Editing Stones: Evaluation and Medical Management (section)

===Infection/Struvite stones===
*'''<span style="color:#ff0000">The preferred management of struvite calculi involves aggressive surgical approaches'''
**'''The medical management of infection calculi centers on the prevention of recurrence, rather than medical dissolution.'''
*'''<span style="color:#ff0000">Acetohydroxamic acid (AHA) may be offered to patients with residual or recurrent struvite stones only after surgical options have been exhausted.</span>'''
** '''Patients treated for struvite stones may still be at risk for recurrent UTIs after stone removal, and in some patients surgical stone removal is not feasible.'''
**'''The use of a urease inhibitor, AHA, may be beneficial in these patients, although the extensive side effect profile may limit its use. In particular, patients taking this medication should be closely monitored for phlebitis and hypercoagulable phenomena'''
**'''<span style="color:#ff0000">Acetohydroxamic acid (AHA)'''
*** '''MOA: urease inhibitor; may reduce the urinary saturation of struvite and therefore delay stone formation'''
*** '''<span style="color:#ff0000">Adverse effects'''
**** Minor side effects common (up to 30% of patients)
**** '''<span style="color:#ff0000">Deep venous thrombosis</span>''' (15%)
**** '''<span style="color:#ff0000">Hemolytic anemia'''
***** '''Most serious side effect'''
***** '''Occurs in up to 15% of the patients; more prevalent in patients with renal insufficiency'''
****'''<span style="color:#ff0000">Phlebitis'''
*** '''Frequently reserved for patients deemed too ill for surgical management.'''
*Long-standing effective control of infection with urea-splitting organisms should be achieved if at all possible with improved bladder health, adequate urinary drainage, and suppressive antibiotics
*'''Phosphate therapy is contraindicated in cases of infection calculi because this medication may promote further stone formation.'''