Treating Radiolucent or Known Uric Acid Bladder Stones in Adults
Clinical Scenario
This protocol applies to adults who have a radiolucent bladder stone identified on plain X-ray, or a bladder stone confirmed or strongly suspected to be of uric acid composition. In this group, the non-surgical, oral route is the recommended first-line approach before procedural intervention is considered.
Treatment Approach
The cornerstone of management is oral chemolitholysis — a non-invasive dissolution strategy — supported by regular urine pH monitoring. The specific agents, target pH threshold, titration schedule, and follow-up imaging regimen are detailed in the full protocol.
Full regimen, dosing guidance, and monitoring intervals available in the structured protocol below.
Treatment Goals
- Urine pH consistently above target throughout treatment
- Bladder stone dissolution confirmed on ultrasound
References
- Offer oral chemolitholysis for radiolucent or known uric acid bladder stones in adults.
- Uric acid stones can be dissolved by oral urinary alkalinisation when a pH > 6.5 is consistently achieved, typically using an alkaline citrate or sodium bicarbonate.
- Use an alkaline citrate or sodium bicarbonate with frequent urine pH monitoring and dose titration to achieve a consistent pH > 6.5.
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