By vgreene, 30 December, 2015 After surgical procedure (if feasible): Consider urease inhibitor, acidifying urine, abx. Monitor UCx for re-infxn w/ urease-producing bacteria, per AUA8
By vgreene, 30 December, 2015 ACP7 concluded multicomponent diet studies showed mixed results. Inadequate evidence on tailoring tx by stone type or blood/urine chemistries, per ACP7 and AHRQ2
By vgreene, 30 December, 2015 Prophylactic abx may be useful in some cases; per AUA;12 EAU10 recommends considering short- or long-term abx
By vgreene, 30 December, 2015 If recurrent or residual stones after surgical options exhausted, urease inhibitor acetohydroxamic acid may be beneficial, per AUA;9 if severe dz, consider acetohydroxamic acid (if available) per EAU.10 AHRQ11 concluded insufficient evidence
By vgreene, 30 December, 2015 Increase fluid intake to achieve target urine output surgical procedures often required
By vgreene, 30 December, 2015 If fluid-restricted (eg, CHF, CKD, etc) consider reducing target urine volume, per ACP5
By vgreene, 30 December, 2015 ↑fluids to achieve urine output of ≥2 L/day per ACP1 and AHRQ;2 whereas AUA3 and EUA4recommend ≥2.5 L/day
By vgreene, 30 December, 2015 Alkalinize urine via medications and diet. F/U 24-hr urine @ 6 mo;8 if no tx response, repeat stone analysis, per AUA9