Urolithiasis最新文献

{"title":"Changes in renal function in patients with chronic kidney disease after ureteroscopy: a systematic review and meta-analysis from EAU endourology.","authors":"Ali Talyshinskii, María Florencia Frascheri, Lazaros Tzelves, Andreas Skolarikos, Robert Geraghty, Niall F Davis, Bhaskar Kumar Somani","doi":"10.1007/s00240-026-02067-1","DOIUrl":"10.1007/s00240-026-02067-1","url":null,"abstract":"<p><p>The impact of ureteroscopy (URS) and retrograde intrarenal surgery (RIRS) on renal function in patients with chronic kidney disease (CKD) remains unclear, particularly given concerns regarding intrarenal pressure and repeated interventions. We performed a systematic review and meta-analysis to evaluate changes in estimated glomerular filtration rate (eGFR) following URS or RIRS in patients with pre-existing CKD. A systematic review and meta-analysis were conducted according to PRISMA guidelines and registered in PROSPERO (2025). Databases were searched in March 2026. Studies reporting pre- and postoperative eGFR in patients with established CKD or cohorts including patients with reduced baseline renal function undergoing standard URS or RIRS were included. A random-effects model (REML with Knapp-Hartung adjustment) was used to calculate pooled mean differences (MD) in eGFR. Seven studies including 742 patients met inclusion criteria. Follow-up ranged from 1 month to over 2 years. The pooled mean difference in eGFR was +2.8 mL/min/1.73 m² (95% CI -2.8 to +8.4; p = 0.27), indicating no significant overall change in renal function, with substantial heterogeneity (I² = 89.6%). A greater increase in eGFR was observed in the ureteral stone subgroup (MD +12.26 mL/min/1.73 m²; 95% CI 9.03-15.49); however, this estimate was derived from a single study and should be interpreted cautiously. No study reported progression to dialysis attributable to ureteroscopic intervention. Evidence certainty remains very low, highlighting the need for prospective studies with standardized long-term assessment. Available evidence does not suggest a clinically meaningful deterioration in renal function following URS or RIRS and indicates that renal function may improve in selected patients after relief of obstruction; however, these findings are based on very low-certainty evidence.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076007","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":"The ROI-modified mayo adhesive probability score as a predictor of postoperative fever after retrograde intrarenal surgery.","authors":"Abdullah Esmeray, Hasan Samet Güngör, Abdurrahman İnkaya, Murat Beyatlı, Cemil Emre Yurtseven, Mehmet Umut Evci, Resul Sobay","doi":"10.1007/s00240-026-02069-z","DOIUrl":"10.1007/s00240-026-02069-z","url":null,"abstract":"<p><p>In our study, we investigated the predictive value of the region of interest (ROI)-modified Mayo Adhesive Probability (MAP) score which objectively assesses perirenal fat density for postoperative fever following retrograde intrarenal surgery (RIRS), as well as its comparative performance against the conventional MAP score. This retrospective study included 318 patients who underwent RIRS with a sterile urine culture between January 2021 and May 2025. Demographic, stone, and procedure-related data were recorded. Both scores were calculated from non-contrast computed tomography (CT) images prior to surgery; independent risk factors for postoperative fever were identified using logistic regression models and compared via receiver operating characteristic (ROC) analysis. Postoperative fever developed in 41 patients (12.9%). In the model including the conventional MAP score, diabetes mellitus (DM) (odds ratio [OR] = 3.475, p = 0.002), recurrent urinary tract infection (UTI) (OR = 3.567, p = 0.039) and MAP ≥ 3 (OR = 2.707, p = 0.006) were identified as independent risk factors. In the model including the ROI-MAP score, DM (OR = 2.953, p = 0.008) and ROI-MAP ≥ 3 (OR = 7.057, p < 0.001) were identified as independent predictors. The ROI-MAP score demonstrated statistically significantly higher predictive accuracy compared to the conventional MAP score (area under the curve [AUC]: 0.789 vs. 0.709; p = 0.011). The ROI-modified MAP score, which reduces interobserver variability through Hounsfield unit (HU)-based measurement of perirenal fat density, may serve as a potentially useful adjunct for identifying patients at risk of fever following RIRS during the preoperative period.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075969","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":"Adherence to medical management of kidney stones: A systematic review.","authors":"Bassel Salka, Rami Barqawi, Sarosh Irani, Mustapha Jaber, Mohammad Jafri, Naveen Kachroo","doi":"10.1007/s00240-026-02066-2","DOIUrl":"10.1007/s00240-026-02066-2","url":null,"abstract":"<p><p>The effectiveness of dietary and pharmacologic stone prevention strategies may be limited by poor patient adherence. This systematic review aims to assess adherence to the American Urological Association (AUA) guidelines for medical management of kidney stone disease by (1) determining how adherence influences clinical outcomes, (2) identifying which preventive interventions demonstrate the highest adherence, and (3) characterizing factors associated with adherence. A systematic review was conducted according to PRISMA guidelines. PubMed, Scopus, and Embase were searched from database inception through January 1, 2026, using terms related to nephrolithiasis and patient adherence/compliance. Studies involving adults with prior kidney stones reporting adherence to dietary, pharmacologic, or metabolic evaluation-based prevention were included. Dual-reviewer screening and standardized data extraction were performed. No protocol was prospectively registered. Of 909 identified studies, 35 met inclusion criteria, comprising 57,970 patients. Across studies, greater adherence consistently correlated with decreased subsequent stone related events. Increased fluid intake demonstrated the highest lifestyle adherence (~ 65-85%), while thiazide diuretics showed the greatest pharmacologic adherence (43-87%), exceeding citrate therapy and dietary modification. Adherence to metabolic evaluation and longitudinal follow-up testing was relatively low. Predictors of improved adherence included older age, higher education and socioeconomic status, prior stone events, and greater disease severity. Traditional physician counseling has a positive relationship on adherence to medical management. Adherence to guideline-based kidney stone prevention strongly influences clinical outcomes. Tailored counseling and prevention plans informed by patient and disease characteristics are critical to improve effectiveness of stone prevention therapy.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076020","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":"Worldwide variations in purchase and per-procedure costs of single-use flexible ureteroscopes and flexible navigable access sheaths: the economic impact of reuse strategies on procedural outcomes from a 40-country YAU-EAU endourology international collaboration.","authors":"Amelia Pietropaolo, Hayder Alhusseinawi, Boyke Soebhali, Johan Cabrera, Azimdjon Tursunkulov, Deepak Ragoori, Fabio C Vincentini, Gaston M Astroza, Kremena Petkova, Cho Sung Yong, Niall Davis, Christopher Netsch, Benedikt Becker, Chu Ann Chai, Frederic Panthier, Chinnakhet Ketsuwan, Otas Durutovic, Catalina Solano, Nariman Gadzhiev, Naeem Bhojani, Stavros Gravas, Bogdan Geavlete, Ahmed Said Zribi, Peter Kronenberg, David Lifshitz, Helene Jung, Vineet Gauhar, Steffi Kar Kei Yuen, Felipe Pauchard, Arman Tsaturyan, Eugenio Ventimiglia, Lazaros Tzelves, Begona Ballesta Martinez, Rifat Burak Ergül, Tarik Emre Sener, Łukasz Nowak, Thomas Tailly, Matthias Boeykens, Alba Sierra, Ali Talyshinskii, Etienne Xavier Keller, Francesco Esperto, Alberto Olivero, Ioannis Mykoniatis, Victoria Jahrreiss, Patrick Juliebø-Jones, Saeed Bin Hamri, Pablo Contreras, Luis Rico, Maria Florencia Frascheri, B K Somani","doi":"10.1007/s00240-026-02058-2","DOIUrl":"10.1007/s00240-026-02058-2","url":null,"abstract":"<p><p>Endourological practice increasingly relies on single-use devices, the costs of which vary considerably across regions and healthcare systems. Flexible single-use ureteroscopes (FURS) and flexible and navigable suction ureteral access sheaths (FANS) represent a substantial proportion of ureteroscopy-related expenditure. To mitigate these costs, some centres have adopted reuse strategies aimed at reducing per-procedure expenses. The aim of this study was to evaluate international variation in the purchase prices and real-world per-procedure costs of FURS and FANS, and to assess the economic impact of device reuse strategies. An international collaborative study coordinated by the Young Academic Urologists (YAU) and European Association of Urology (EAU) Endourology Groups was conducted across 40 countries. Endourologists provided real-world procurement data regarding purchase prices, utilization patterns, and equipment-related procedural cost of single-use FURS and FANS between March 2025 and January 2026. All costs were converted to Euros (€). In centres adopting institution-validated reuse protocols, weighted per-procedure costs were calculated by dividing device acquisition costs by the number of effective uses. Countries were stratified according to cost quartiles to assess global variability. Data were collected from 40 countries across Europe, Asia, North and South America, and the Middle East. The median purchase cost of single-use FURS was €676.7 (IQR €579.0-975.0), ranging from €310 in Romania to €1638 in Cyprus. When adjusted for reuse practices, the median equipment-related procedural cost decreased to €425.0 (IQR €216.4-611.2), with values ranging from €92 in Brazil to €1343 in Ireland. The median purchase cost of FANS was €180 (IQR €130-226), ranging from €36 in Uzbekistan to €400 in the United States. Weighted per-procedure costs decreased to a median of €130.5 (IQR €77.5-182.2). The combined equipment cost of FURS and FANS for suction-assisted ureteroscopy ranged from €139.2 in Uzbekistan to €1691 in the United States (USA). Countries adopting cost-conscious reuse strategies achieved substantial reductions in per-procedure expenditure despite high initial acquisition costs. Marked international variability exists in the procurement and equipment-related procedural cost of FURS and FANS, with up to fourfold differences observed between countries. Reuse strategies substantially reduce equipment-related expenditure and may improve the economic sustainability of ureteroscopy. These findings highlight the importance of considering regional cost structures and resource utilization when evaluating the value of emerging endourological technologies.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040575","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":"Percutaneous nephrostomy tubes in pregnancy: a multi-institutional experience.","authors":"Jonathan J Song, Annaliese Ionson, Grayden Cook, Madison Lyon, Daniel A Wollin, Smita De","doi":"10.1007/s00240-026-02054-6","DOIUrl":"10.1007/s00240-026-02054-6","url":null,"abstract":"<p><p>Renal colic in pregnancy poses challenges from initial imaging modality to need for urgent decompression and subsequent management. Each decision carries risks for mother and fetus. We share our multi-institutional experience with percutaneous nephrostomy tubes (PCNs) in pregnant patients with suspected renal colic. Pregnant patients with suspected renal colic initially managed with PCNs were identified at two institutions from 2011-2025. Retrospective chart review included demographics, obstetric history, imaging, radiation exposure, and other clinical outcomes. Descriptive statistics identified clinical trends. Of 55 included patients, mean age at presentation was 29.7 ±5.6 years with gestational age of 24.1 ±8.2 weeks. Bilateral PCNs were placed in 9 (16.4%) patients, 5 (9.1%) patients previously experienced preterm birth, and 31 (56.4%) patients had prior stones. Readmissions were common, with 33 (60%) patients readmitted for PCN malfunction, 26 (47.3%) patients for pyelonephritis, and 28 (50.9%) patients for pain. Thirty-eight patients underwent at least one PCN exchange, with a mean of 2.3 ±2.8 exchanges per patient at an interval of 29.5 ±17.2 days. Of 128 PCN exchanges, 71 (55.4%) were complicated, with 48 (37.5%) performed for blockage or encrustation. Mean cumulative radiation exposure over the pregnancy was 178.8 ±330.9 mGy. Sixteen (29.1%) patients had PCNs removed during ureteroscopy for definitive treatment, while 11 (20%) patients experienced preterm birth. PCNs in pregnancy carry risks, including readmissions, complicated exchanges, radiation exposure, and preterm birth. We highlight the need for optimized management that coordinates care across specialties, improves patient selection, and includes primary ureteroscopy when safe.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040642","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":"Incidence and context-specific risk patterns of ureteral avulsion and perforation during ureteroscopy: EAU endourology systematic review and meta-analysis.","authors":"Ali Talyshinskii, Nariman Gadzhiev, Vigen Malkhasyan, Selçuk Güven, Theodoros Tokas, Steffi Kar Kei Yuen, Vineet Gauhar, Arman Tsaturyan, Panagiotis Kallidonis, Eugenio Ventimiglia, Patrick Juliebø-Jones, Bhaskar Kumar Somani","doi":"10.1007/s00240-026-02068-0","DOIUrl":"10.1007/s00240-026-02068-0","url":null,"abstract":"<p><p>Ureteral perforation and avulsion are rare but potentially severe complications of ureteroscopy (URS), and their reported incidence varies substantially because of heterogeneous populations, techniques, and denominators. The objective of presented meta-analysis was to estimate the procedure-level incidence of ureteral perforation and avulsion during URS for ureteral stones and explore study-level factors associated with these complications. This systematic review and meta-analysis followed the PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420261441125). PubMed/MEDLINE, Embase, Scopus, Web of Science, the Cochrane Library, and Google Scholar were searched on June 1, 2026. Random-effects meta-analyses of proportions used logit transformation and REML estimation. Heterogeneity, prediction intervals, small-study effects, influence diagnostics, subgroup analyses, and exploratory univariable meta-regression were assessed. Risk of bias was evaluated using the JBI Critical Appraisal Checklist for Case Series. Fifteen studies comprising 20,635 ureteroscopic procedures were included. The pooled incidence of ureteral perforation was 1.89% (95% CI 1.11-3.19%; I²=93.5%), with a prediction interval of 0.26-12.45%. Perforation incidence was 1.39% in studies not restricted to impacted stones versus 13.71% in impacted-only cohorts. The pooled incidence of ureteral avulsion was 0.32% (42 events; I²=64.9%), with a prediction interval of 0.04-2.76%; corresponding subgroup rates were 0.24% and 2.44%, respectively. Among non-impacted-only studies, a higher male proportion was associated with greater study-level odds of perforation (OR 2.03 per 10% increase; 95% CI 1.26-3.26; p = 0.003). Other examined demographic, stone, instrument, and lithotripsy variables were not significantly associated with either outcome; meta-regression findings remain exploratory. Ureteral perforation and avulsion remain uncommon but clinically important URS complications. Impacted stones identify a markedly higher-risk procedural context, supporting risk-stratified, atraumatic ureteroscopic strategies.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040941","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":"Therapeutic and antioxidant effects of Camelus dromedarius hump fat oil against ethylene glycol-induced nephrocalcinosis and hepato-renal damage in wistar rats: a biochemical and histopathological study.","authors":"Beybeti Ishagh, Abderrazak Aboulghazi, Widad Tbatou, Asmae El Ghouizi, Badiaa Lyoussi, Zineb Benziane Ouartini","doi":"10.1007/s00240-026-02055-5","DOIUrl":"10.1007/s00240-026-02055-5","url":null,"abstract":"<p><p>Renal stones remain a prevalent renal disorder characterized by high recurrence rates and limited therapeutic options, encouraging continued research into novel agents capable of treating established stone disease. Camelus dromedarius hump fat has long been used in North African alternative medicine to treat various dermal and inflammatory diseases. This study aims to evaluate the antioxidant activity, specifically radical scavenging, and the therapeutic potential of this fat against Calcium oxalate stones induced by Ethylene glycol in a Wistar rat model. Twenty Wistar rats were divided into four groups (n=5). The first group serves as the control. The three other groups received EG in their drinking water until stones formed. Rats were fed a fresh dromedary hump fat diet at 45% w/w daily. Urinary parameters (volume, pH, electrolytes), serum biochemical assessments, and measured creatinine clearance were analyzed. Renal histopathology was performed to evaluate tissue changes. The EG-treated rats showed significant disturbances in all physiological parameters, including decreases in urinary volume, pH, and urinary electrolyte excretion. DHF demonstrated strong antioxidant activities, with DPPH scavenging (69.158%-85.571%), FRAP values (70.785%-83.971%), and ABTS (59.145%-89.195%), indicating potential to reduce oxidative stress. In addition to that, treatments with the DHF diet significantly increase urinary volume from 6.3 ± 0.2 ml to 10.12 ± 0.1 ml (p < 0.001). These alterations extend to serum creatinine and urea levels. A high increase in serum creatinine and urea levels was shown. The DHF-treated group showed a creatinine clearance of 3.46 ± 0.68 ml/min on day 21. Importantly, the DHF diet protected the liver from EG-induced damage, as evidenced by serum levels of gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) that were near control levels. In contrast, the EG-only group exhibited marked elevations in enzyme levels (p < 0.01). These findings suggest that the DHF 45% w/w diet may exert its protective effect by reducing oxidative stress and preserving tubular epithelial integrity, thereby improving urinary electrolyte excretion, decreasing crystal formation, and protecting renal tissue.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040589","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":"Impact of enhanced preoperative education on postoperative pain and emergency department visits following ureteric stent insertion: a prospective, exploratory (pilot) randomized controlled trial.","authors":"Dor Golomb, Ido Bar, Alon Moore Galindo, Orit Raz","doi":"10.1007/s00240-026-02065-3","DOIUrl":"10.1007/s00240-026-02065-3","url":null,"abstract":"<p><p>To evaluate the effect of comprehensive preoperative patient education on postoperative pain and unplanned emergency department (ED) visits following ureteric stent insertion, we conducted a prospective, exploratory (pilot) randomized controlled trial. Patients were randomized 1:1 using a computer-generated sequence and sealed, sequentially numbered opaque envelopes prepared by an investigator independent of enrollment; the intervention group received an in-depth, multimodal educational session (an extended verbal explanation, a short video, and handling of a sample stent), while the control group received standard counseling (a brief explanation and a pamphlet). Co-primary outcomes were maximum Visual Analog Scale (VAS) pain score on postoperative day 1 (POD1) and unplanned ED visits within 30 days. No a priori sample-size calculation was performed; the sample reflects consecutive eligible patients enrolled over a prospectively defined 11-month window, and the trial is reported as exploratory and hypothesis-generating. Among 48 randomized patients (19 intervention, 29 control - an imbalance attributable to unrestricted, non-blocked randomization in a small sample), the intervention group had a lower median POD1 VAS score (1 vs. 3; Mann-Whitney p = 0.084) and fewer unplanned ED visits (5.3% vs. 24.1%; exact conditional odds ratio 0.18, 95% CI 0.004-1.62; risk difference - 18.9% points, 95% CI - 37.4 to 3.9 (Newcombe score method; p = 0.123). Neither co-primary outcome reached statistical significance, and the wide confidence intervals are compatible with both a clinically meaningful benefit and with no true effect. Complication rates were low and similar between groups. These preliminary, hypothesis-generating findings suggest that enhanced preoperative education is a low-cost, clinically plausible strategy for reducing stent-related pain and unplanned healthcare utilization, but do not establish efficacy; confirmation in an adequately powered, multicenter trial is required before any change in practice can be recommended.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040877","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":"Technique-stratified whole-stone laser energy consumption during RIRS using a 150-W Ho: YAG laser.","authors":"Kadir Böcü, Doğucan Nuri Uğur, Nurullah Altınkaya","doi":"10.1007/s00240-026-02059-1","DOIUrl":"10.1007/s00240-026-02059-1","url":null,"abstract":"<p><p>To determine whether technique-stratified whole-stone laser energy consumption (LEC) provides interpretable benchmarking during retrograde intrarenal surgery (RIRS) performed with a 150-W holmium: YAG platform. This retrospective single-center cohort identified 350 procedures performed from January 2023 to January 2025 and included all 300 eligible procedures (100 per technique). Total energy was reconstructed from case-level pulse energy, frequency, and laser-on time. Whole-stone LEC was energy divided by preoperative computed-tomography stone volume. Strict zero-residual stone-free rate (SFR) and < 2 mm clinical success were assessed by computed tomography at 3 months. Median whole-stone LEC was 19.3 [17.1-22.0] J/mm³ for dusting, 11.7 [10.4-13.3] for fragmentation, and 24.1 [21.3-27.6] for pop-dusting (p < 0.001). Fragmentation used the least total energy but had the longest operation time. Strict SFR was 71.0%, 80.0%, and 67.0% (p = 0.107), whereas clinical success was 93.0%, 93.0%, and 94.0% (p = 0.948). After adjustment for comorbidity, stone volume, density, and lower-calyx location predicted strict SFR; technique and LEC did not. Adding technique and LEC did not improve repeated cross-validated discrimination and produced modest overfitting. Technique-specific whole-stone LEC is best interpreted as a benchmarking measure alongside operative time and CT outcomes, not as an independent preoperative predictor.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009125","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":"From anatomical sampling to clinical validation of GLS and LPIN2.","authors":"Yaqian Zhu, Yanqin Guo, Xiaoxue You","doi":"10.1007/s00240-026-02063-5","DOIUrl":"10.1007/s00240-026-02063-5","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009068","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}