Urolithiasis最新文献

{"title":"Residual fragments after percutaneous nephrolithotomy: is it mandatory to treat them all?","authors":"Andrea Li Puma, Federica Passarelli, Elisa De Lorenzis, Emanuele Montanari, Giancarlo Albo, Luca Boeri","doi":"10.1007/s00240-025-01775-4","DOIUrl":"https://doi.org/10.1007/s00240-025-01775-4","url":null,"abstract":"<p><p>To investigate complication rates, stone growth and passage according to residual fragments (RFs) size in a cohort of patients treated with miniPCNL (mPCNL). We retrospectively analysed data from 572 patients who underwent mPCNL between 01/2018 and 11/2023. We identified 105 (19.4%) patients with RFs and at least 1-year follow up. Demographics and RFs passage, regrowth and complications were recorded by chart review and phone interviews. RFs were stratified into ≤ 5 mm; 6-9 mm and ≥ 10 mm groups. Descriptive statistics and logistic regression models were applied to test the association between RFs size and stone related events. Median number and diameter of RFs were 2 (1-3) and 8 (5-10) mm, respectively. RFs of ≤ 5 mm (Group 1), 6-9 mm (Group 2) and ≥ 10 mm (Group 3) were detected in 27 (25.7%), 47 (44.7%) and 31 (29.6%) cases, respectively, after mPCNL. Overall, 23 (21.9%), 20 (19%) and 9 (8.5%) patients had a stone related event [emergency room (ER) admission], stone growth and passage during follow up, respectively. Renal colic requiring ER admission were more frequent in Group 2 compared to the ≥ 10 and ≤ 5 mm one (36.1% vs. 9.6% vs. 11.1%, p = 0.01). Conversely, Group 1 showed higher rates of stone growth compared to the other groups (37.0% vs. 17.0% vs. 6.4%, p = 0.02). No difference in the rate of UTIs and stone passage was reported according to RFs size. Multivariable logistic regression analysis showed that RFs of 6-9 mm had higher risk of stone related events (OR 5.5, p = 0.04) compared to the other groups, even after adjusting for patients' BMI. Conversely, patients with RFs ≤ 5 mm had higher risk of stone growth (OR 9.6, p = 0.04), compared to the other RFs groups, after adjusting for patients' BMI. RFs after mPCNL have different impact on patient's clinical course, according to their size. Large RFs are less likely to grow or cause stone-related events. Conversely, RFs of medium size (6-9 mm) are associated with higher risk of ER admission and should be promptly treated. Small RFs can increase in size, but conservative management or delayed surgery may be considered, as they typically remain asymptomatic during follow-up.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"107"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217076","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 clinical efficacy analysis of One-stage flexible ureteroscopic lithotripsy assisted by CT urography and intelligent pressure control platform and the establishment of a prediction model for stone clearance rate.","authors":"Deng Chaohua, Zhang Yu, Li Zhishen, He Yan, Ma Xuebing, Song Leming, Zhu Xianxin, Hu Xiaodong","doi":"10.1007/s00240-025-01778-1","DOIUrl":"https://doi.org/10.1007/s00240-025-01778-1","url":null,"abstract":"<p><p>To explore the clinical efficacy of the first-stage flexible ureteroscope lithotripsy assisted by CT urography (CTU) combined with an intelligent pressure control platform, and to establish a clinical prediction model after analyzing the influencing factors of the stone-free rate (SFR). The clinical data of patients who underwent the first-stage flexible ureteroscope lithotripsy assisted by preoperative CTU combined with intraoperative intelligent pressure control platform in our hospital from January 2019 to September 2024 were retrospectively analyzed. The stone-free rate was taken as the main indicator for evaluating the clinical efficacy. Logistic regression analysis was performed to identify the independent risk factors affecting the clinical efficacy and to establish a clinical prediction model for the stone-free rate. A total of 368 patients in our hospital underwent the first-stage flexible ureteroscope lithotripsy assisted by preoperative CTU combined with intraoperative intelligent pressure control platform, and all of them successfully completed the first-stage flexible ureteroscope lithotripsy. The SFR was 93% one month after the operation and 96.2% three months after the operation. After identifying the independent risk factors through Logistic regression analysis, the clinical prediction model for the SFR was established as follows: L = ureteral stricture + 1.288/1.144 × urinary tract infection + 1.315/1.144 × CT value of the stone + 1.154/1.144 × IPA angle + 4.989/1.144 × stone volume + 1.237/1.144 × stone composition. The areas under the ROC curve were as follows: combined predictor (0.913) > stone volume (0.895) > stone composition (0.639) > IPA angle (0.627) > ureteral stricture (0.609) > urinary tract infection (0.595). The first-stage flexible ureteroscope lithotripsy assisted by CTU combined with an intelligent pressure control platform for the treatment of patients with upper urinary tract stones is a surgical mode worthy of clinical promotion and reference. Using this prediction model to score the preoperative stone-free rate, when the score is > 20.61, it indicates that there may be residual stones after the operation.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"106"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217011","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":"RIRS with flexible vacuum-assisted UAS versus MPCNL for impacted upper ureteral stones: a prospective, randomized controlled study.","authors":"Qing-Lai Tang, Ping Liang, Ling-Hui Li, Tian-Xiao Yang, Du-Jian Wang, Xing-Zhu Zhou, Rong-Zhen Tao","doi":"10.1007/s00240-025-01781-6","DOIUrl":"10.1007/s00240-025-01781-6","url":null,"abstract":"<p><p>To observe the efficacy and safety of retrograde intrarenal surgery (RIRS) combined with flexible vacuum-assisted ureteral access sheath (FV-UAS) and minimally invasive percutaneous nephrolithotomy (MPCNL) in patients with impacted upper ureteral stones (IUUS). The study included 189 patients, of which 95 were included in the FV-UAS group and 94 in the MPCNL group. The primary study outcome was the stone-free rates (SFRs) on the first postoperative day. Secondary outcomes included the total SFRs 1 month postoperatively, operative time, reduction in hemoglobin levels, length of postoperative hospital stay, improvement in the quality of life as measured by the QoL score, incidence of ureteral stricture at 3 months postoperatively, and any surgery-related complications. There was no obvious difference between two groups in patients' demographics and preoperative clinical characteristics (P > 0.05). The mean decrease in hemoglobin was significantly lower in the FV-UAS group than in the MPCNL group (5.1 vs. 14.7 g/L, P < 0.001). Similarly, the FV-UAS group had a shorter average hospital stay than the MPCNL group (2.7 vs. 4.9 days, P < 0.001). However, SFRs at the first postoperative day and 4 weeks postoperatively were statistically similar between the two groups (P > 0.05). QoL improvement, measured by the QoL score, was significantly higher in the FV-UAS group than in the MPCNL group (32.5 vs. 27.1, P < 0.001). At 3 months postoperatively, the difference between two groups in the terms of ureteral stricture was not statistically significant (P > 0.05). Notablely, the overall rate of postoperative complications was markedly lower in the FV-UAS group than in the MPCNL group (P < 0.001). Our study revealed that RIRS with FV-UAS is a promising approach to treat IUUS, achieving satisfactory SFRs compared to MPCNL and notable improvements in QoL with a low complication rate.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"105"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217010","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 role of preoperative ureteral diameter measurements in predicting difficult access during retrograde ıntrarenal surgery: a retrospective analysis of 234 patients.","authors":"Basri Çakıroğlu, Ali Egemen Avcı, Bekir Sami Uyanık, Süleyman Hilmi Aksoy, Elif Evrim Ekin","doi":"10.1007/s00240-025-01754-9","DOIUrl":"10.1007/s00240-025-01754-9","url":null,"abstract":"<p><p>Retrograde intrarenal surgery (RIRS) is a minimally invasive procedure used for the management of renal and ureteral stones. However, successful placement of a ureteral access sheath (UAS) remains a critical challenge, particularly in patients with narrow ureters. Preoperative measurement of ureteral diameter via computed tomography (CT) may help predict access difficulties and optimize surgical planning. This study aimed to evaluate the role of preoperative ureteral diameter measurements (distal, iliac, and upper ureters) in predicting difficult UAS placement during RIRS. A retrospective analysis was conducted on 234 patients who underwent RIRS for kidney stones. Ureteral diameters were measured at three anatomical levels using preoperative CT. Patient demographics, stone size, operative time, and surgical outcomes were recorded. Difficult access was defined as unsuccessful initial UAS placement requiring additional interventions such as guidewire manipulation, balloon dilation, or selection of a smaller sheath. Patients with smaller ureteral diameters at all three measured levels had a significantly higher incidence of difficult UAS placement (p < 0.05). Multivariate analysis confirmed ureteral diameter as an independent predictor of difficult access. Additionally, previous stone-related interventions and patient demographics showed significant associations with ureteral diameter, further influencing surgical outcomes. Preoperative ureteral diameter measurement via CT provides valuable predictive insights into access challenges during RIRS. Routine assessment of ureteral diameter can enhance surgical planning, improve procedural efficiency, and reduce perioperative complications.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"104"},"PeriodicalIF":2.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200115","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":"Optimizing aspiration efficiency in RIRS: the impact of ratio of endoscope-sheath diameter, irrigation flow, and negative pressure in an vitro study.","authors":"Tianfu Ding, Zheng Xu, Zhongyue Huang, Weiguo Hu, Bo Xiao, Jianxing Li","doi":"10.1007/s00240-025-01773-6","DOIUrl":"https://doi.org/10.1007/s00240-025-01773-6","url":null,"abstract":"<p><p>To examine the impact of ratio of endoscope-sheath diameter (RESD), irrigation rate, and negative pressure on the efficiency of stone fragment aspiration during retrograde intrarenal surgery (RIRS) in an in vitro setting. Five grams of stone fragment were precisely measured and placed in renal calyx. A flexible ureteroscope with a Flexible Adjustable Navigation Suction Ureteral Access Sheath (FANS) was introduced into the renal calyx, connected to an irrigation pump and suction pump. A urologist performed 1-minute simulated intraoperative aspiration maneuvers. Residual stone dust was collected from the suction system, dried, and reweighed. Experimental variables included ureteroscope dimensions (7.5Fr and 8.6Fr), FANS sizes (10/12Fr and 12/14Fr), negative pressure levels (0.02 MPa and 0.01 MPa), and irrigation flow rates (100, 150, 200, 250, and 300 ml/min). Intrarenal pelvic pressure was monitored in real time with a digital pressure transducer probe in the renal pelvis. Experiments were conducted in the upper, middle, and lower calyces, with each parameter combination repeated five times in a randomized order to ensure statistical reliability.The study demonstrated that under low negative pressure (0.01 MPa), stone fragment aspiration efficiency exhibited a parabolic relationship with irrigation flow rate. Maximum efficiency was observed at 200 ml/min across all ureteroscope-FANS configurations. Elevating negative pressure to 0.02 MPa significantly enhanced aspiration efficiency, with peak performance maintained at 200 ml/min. The different positions of the renal calyces have a significant impact on the aspiration efficiency, and the aspiration efficiency of the lower calyx is significantly lower than that of the upper and middle calyces. Smaller FANS-to-endoscope ratios (e.g., 10/12Fr UAS with 7.5Fr f-URS, RESD = 0.75) demonstrated 27.2% lower aspiration efficiency compared to larger sheaths (12/14Fr FANS, RESD = 0.64) at 200 ml/min under 0.02 MPa (P < 0.001). All f-URS and FANS configurations maintained intrapelvic pressure (IPP) within safe thresholds across varying irrigation flow rates and negative pressure conditions.The efficiency and safety of stone fragment aspiration is high when the infusion rate is 200 ml/min and the negative pressure is 0.02Mpa. A smaller RESD leads to greater aspiration efficiency.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"102"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188080","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":"A phase I efficacy study of ureteroscopy-assisted flexible negative pressure Suction sheath in the treatment of renal stones larger than 4 cm.","authors":"Changyi Liu, Jinfeng Wen, Bufang Xiong, Yanfeng He, Wenwei Chen, Biqiong Zheng, Rui Gao","doi":"10.1007/s00240-025-01772-7","DOIUrl":"https://doi.org/10.1007/s00240-025-01772-7","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"101"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188077","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":"Comment on \"predictors and associations of complications in ureteroscopy for stone disease using AI: outcomes from the FLEXOR registry\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1007/s00240-025-01777-2","DOIUrl":"https://doi.org/10.1007/s00240-025-01777-2","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"100"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188078","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":"Disruptions in Tiopronin therapy: impacts on clinical outcomes of pediatric cystinuria patients during the COVID-19 pandemic.","authors":"Hülya Gözde Önal, Hülya Nalçacioğlu, Demet Tekcan Karali, Meltem Necibe Ceyhan Bilgici, Ozlem Aydog, Ozan Özkaya, Ender Özdem, Saban Sarikaya","doi":"10.1007/s00240-025-01767-4","DOIUrl":"10.1007/s00240-025-01767-4","url":null,"abstract":"<p><p>Cystinuria, characterized by defective renal absorption of cystine causing recurrent nephrolithiasis, demands ongoing management. This study examines the effects of COVID-19-related disruptions in tiopronin availability on the clinical outcomes of pediatric cystinuria patients. This retrospective cohort study analyzed medical records of 11 pediatric patients with cystinuria, followed from 2001 to 2023. Patients were diagnosed using urine microscopy/biochemistry and stone composition analysis. Clinical outcomes, including renal function and stone status, were assessed using serial ultrasonographic evaluations and 24-hour urinary cystine measurements. At diagnosis, the median age was 13 months, and 63.6% were female. Acute kidney injury was observed in 36.4% of patients, with 27.3% requiring emergency dialysis. The interruption of tiopronin treatment led to significant renal function deterioration and increased stone burden, as evidenced by an increase in the median number of kidney stones from 2 (IQR: 1-3) to 4 (IQR: 2-5, p = 0.045) and a rise in 24-hour urinary cystine levels from 286 mg/1.73 m² (IQR: 82-552.5) to 434 mg/1.73 m² (IQR: 198-854, p = 0.043). Data prior to the interruption showed a median glomerular filtration rate (GFR) of 80.4 mL/min/1.73 m² and creatinine levels of 2.47 mg/dL. After resuming tiopronin, there was a notable improvement to a median GFR of 161 mL/min/1.73 m² and creatinine levels of 0.48 mg/dL. Managing cystinuria during the pandemic underscored the critical role of continuous access to medications like tiopronin in preventing renal deterioration. Developing strategies to ensure an uninterrupted drug supply during global health emergencies is crucial for managing chronic conditions such as cystinuria.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"103"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188079","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":"Origin of monosodium urate Randall's plaques.","authors":"Els Van de Perre, Elise Maréchal, Karl Martin Wissing, Jean-Philippe Haymann, Michel Daudon, Emmanuel Letavernier","doi":"10.1007/s00240-025-01743-y","DOIUrl":"https://doi.org/10.1007/s00240-025-01743-y","url":null,"abstract":"<p><p>In 3.4% of Randall's plaques, monosodium urate can be detected. The formation mechanism of these Randall's plaques is unrevealed and the clinical and biochemical characteristics of affected patients are unknown. In this single centre study, we retrospectively analysed the clinical and biochemical characteristics of patients with kidney stone formation related to monosodium urate-containing Randall's plaques (NaUr ^pos RP) and those with stone formation related to \"classical\" Randall's plaques (NaUr ^neg RP). There was a significantly higher urinary calcium and magnesium excretion in the NaUr ^neg RP group (6.09 vs. 4.61 mmol/24 h, p = 0.03 and 4.78 vs. 3.55 mmol/24 h, p = 0.02). There was no significant difference in urinary uric acid excretion or urinary pH between both groups. The NaUr ^pos RP group tended to have more frequent hyperuricemia (71.4 vs. 44.8%, p = 0.08) and to be more frequently male (92.9 vs. 70.1%, p = 0.10) and had higher median age (53.5 vs. 27.5, p < 0.001) and serum creatinine (96.4 vs. 77.0 µmol/L, p < 0.001). Additionally, there was a signal of higher prevalences of hypertension, dyslipidemia, cardiovascular disease and gout in the NaUr ^pos RP group. Different formation mechanisms seem implicated in the formation of NaUr ^pos RP and NaUr ^neg RP - associated kidney stones. We hypothesize a mechanism of interstitial monosodium urate precipitation at the renal papilla driven by high systemic uric acid serum concentration to be involved in NaUr ^pos RP formation. Treatment with xanthine oxidase inhibitors may reduce the risk of recurrent stone formation on this specific Randall's plaque.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"99"},"PeriodicalIF":2.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151888","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":"UreteroPyeloVisClear catheter: a new frontier in ureteroscopic lithotripsy for ureteral stones.","authors":"Chen Yang, Huang Haiwen, Zeng Xue, Ding Tianfu, Lin Shen, Xiao Bo, Li Jianxing","doi":"10.1007/s00240-025-01769-2","DOIUrl":"10.1007/s00240-025-01769-2","url":null,"abstract":"<p><p>Conventional semirigid ureteroscopy for ureteral stones faces challenges such as stone retropulsion, poor intraoperative vision, and elevated intrarenal pressure. This study evaluates the safety and efficacy of a novel multi-channel negative pressure suction catheter (UreteroPyeloVisClear Catheter, VCC) in ureteroscopic lithotripsy. To compare the performance of VCC with conventional rigid ureteroscopy, this study evaluated operative time, stone clearance rates, and complication incidence between VCC and traditional semirigid ureteroscopy. A prospective cohort study included 42 patients with ureteral stones (diameter ≤ 2.0 cm), randomized into VCC (n = 21) and traditional (n = 21) groups. The VCC group utilized an integrated negative pressure suction and active water circulation system, while the traditional group used standard semirigid ureteroscopy. The primary outcome was operative time, with secondary outcomes including stone clearance rates, retropulsion incidence, basket utilization, and complication rates. The VCC group demonstrated significantly shorter operative time (39.95 ± 10.24 vs. 53.00 ± 26.95 min, p = 0.001) and reduced basket utilization (5% vs. 57%, p < 0.001). Stone retropulsion rates were lower in the VCC group (5% vs. 14%, p = 0.294), though not statistically significant. Both groups achieved 100% stone-free rates at 1 month. Postoperative pain scores (VCC: 0.90 ± 1.36 vs. traditional: 1.24 ± 1.49) and complication rates (0% vs. 5%) showed no significant differences. The VCC significantly reduces operative time and reliance on auxiliary instruments while maintaining safety and stone-free outcomes. Its innovative design addresses key limitations of traditional ureteroscopy, offering a promising advancement for ureteral stone management.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"97"},"PeriodicalIF":2.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136343","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}