Urolithiasis最新文献

{"title":"Impact of double stent type on anxiety levels in patients undergoing ureteroscopy with double-J stent placement.","authors":"Akif Erbin, Yusra Nur Aksakal, Halil Lutfi Canat","doi":"10.1007/s00240-025-01694-4","DOIUrl":"https://doi.org/10.1007/s00240-025-01694-4","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"23"},"PeriodicalIF":2.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal pelvis pressure and flowrate with a multi-channel ureteroscope: invoking the concept of outflow resistance.","authors":"Anthony F Bonzagni, Timothy L Hall, Khurshid R Ghani, William W Roberts","doi":"10.1007/s00240-025-01691-7","DOIUrl":"https://doi.org/10.1007/s00240-025-01691-7","url":null,"abstract":"<p><p>Understanding renal pelvis pressure (P_RP) during ureteroscopy (URS) has become increasingly important. High irrigation rates, desirable to maintain visualization and limit thermal dose, can increase P_RP. Use of a multi-channel ureteroscope (m-ureteroscope) with a dedicated drainage channel is one strategy that may facilitate simultaneous low P_RP and high flowrate. We sought to define the relationship between P_RP and flowrate across a range of different outflow resistance scenarios with an m-ureteroscope versus a single-channel ureteroscope (s-ureteroscope). The m- or s-ureteroscope was placed into the pelvis of a validated silicone kidney-ureter model. Trials were conducted at irrigation pressures (50-150 cmH₂0) and five different outflow resistance scenarios simulated with catheters of different lengths and diameters. P_RP was measured with a fiber optic pressure sensor positioned in the renal pelvis. Flowrate was determined by measuring the mass of drainage fluid over 60 s. P_RP was lower with the m-ureteroscope than the s-ureteroscope when equivalent flowrates were delivered (i.e. 34 vs. 82 cmH₂0 respectively with 15 ml/min irrigation in a high outflow resistance scenario). Flowrate was higher with the m-ureteroscope than the s-ureteroscope when equivalent irrigation pressures were applied (i.e. 28 vs. 14 ml/min respectively with irrigation pressure 150 cmH₂0 in a high outflow resistance scenario). The m-ureteroscope has improved pressure-flow dynamics imparting important clinical benefits. More importantly, this approach to framing ureteroscopy in the context of pressure-flow relationships related by resistance values allows quantification of ureteroscopy within a deterministic system, which can be used to streamline future device development and technological innovation.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"22"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constructive feedback on the use of FV-UAS with RIRS for treating 2-3 cm upper urinary tract stones.","authors":"Sigen Huang, Xiaolan Huang, Jianbin Luo","doi":"10.1007/s00240-025-01692-6","DOIUrl":"https://doi.org/10.1007/s00240-025-01692-6","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"21"},"PeriodicalIF":2.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating postoperative complications in standard percutaneous nephrolithotomy for renal stones larger than 2 cm: a retrospective study utilizing the E-PASS scoring system.","authors":"Mucahit Gelmis, Berk Bulut, Mustafa Gokhan Kose, Serkan Gonultas, Ali Ayten, Burak Arslan","doi":"10.1007/s00240-024-01689-7","DOIUrl":"https://doi.org/10.1007/s00240-024-01689-7","url":null,"abstract":"<p><p>Percutaneous nephrolithotomy (PCNL) is a widely preferred method for treating complex kidney stones, particularly in patients with larger or more complicated stones. Despite its advantages, such as minimal invasiveness and a shorter recovery time, postoperative complications can occur, thereby necessitating effective risk assessment tools to identify at-risk patients. This study evaluated the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system's utility in predicting postoperative complications following standard PCNL. This retrospective study included 218 patients who underwent standard PCNL from June 2020 to August 2024 at our institution. Data on demographics, comorbidities, and perioperative factors were collected and analyzed. Postoperative complications were classified using the modified Clavien-Dindo system. The E-PASS scoring system, which incorporates the Preoperative Risk Score (PRS), Surgical Stress Score (SSS), and Comprehensive Risk Score (CRS), was applied to stratify risk. Postoperative complications occurred in 38 patients (17.4%). Significant predictors included advanced age, higher American Society of Anesthesiologists (ASA) scores, and comorbidities like diabetes and coronary artery disease. Intraoperative factors, such as prolonged operative times, number of access and greater blood loss, were also associated with complications. Multivariate analysis identified higher CRS and greater stone burden as independent predictors (p = 0.012 and p = 0.037, respectively). The CRS demonstrated moderate discrimination, with an area under the curve (AUC) of 0.747. The E-PASS scoring system effectively predicts postoperative complications in PCNL, underscoring the importance of thorough preoperative and intraoperative evaluation. Future studies should explore its broader applicability across other urological procedures.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"20"},"PeriodicalIF":2.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ureteral access sheath or percutaneous nephrostomy during flexible ureteroscopy: which is better?","authors":"Mohamed Abdelrahman Alhefnawy, Moaz Fathy Ismail Abdelrahman, Hosam Abdel-Fattah Abo-Elnasr, Helmy Ahmed Eldib","doi":"10.1007/s00240-024-01683-z","DOIUrl":"10.1007/s00240-024-01683-z","url":null,"abstract":"<p><p>Studies in literature discussed the drawbacks of the ureteral access sheath use in flexible ureteroscopy and in the same time mentioned the benefits of ureteral access sheath in decreasing the incidence of urosepsis and better stone free rate. In the current study we aim to compare between percutaneous nephrostomy tube (PCN) insertion before flexible ureteroscopy and conventional ureteral access sheath (UAS) flexible ureteroscopy in terms of safety, efficacy and perioperative outcomes. In all, 100 Patients aged 20 to 67 years with upper ureteric stones and mild hydronephrosis or renal pelvic stones less than 20 mm with mild hydronephrosis were randomized into 2 groups; patients undergoing PCN insertion before flexible ureteroscopy, and patients undergoing the conventional UAS flexible ureteroscopy. Patients with active urinary tract infection, patients with urinary diversions or malformations and patients with uncontrolled coagulable status were excluded from the study. Perioperative data were recorded. This study was conducted on 50 PCN group and 50 UAS group. Age varied from 20.0 to 67.0 years. Males consisted more than half of study groups, 52% of PCN group and 66% of UAS group. Weak significant difference was found in need for ureteral pre-operative stenting between groups (8% with PCN vs. 22% with UAS, p 0.04995). There was no significant difference between two groups in intra-operative complications (mucosal injury, failed operation, perforation, false passage and conversion to other procedure), but there was significant difference in bleeding between the groups (6% with PCN vs. 22% with UAS, p = 0.021). There was no significant difference between two groups in post-operative complications (infection, fever, pain, hematuria, other complications, stone free rate, readmission and stent duration), but there was significant decrease in operative time (48.85 ± 13.861 in PCN group versus 56.82 ± 14.61 in UAS group, p = 0.0003). We conclude that PCN insertion before flexible ureteroscopy provides a safe technique with comparable outcomes to UAS use.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"18"},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing lithotripsy efficiency in retrograde intrarenal surgery via a flexible kidney-fixed position: findings from a prospective cohort study.","authors":"Zhen Zhang, Lei Zhou, Zongsan Cheng, Xiaoma Zhang","doi":"10.1007/s00240-024-01690-0","DOIUrl":"10.1007/s00240-024-01690-0","url":null,"abstract":"<p><p>Retrograde intrarenal surgery (RIRS) is recognized as an effective intervention for renal stones measuring less than 20 mm. This study aims to assess the efficacy and safety of a novel flexible kidney-fixed position compared to the conventional lithotomy position, focusing on lithotripsy efficiency and stone-free rates (SFR). A total of 100 patients undergoing unilateral RIRS between January 2023 and September 2024 were randomly allocated to either the conventional lithotomy position group or the kidney-fixed position group. Comparative analyses were conducted on demographic data, stone characteristics, intraoperative parameters, kidney movement metrics, and postoperative complications. A total of 97 patients successfully completed the study, with 47 participants assigned to the conventional lithotomy group and 49 to the kidney-fixed group. The kidney-fixed position was associated with a significant reduction in kidney movement (4.00 mm compared to 15.30 mm, p < 0.001) and a decrease in operative time (48.35 min versus 71.72 min, p < 0.001). Additionally, the SFR for stones measuring ≤ 4 mm was significantly higher in the kidney-fixed group (91.84% compared to 68.09%, p = 0.020). The implementation of a flexible kidney-fixed position markedly improves the efficacy of lithotripsy during RIRS, resulting in reduced operative time and an elevated SFR without a corresponding increase in postoperative complications. This technique holds promise for advancing the surgical management of renal calculi, warranting further investigation to substantiate these findings and assess long-term outcomes.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"19"},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of flexible and navigable suction ureteral access sheath with conventional ureteral access sheath for pediatric retrograde intrarenal surgery: a single-center propensity-matched analysis.","authors":"Bilge Turedi, Ali Sezer","doi":"10.1007/s00240-024-01686-w","DOIUrl":"https://doi.org/10.1007/s00240-024-01686-w","url":null,"abstract":"<p><p>The flexible and navigable suction ureteral access sheath (FANS-UAS) has increasingly been recognized as a potential game changer for retrograde intrarenal surgery (RIRS). While this innovative technology has demonstrated promising results in adult populations, there is a notable lack of evidence regarding its application in pediatric cases, particularly in comparison to conventional ureteral access sheaths (CUAS). This study aimed to perform a comparative analysis of pediatric kidney stone cases treated with RIRS using FANS-UAS and CUAS. We conducted a retrospective matched pair analysis, matching patients based on preoperative age, stone location, and stone size. After matching, data from 46 patients (23 in each group) were analyzed. The groups were comparable in terms of age, hydronephrosis degree, location and size of the stone (p = 0.543, p = 0.807, p = 0.840, and p = 0.577, respectively). Operation times were shorter in the FANS-UAS group (CUAS: 67.9 ± 21.0 min, FANS-UAS: 50.4 ± 21.1 min, p = 0.007). The initial stone-free rate (SFR) was 65.2% in the CUAS group and 91.3% in the FANS-UAS group, with a statistically significant difference (p = 0.032). However, no significant difference was found regarding the final SFR (p = 0.295). The number and duration of DJ-stents, were significantly higher in the CUAS group (p = 0.006 for both). The FANS-UAS group had a significantly fewer anesthesia sessions (p = 0.001). There were no significant differences in complication rates (p = 0.303). Our findings suggest that FANS-UAS offers significant advantages over CUAS in pediatric RIRS, including higher initial success rates, shorter operation times, reduced anesthesia requirements, and fewer treatment sessions, with comparable safety profiles.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"17"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolyl hydroxylase domain inhibitors prevent kidney crystal formation by suppressing inflammation.","authors":"Kengo Kawase, Shuzo Hamamoto, Rei Unno, Kazumi Taguchi, Atsushi Okada, Takahiro Yasui","doi":"10.1007/s00240-024-01677-x","DOIUrl":"https://doi.org/10.1007/s00240-024-01677-x","url":null,"abstract":"<p><p>The early stages of kidney crystal formation involve inflammation and hypoxia-induced cell injury; however, the role of the hypoxic response in kidney crystal formation remains unclear. This study investigated the effects of a prolyl hydroxylase domain inhibitor (roxadustat) on renal calcium oxalate (CaOx) crystal formation through in vitro and in vivo approaches. In the in vitro experiment, murine renal tubular cells (RTCs) were exposed to varying roxadustat concentrations and CaOx crystals. CaOx monohydrate (COM) crystal adhesion was evaluated using fluorescent labels, whereas western blotting was used to examine protein expression. Quantitative real-time polymerase chain reaction was used to analyze gene expression changes. Macrophage responses were investigated by co-culturing them with RTCs treated with COM. In the in vivo experiment, C57BL/6J mice were injected with roxadustat or saline for 2 days, followed by glyoxylate for 6 days to induce renal crystal deposition. Biochemical measurements recorded plasma erythropoietin, urinary data, and pH levels. Roxadustat suppressed the adhesion of COM crystals to RTCs and the expression of proinflammatory genes, such as chemokine (C-C motif) ligand 2 (Ccl2) and secreted phosphoprotein 1 (Spp1). Roxadustat decreased the expression levels of Ccl2, tumor necrosis factor (Tnf), and interleukin 6 (Il6) in co-cultured macrophages. In the in vivo experiment, the amount of renal CaOx crystal deposits was significantly lower in the roxadustat-treated group than in the vehicle group. Roxadustat treatment decreased Ccl2, Tnf, and adheision G protein-coupled receptor E1 (Adgre1) expression in the kidneys. Roxadustat reduced kidney inflammation and CaOx crystal deposition, suggesting its potential as a therapeutic option for kidney stone prevention.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"16"},"PeriodicalIF":2.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative use of the new pulsed-thulium: YAG laser for ureteroscopic lithotripsy: can the \"kidney stone calculator\" predict lithotripsy duration?","authors":"Stessy Kutchukian, Marie Chicaud, Steeve Doizi, Catalina Solano, Olivier Traxer, Frédéric Panthier","doi":"10.1007/s00240-024-01679-9","DOIUrl":"https://doi.org/10.1007/s00240-024-01679-9","url":null,"abstract":"<p><p>To assess the accuracy of Kidney Stone Calculator(KSC), a software designed for surgical planning, in predicting the duration of lithotripsy during flexible ureteroscopy(FURS) when using the novel pulsed-Thulium: YAG(p-Tm: YAG) laser. From February to August 2023, a single-center prospective study was conducted, including patients with kidney or ureteral stones through non-contrast computed tomography(NCCT), who underwent FURS with p-Tm: YAG laser lithotripsy. KSC used three-dimensional segmentation of the stones from NCCT images, along with an interactive user interface for laser settings, to estimate the stone volume(SV) and the lithotripsy duration(LD). The correlation between the estimated(esLD) and effective(efLD) lithotripsy duration was evaluated. A multiple linear regression analysis was conducted to identify preoperative and intraoperative factors affecting discrepancies between esLD and efLD. Twenty-eight patients were included with a median age of 55(48-74) years and 71% of men. Stone were located in the renal cavities(71%), ureter(21%) or both locations(8%). Median maximum stone diameter(MSD) and SV were respectively 14(11-30)mm and 1239(294, 2000)mm³. Nine patients had a SV equal to or greater than 2000mm³. EsLD and efLD did not differ(28 vs. 32 min, p = 0.8892), and were highly and positively correlated(r = + 0.90,p-value = < 0.001). Multivariate analysis indicated that the difference between estimated and effective lithotripsy were correlated with the stone volume(> 2000mm³), the use of ureteral access sheath and for struvite stones. \"Kidney Stone Calculator\" can accurately estimate LD during FURS with the p-Tm: YAG laser. Variables such as stone volumes over 2000mm³ and stone composition could be integrated the estimation. KSC is the only software that estimates LD with Holmium: YAG, Thulium Fiber and p-Tm: YAG lasers.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"14"},"PeriodicalIF":2.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Supracostal ultrasound guided approach percutaneous nephrolithotomy (SUGA-PNL) versus retrograde intrarenal surgery for large volume isolated upper calyceal stones: a prospective randomized analysis.","authors":"Jinchen Wu, Liling Qiu, Jiansheng Xiao","doi":"10.1007/s00240-024-01687-9","DOIUrl":"https://doi.org/10.1007/s00240-024-01687-9","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"13"},"PeriodicalIF":2.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}