BERKELEY, CA (UroToday.com) - In another excellent article from the University of Wisconsin, the authors point out again the effectiveness of medical therapy for preventing recurrent cystine stone disease. Over a 3.5 year period, the 11 compliant patients (i.e. present for at least 50% of their scheduled appointments) had a stone free rate of 73% and a surgical event rate of 1 per patient whereas the 9 noncompliant patients had a stone free rate of only 33% and a surgical event rate of 4 per patient. The regimen consisted of urinary alkalinization with potassium citrate and the use of a medication to reduce the cystine concentration (e.g. captopril, D penicillamine or alpha -mercaptopropionyl glycine). The latter regimen was pushed until the cystine level dropped to under 300 mg/l. In addition, to these measures, other factors that may be helpful is pushing urine output to a minimum of 3 liters per day and reducing sodium intake. To be sure this is a difficult disease to treat; however, it is heartening to know, that the therapy, when followed, works!

J. Urology 174: 2250-2252, December, 2005