Urolithiasis最新文献

{"title":"What is the preferred management of lower ureteral stones? SWL or URS - a critical evaluation with an emphasis on the changes in patient's quality of life.","authors":"Erhan Erdoğan, Alper Aşık, Hikmet Yaşar, Göksu Sarıca, Kemal Sarıca","doi":"10.1007/s00240-025-01693-5","DOIUrl":"10.1007/s00240-025-01693-5","url":null,"abstract":"<p><p>To compare the efficacy and safety of two treatment methods for lower ureteral stones: shock wave lithotripsy (SWL) and ureteroscopic treatment (URS), with a focus on the impact on patients' Quality of Life (QoL). A total of 174 patients with solitary radiopaque lower ureteral stones (5-10 mm) between July 2023 and October 2024 were treated with SWL (78 patients) or URS (96 patients). Stone-free (SF) status was evaluated at 3 months using Non-Contrast Computed Tomography (NCCT). Data included age, gender, body mass index (BMI), stone size, and post-procedural analgesic requirement. QoL was measured using the Short Form-36 (SF-36) index. Although SF rates were significantly higher in the URS group (96.9% vs. 84.6%, p = 0.009), comparable SF rates for stones < 10 mm and symptom-free status during long-term follow-up suggest that SWL remains a valuable alternative. Additionally, 96.2% of patients expressed willingness to choose SWL again, highlighting patient satisfaction. SWL produced similar results to URS in physical functioning and general health, but URS showed better outcomes in pain and emotional well-being, possibly due to residual stone fragments. SWL offers advantages such as shorter recovery times, reduced need for pain medication, and no requirement for general anesthesia, making it a preferred option for patients seeking non-invasive treatment. Both methods showed similar outcomes in QoL, particularly in physical functioning and general health, demonstrating that SWL is an effective non-invasive treatment for lower ureteric stones.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"29"},"PeriodicalIF":2.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410706","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":"Advances in the mechanism of urinary proteins in calcium oxalate kidney stone formation.","authors":"Mingcheng Shi, Xiaozhe Su, Heng Xiang, Qianlin Song, Sixing Yang","doi":"10.1007/s00240-025-01703-6","DOIUrl":"https://doi.org/10.1007/s00240-025-01703-6","url":null,"abstract":"<p><p>Kidney stones are a common urological disease worldwide, imposing a significant burden on healthcare systems. Calcium oxalate stones are the predominant form of urinary calculi, with two main theoretical models explaining their pathogenesis: the fixed particle and free particle models. Regardless of the model, the formation of calcium oxalate kidney stones is inseparably linked to crystal nucleation, growth, aggregation, and adhesion in urine. Growing evidence highlights the significant role of urinary proteins, particularly matrix proteins, in the development of calcium oxalate stones. The review classifies urinary proteins impacting calcium oxalate stone formation into three groups: inhibitors, promoters, and dual-regulators, outlining their contributions to the formation process.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"27"},"PeriodicalIF":2.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391807","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":"Radiation exposure using leaded versus regular latex surgical gloves in endourological procedures: a prospective comparative study.","authors":"Esteban Emiliani, Alejandra Bravo-Balado, Agustín Ruiz-Martinez, Irene Girón-Nanne, Sofia Fontanet, Paolo Verri, Antoni Sánchez-Puy, Andrés-Koey Kanashiro, Andreas Skolarikos, Bhaskar Somani, Olivier Traxer, Francisco Sánchez-Martín, Félix Millán, Oriol Angerri","doi":"10.1007/s00240-024-01676-y","DOIUrl":"https://doi.org/10.1007/s00240-024-01676-y","url":null,"abstract":"<p><p>Our aim was to compare hand radiation exposure using leaded vs. regular latex surgical gloves in endourological procedures. We conducted a single-center prospective comparative study between January 2017 and December 2020. Surgeon 1 wore leaded surgical gloves, while Surgeon 2 voluntarily wore regular latex surgical gloves. A ring badge and chest dosimeters were used to estimate hand and whole-body scattered radiation dose in all endourological stone procedures (ureteroscopy (URS), retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL)). We found that Surgeon 1 and 2 performed a mean of 158 (SD 15.2) and 158 (SD 15.1) procedures/year, respectively, for a total of 1,092 between 2017 and 2020 between the two surgeons (696 URS/RIRS and 396 PCNL). The overall mean hand annual radiation exposure dose for Surgeon 1 and 2 was 2.87 mSv (SD 1.3) and 14.89 mSv (SD 7.87), respectively (p = 0.027), which corresponds to a mean of 0.02 (SD 0.02) and 0.1 mSv (SD 0.1) per procedure (p < 0.001). The estimated annual scattered radiation was 0.0012 and 0.0016, respectively (p = 0.63). We concluded that the use of leaded gloves in endourological stone procedures showed a significant reduction of radiation dose per year and per procedure compared to regular latex gloves; no increase in whole-body scattered radiation was detected with their use. We believe that the use of leaded gloves may be recommended, especially in urologists who dedicate most of their practice to endoscopic stone surgery. Further studies are needed to define whether these gloves could increase patient radiation exposure.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"26"},"PeriodicalIF":2.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391809","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":"Integrated proteomics reveals enrichment of oxidative stress and inflammatory proteins in the urine and stone matrix of calcium oxalate stone formers.","authors":"Suttipong Suttapitugsakul, Supatcha Sassanarakkit, Paleerath Peerapen, Visith Thongboonkerd","doi":"10.1007/s00240-025-01697-1","DOIUrl":"https://doi.org/10.1007/s00240-025-01697-1","url":null,"abstract":"<p><p>Nephrolithiasis is a multifactorial disease associated with urinary and matrix proteins that become a focal point of research for diagnostic and preventative strategies. The functional relevance of these proteins in lithogenesis, along with their origins and impacts, remains a major subject of ongoing lithogenic research. Here, an integrated analysis was done on multiple proteome datasets compiled from various studies of normal urine (NU), urine from calcium oxalate stone formers (SFU), and calcium oxalate stone matrix (SM). Functional annotation and network analysis revealed the profound enrichment of proteins associated with oxidative stress and inflammation only in the stone-related samples (both \"SFU but not NU\" and \"SM but not NU\" cohorts). The oxidative stress and inflammation-related proteins were most abundant in the \"SM but not NU\" cohort and had higher proportions in the \"SFU but not NU\" cohort than the \"NU only\" cohort. KEGG pathway analysis corroborated such observation and highlighted the inclusion of proteins in the complement and coagulation pathways, particularly in SM. The findings of this study inform some mechanistic insights into the roles of calcium oxalate stone-related proteins and may help develop effective prevention and treatment strategies for nephrolithiasis.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"25"},"PeriodicalIF":2.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256696","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":"Re: Multicenter outcome analysis of different sheath sizes for Flexible and Navigable Suction ureteral access sheath (FANS) ureteroscopy: an EAU Endourology collaboration with the global FANS study group.","authors":"Nursah Sariduman, Mustafa Kaba, Ozdemir Serhat Gurocak, Mustafa Ozgur Tan","doi":"10.1007/s00240-025-01701-8","DOIUrl":"https://doi.org/10.1007/s00240-025-01701-8","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"24"},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190757","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 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}