Chemolysis of urinary calculi

Chemolysis can be accomplished with systemic or local administration of the active agent. Its use depends on an accurate knowledge of the composition of the stone. Chemolysis is valuable as a clean-up technique after various debulking procedures for struvite calculi. Uric acid calculi are the most soluble of all the stones, making chemolysis satisfying as a primary and adjunctive therapy. Chemolysis of cystine stones generally should follow extracorporeal or percutaneous lithotripsy. Patients at risk for surgery may be treated well with this technique. In the era of cost-containment and decreasing length of stay, however, it is increasingly difficult to justify admissions for this form of therapy.