Which of the following stones is hard to break by ESWL
Correct Answer: Calcium oxalate monohydrate
Description: In general CYTINE , calcium phosphate,specifically Brushite ( Calcium phosphate Hydroxyapatite) and Calcium oxalate monohydrate stones , Matrix stones ( Protien rich stone) are most resistant to ESWL . All these are RADIO OPAQUE. Treatment of choice:- Renoscopic removal. The remainder of common stone type by order of increasing fragility are struvite , calcium oxalate dihydrate and finally uric acid stones.These are RADIO LUCENT ref :- Campbell - Walsh urology 11th edition .chapter 53 , pg no :- 1242 Bailey and Love 27th edition . chapter 76 , pg no 1408.
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