks grandma should have her high systolic pressure as a defense against stroke, as a way to perfuse her brain. It would be as wrong as it was wrong, once, to think the opposite.
There is a power that cause confers, not always channeled into remedy, at least not right away, but a power of vision, of prophecy, of understanding. I would like to say we pursue the causes of things because of that power, but the truth may be otherwise.
The world our senses show us came to be the way it is, somehow, and how is present never to our senses, only to our imaginings, our dreaming selves. Bacteria living in our stomachs, an idle trait of age a lurking killer, how odd to imagine this. But those who did conceived a change of kind, of type, of truth as we can know it.
Such time as we spend in dreaming, howsoever profitable, is time not spent in more pragmatic, workmanlike pursuits. Thus, the unavoidable tension, the inevitable dispute. If false dreams issue from the gates of ivory, the time for them is lost time, the money spent for them lost money while the world waits for us, expecting something better for our pay. So it is, the dreamer lives in hopes of vindication, while the rest content themselves to do the work of the world.
This book depicts, whose preface I am writing, all we have, our field in full abundance and, as best we know, what made it so, and what might come of knowing.
As every book of medicine portrays some field caught up in time, like smiling pictured children age long since has swept away, we are here upon a moment, knowledge and uncertainties, wisdom and silliness mixed together as in all of medicine. Those experts who wrote here made of what they think is true a grand and royal portrait time will prove false howsoever beautiful its colors and its shapes. They made a book of certainties. They made a book of dreams.
Who worked this field before us, were as fine as we, but we have worked as they, and taken things beyond their time. I have heard some say nothing alters, and we are where we were a generation past. This book is our rebuke, our argument, and our disdain in trade for theirs.
Science is forever moving, not toward eternal truth, for that is silliness, but toward a greater richness. Scientists measure, and what they measure an enduring legacy to whom their field will pass. Tests of remedy or a dream, all dreams that fail and those not failed enrich the treasury. What's false is burned away. The rest, like jeweled crowns and diadems, remains the kingdom's riches. Thus it is that science is forever growing, and forever new.
As for me, I have long worked this amiable soil and offered up to the judgments of time what it has yielded me. I have had my dreams proved false, some hopeful yet, in seeming true. And I delight to look upon this thing, this work of those I work with, those I know and prize for their accomplishments. Here are their offerings, the gorgeous artifacts of labor spent, the brilliancies of cultivated minds. Strangers come, someday, to work our field will gaze upon this portrait at a time we cannot know, and say: ‘Who worked this field before us were as fine as we, but we shall carry things beyond their time.’
Fredric L Coe
Acknowledgments
I wish to thank Mr Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President) and the editorial team at Jaypee Brothers Medical Publishers, New Delhi, India for their dedicated guidance and expertise with special mention of Ms Chetna Malhotra Vohra (Associate Director—Content Strategy) and Ms Anamika Talukdar (Development Editor) to help me complete the chapters. It was a pleasure working with all the publishing team at Jaypee Brothers Medical Publishers, New Delhi, India for the book proofs and editing, etc.