Do you periodically check a urine culture for patients without dysuria but who have a history of struvite kidney stones and urinary tract infections with urease producing organisms?  

Struvite nephrolithiasis is caused by a high urine pH (usually>7.0). Typically, a urine this alkaline requires urinary infection with a bacterium that produces urease, (Proteus, Providencia, Klebsiella) which in turn splits naturally occurring urea into ammonium, driving the pH to supraphysiologi...