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Struvite Stone (Infection Stone)

Magnesium-ammonium-phosphate stones developing as a result of urinary tract infection.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Struvite Stone (Infection Stone)?

Struvite stones (also known as MAP - magnesium-ammonium-phosphate stones or infection stones) are urinary tract stones developing as a result of urinary tract infection (UTI) caused by urease-producing bacteria; they account for 10-15% of all urinary stones. Causative organisms are primarily Proteus mirabilis (accounting for >60%), and Klebsiella, Pseudomonas, Staphylococcus, and Mycoplasma.

Bacterial urease enzyme breaks down urea into ammonia and CO2, increasing urine pH (>7.5), forming MAP and carbonate apatite crystals. Stones are typically large, soft, and rapidly grow into staghorn calculi (filling the entire collecting system), often associated with concurrent infection of the kidney parenchyma; they may lead to chronic renal failure if untreated.

Predisposing factors are recurrent UTIs (especially women), neurogenic bladder, urinary catheter, anatomic abnormalities, vesicoureteral reflux, ileal conduit, and immobilization. Diagnosis includes urine culture, contrast-enhanced CT, X-ray (radiopaque), urinalysis (alkaline pH, MAP crystals); treatment must include complete stone removal (PCNL preferred) + long-term targeted antibiotics; otherwise recurrence is inevitable.

Symptoms

Often asymptomatic in early stages
Recurrent urinary tract infection
Flank pain (vague, dull)
Hematuria
Fever, chills (with infection)
Cloudy and foul-smelling urine
Burning urination, frequency
Pyelonephritis-like findings (in active infection)
Renal failure findings (advanced stage)

Risk Factors

Recurrent urinary tract infections
Female sex (2:1)
Neurogenic bladder
Long-term urinary catheter use
Vesicoureteral reflux
Anatomic urinary tract abnormalities
Spinal cord injury
Long-term immobilization
Ileal conduit, urinary diversion
Diabetes
Immunosuppression

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent UTI history (>3 episodes/year)
  • Persistent flank pain
  • Fever-chills accompanied by urinary symptoms
  • Frequent need for urinary catheter changes
  • Hematuria
  • Persistent burning urination after pyelonephritis treatment
  • Decline in renal function findings

Treatment Methods

01
Urine culture and sensitivity (targeted antibiotic)
02
Contrast-enhanced CT (size, location, anatomy)
03
PCNL (Percutaneous Nephrolithotomy) - first-line (large stones)
04
ESWL: only small fragments
05
Stone-free goal: 100% (any residue triggers recurrence)
06
Pre-op IV antibiotic + long-term post-op (6-12 months)
07
Citrate solutions: hemiacidrin (Renacidin) chemolysis
08
Acetohydroxamic acid (urease inhibitor) - selected cases
09
Hydration (>3 L/day)
10
Acidifying foods (cranberry, ascorbic acid)
11
Catheter care, intermittent catheterization (neurogenic bladder)
12
Annual UTI screening and renal imaging follow-up

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.