Urolithiasis最新文献

{"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}

{"title":"Comment on \"ABO blood group distribution in patients with upper urinary tract stones: a case-control study\".","authors":"Chujie Chen","doi":"10.1007/s00240-026-02062-6","DOIUrl":"https://doi.org/10.1007/s00240-026-02062-6","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":"149009042","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":"Complication profiling in ureteroscopy: A prospective multicenter comparison of the Clavien-Dindo classification and the comprehensive complication index.","authors":"Yiloren Tanidir, Tunahan Ates, Reha Girgin, Murat Gulsen, Onur Kalayci, Cemil Aydin, Metin Kizgin, Volkan Sen, Can Sinirsiz, Ilker Akarken, Eren Can Aydin, Tarik Emre Sener, Dogancan Dorucu, Ahmet Furkan Ozsoy, Yunus Emre Goger, Nebil Akdogan","doi":"10.1007/s00240-026-02056-4","DOIUrl":"10.1007/s00240-026-02056-4","url":null,"abstract":"<p><p>The Clavien-Dindo Classification remains the most widely accepted method for grading surgical complications. The Comprehensive Complication Index, a continuous scale integrating all postoperative events, may provide a more comprehensive overview. This study compared the sensitivity and clinical applicability of the Clavien-Dindo Classification and the Comprehensive Complication Index in assessing complications following ureteroscopic stone surgery. In this multicenter prospective study, data from patients undergoing ureteroscopic stone surgery were collected, including demographic, perioperative, and complication variables. Complications were graded using the Clavien-Dindo Classification, and cumulative morbidity was subsequently calculated using the Comprehensive Complication Index based on assigned Clavien-Dindo grades. Patients were stratified by minor (I-II) or major (≥ III) complications. Correlation analyses between complication scores and clinical parameters, including comorbidity indices and hospital stay, were performed. A total of 1607 patients were included; 98 (6.1%) experienced complications. Comprehensive Complication Index showed a numerically higher correlation with hospital stay in patients with minor complications, whereas Clavien-Dindo Classification showed a numerically higher correlation in patients with major complications; however, formal statistical comparison of these correlations did not demonstrate a significant difference between the two systems. In 39 patients, Comprehensive Complication Index exceeded corresponding the Clavien-Dindo Classification grade, suggesting improved sensitivity for overall morbidity. Both systems showed moderate correlations with comorbidity indices and hospital stay; however, the Comprehensive Complication Index performed better with multiple minor complications. Limitations of this study include its observational nature, the lack of long-term patient-reported quality of life outcomes, and potential variations in surgeon experience across the participating centers. Comprehensive Complication Index provides refined reflection of cumulative minor complications, while Clavien-Dindo Classification offers clearer categorization of major events. Neither system demonstrated absolute superiority; however, their combined application may enhance complication reporting and facilitate comprehensive outcome assessment in ureteroscopic stone surgery. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (https//clinicaltrials.gov), NCT06394908.</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":"149009025","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 \"Comparative evaluation of flexible ureterorenoscopy and mini-percutaneous nephrolithotomy for the management of renal pelvic stones less than 2 cm with high attenuation value in pediatric patients: a prospective randomized study\".","authors":"Emrah Küçük, Mesut Şengül, Reha Ordulu","doi":"10.1007/s00240-026-02064-4","DOIUrl":"10.1007/s00240-026-02064-4","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":"149009045","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":"β-carotene attenuates calcium oxalate crystal-induced renal injury through suppression of NF-κB-mediated inflammation.","authors":"Mingqin Su, Yuxiang Guan, Hongquan Wei, Lijun Chen, Wei Dong","doi":"10.1007/s00240-026-02053-7","DOIUrl":"10.1007/s00240-026-02053-7","url":null,"abstract":"<p><p>Calcium oxalate (CaOx) nephrolithiasis represents the most prevalent form of kidney stone disease and is characterized by persistent renal inflammation and tissue damage. β-Carotene, a naturally occurring carotenoid with well-documented anti-inflammatory properties, has demonstrated beneficial effects in a variety of inflammatory conditions; however, its potential role in CaOx crystal-associated renal injury remains largely unexplored. In this study, the effects of β-carotene on CaOx-induced renal damage were evaluated using both cellular and animal models. In human renal proximal tubular epithelial (HK-2) cells, β-carotene effectively alleviated calcium oxalate monohydrate (COM)-induced injury, decreased kidney injury molecule-1 (KIM-1) expression, and reduced the production of pro-inflammatory mediators, including TNF-α, IL-1β, IL-6, and MCP-1. Similarly, in a glyoxylate-induced nephrocalcinosis mouse model, β-carotene attenuated CaOx crystal accumulation, improved renal histopathological alterations and functional impairment, and suppressed inflammatory responses. To investigate the underlying mechanisms, network pharmacology and molecular docking analyses were conducted. A total of 145 overlapping targets were identified, and enrichment analyses identified NF-κB signaling as one of the candidate pathways potentially involved in the protective effects of β-carotene. Molecular docking analysis suggested favorable binding affinities between β-carotene and several key targets. Experimental validation demonstrated that β-carotene markedly inhibited NF-κB activation in both in vitro and in vivo settings, whereas pharmacological activation of NF-κB partially abolished its beneficial effects. Taken together, these findings indicate that β-carotene ameliorates CaOx crystal-induced renal injury and inflammation, at least in part through suppression of NF-κB signaling, and may offer a potential basis for the development of novel preventive and therapeutic approaches for kidney stone disease.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956958","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":"Suction mini-PCNL versus standard PCNL for 2-4 cm renal stones: a prospective cohort analysis of average effects, heterogeneity, and policy value.","authors":"Yan Yang, Wen Zhong","doi":"10.1007/s00240-026-02047-5","DOIUrl":"10.1007/s00240-026-02047-5","url":null,"abstract":"<p><p>We compared 18Fr suction mini-percutaneous nephrolithotomy (SMP) with standard percutaneous nephrolithotomy (sPCNL) for 2-4 cm renal stones in a prospective, single-center, non-randomized cohort and separated three questions: population-average effects, treatment-effect heterogeneity, and the value of acting on that heterogeneity. Among 900 patients, 450 underwent each procedure. Targeted maximum likelihood estimation with cross-validated Super Learner estimated outcome-specific average effects. A Net Clinical Utility (NCU) composite was analyzed with doubly robust estimation, an honest causal forest, and fivefold cross-fitted policy evaluation. SMP-minus-sPCNL differences were +2.7 percentage points for 1-day stone-free rate (95% CI - 1.85 to 6.20), + 1.69 percentage points for 1-month stone-free rate (- 1.84 to 5.23), - 1.09 percentage points for 24-hour pain (- 1.17 to - 1.01), - 1.23 g/L for hemoglobin drop (- 1.61 to - 0.86), and - 0.56 days for hospitalization (- 0.69 to - 0.42). Fever was inconclusive (- 3.36% points; -7.01 to 0.29). The population-average NCU effect was + 2.70 points (- 0.84 to 6.23; P = 0.135). Differential calibration did not support reliable heterogeneity (P = 0.192), and a depth-2 policy tree did not outperform the higher-valued fixed all-SMP strategy (+ 1.13 NCU; -1.10 to 3.37; P = 0.321). Thus, outcome-specific recovery associations favored SMP, but neither global NCU superiority nor a validated individualized strategy was established. These observational findings require external prospective validation.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913649","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":"Correction: L-arginine role for stone lower ureter: A randomized controlled trial.","authors":"Ahmed Mahmoud Mohammed Ahmed Elsherief, Ahmed Mahmou Riyad, Emad Abdellah Ali, Amr Alam-Eldin Ahmed, Hassan Ali Gad, Ahmed Mamdouh Abd Elhameid","doi":"10.1007/s00240-026-02046-6","DOIUrl":"10.1007/s00240-026-02046-6","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913674","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":"Flexible ureteroscopy with a flexible and negative suction ureteral access sheath versus traditional sheath for treatment of infectious upper urinary tract stones: A prospective, randomized controlled study.","authors":"Qing Wang, Qing-Lai Tang, Fa-de Liu, Yi-Qing Liu, Yun-Peng Li, Rong-Zhen Tao","doi":"10.1007/s00240-026-02041-x","DOIUrl":"10.1007/s00240-026-02041-x","url":null,"abstract":"<p><p>To evaluate the efficacy and safety of the flexible ureteroscopy (fURS) with a flexible and negative suction ureteral access sheath (FANS) versus traditional sheath for patients with infectious upper urinary tract stones (IUUTS). A total of 185 patients were enrolled, with 93 assigned to the FANS group and 92 to the traditional UAS group. The primary outcome was the stone-free rate (SFR) at the first postoperative day. Secondary outcomes included the SFR at 30 days postoperatively, operative time, hemoglobin reduction, length of hospital stay, quality of life (QoL) improvement, incidence of ureteral stricture at 3 months, and surgery-related complications. No significant differences were observed between the two groups in baseline demographics or preoperative clinical characteristics (P > 0.05). The FANS group had significantly lower white blood cell count, C-reactive protein, and procalcitonin levels at 6 and 24 h postoperatively (all P < 0.05). Mean operative time was significantly shorter (P < 0.001), QoL improvement was obviously greater (P < 0.001), and average hospital stay was shorter in the FANS group (P < 0.001). The SFRs on postoperative day 1 and at 30 days were both significantly higher in the FANS group (both P < 0.05). At 3 months, ureteral strictures occurred in three patients in the traditional UAS group and one in the FANS group, a difference that was not statistically significant (P > 0.05). The overall complication rate was significantly lower in the FANS group (P < 0.05). For patients with IUUTS, fURS combined with FANS effectively improves stone clearance efficiency and reduces the risk of postoperative infection.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913621","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":"Computed tomography-based mapping of ureteral stone distributions by anatomical segment and vertebral level.","authors":"Nazlı Gülriz Çeri, Emrehan Şahin Yağmur, Erhan Ateş, Göksel Tuzcu, Çağatay Özsoy","doi":"10.1007/s00240-026-02052-8","DOIUrl":"10.1007/s00240-026-02052-8","url":null,"abstract":"<p><p>Classical anatomical teaching describes three ureteral narrowing points as the principal sites associated with ureteral stone localization; however, contemporary imaging studies suggest a more complex distribution. This retrospective study aimed to characterize ureteral stone distributions using detailed vertebral-level mapping complemented by conventional segmental classification and multiplanar stone measurements. Non-contrast computed tomography (CT) images of 398 patients, each contributing a single ureteral stone, were subjected to analysis. Stones were classified according to five anatomical ureteral segments and detailed vertebral levels. Vertical, transverse, sagittal, and maximum stone diameters were measured. The proximal ureter was the most frequent stone location (34.4%), followed by the ureteropelvic junction (UPJ; 26.1%) and ureterovesical junction (19.8%). Vertebral-level mapping demonstrated distinct clustering: UPJ stones were most frequently located at the upper third of L3 (25.0%), whereas proximal ureteral stones clustered predominantly around L3-L4, with the highest proportion at the lower third of L4 (21.9%). Stone dimensions differed significantly across the ureteral segments (p < 0.001 for all), the largest dimensions being observed at the UPJ and an overall tendency toward smaller dimensions at more distal locations. These findings demonstrate that ureteral stone distributions at CT presentation are not confined to the traditionally described narrowing points. Detailed vertebral-level mapping provides a more granular topographic characterization of stone localization than conventional segmental classification and may serve as a standardized anatomical framework for future studies.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913676","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}