SCANNING ELECTRON MICROSCOPIC EXAMINATIONS OF CRYSTAL AGGLOMERATION IN URINE OF STONE-FORMERS ASSOCIATED WITH URINARY INFECTION

Abstract

Freshly voided urine and four-hour-standing urine samples from five stone-formers associated with infection of the upper urinary tract were collected to investigate the possible role of urinary infection in agglomerating urinary crystalloid substances. A control group consisted of seven simple stone-formers and seven recurrent and multiple stone-formers of the upper urinary tract. The urine sample was filtered through a nuclepore filter, and then the agglomerates obtained were studied under scanning electron microscopy. Crystal agglomerates were small in size and number in the simple stone-formers. The sizes and numbers of crystal agglomerates in the recurrent and multiple stone-formers were bigger than those in the simple stone-formers. In the stone-formers associated with urinary infection, crystal agglomerates were combined with erythrocytes, fibrin, other organic substances and bacteria. And crystal agglomerates were larger than those of the control group. Bacteria seemed to play a special role as an adhesive agent for crystal agglomerates and/or organic substances.
The results obtained suggest that urinary infection acclerates crystal agglomeration in the urine of stone-formers mainly through bacterial adherence or cohesion.