PAEA Surgery End Of Rotation (EOR) Practice Exam

Struvite stones are primarily managed by what treatment strategy?

1. Alkalinization of urine

2. Acidification of urine and long-term antibiotic use

3. Surgical intervention

4. Increasing fluid intake

The correct answer is: Acidification of urine and long-term antibiotic use

Struvite stones, also known as infection stones or triple phosphate stones, are formed in the setting of urinary tract infections caused by urease-producing bacteria. These stones typically result from the presence of ammonia in the urine, leading to a more alkaline urine environment, which contributes to their formation. The primary treatment strategy for managing struvite stones involves not only addressing the stones themselves but also tackling the underlying infection. Therefore, the focus is on acidifying the urine to inhibit further stone formation while simultaneously employing long-term antibiotic therapy to control the bacterial infection responsible for the stones. This approach helps prevent recurrence by maintaining an acidic urine pH that is less conducive to struvite stone formation. While surgical intervention may be necessary for larger stones or when there are complications, it is usually not the first-line treatment for struvite stones themselves. Increasing fluid intake is a supportive measure that can help dilute the urine but does not directly address the underlying infection or stone formation issue. Alkalinization of urine would actually worsen the condition by promoting further struvite stone development. Thus, the correct strategy of acidification of urine along with long-term antibiotic therapy effectively targets both the stones and their causative infection, making it the most suitable choice for managing