Urolithiasis最新文献

{"title":"Commentary on \"assessment of a novel bendable-tip ureteral access sheath with integrated suction: an in vitro study\".","authors":"Huacai Zhu, Jianhua Huang, Pengpeng Zhao, Zhanping Xu","doi":"10.1007/s00240-025-01787-0","DOIUrl":"https://doi.org/10.1007/s00240-025-01787-0","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"115"},"PeriodicalIF":2.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302945","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":"Urologic training does not impact ability to accurately size kidney stone fragments.","authors":"Kelly Lehner, Jayson Kemble, Jamal Alamiri, Aaron Potretzke, Kevin Koo","doi":"10.1007/s00240-025-01780-7","DOIUrl":"https://doi.org/10.1007/s00240-025-01780-7","url":null,"abstract":"<p><p>Accurate estimation of stone fragment size during ureteroscopy facilitates safe extraction. We aimed to determine whether training experience improves the accuracy of estimating fragment size. Six mock stones (range 1.2-7.4 mm) were placed in a renal model for simulated flexible ureteroscopy. Urology residents and high-volume ureteroscopy surgeons estimated fragment size and extractability through a 12/14-French sheath. Responses were compared among 3 training levels (PGY 1-2, PGY 3-5, and surgeons) and analyzed by objective measures of surgical experience and technical skill. Categorical and continuous variables were analyzed using ANOVA and Pearson correlation, respectively. 16 residents and 6 surgeons were included. Participants underestimated fragment size by 30% overall. As fragment size increased, the discrepancy between estimates and true size also increased. There was no statistical difference in accuracy among training groups and no association with experience or skill. Participants nearly always (98%) correctly identified < 4 mm fragments as extractable; in contrast, participants identified > 4 mm fragments as not extractable only 59% of the time. There was similarly no difference in predicting extraction by training level, experience, or skill. Both novice and experienced surgeons substantially underestimate fragment size during ureteroscopy, which may increase the risk of unsafe extraction. Technologies that enable real-time measurement may improve accuracy, regardless of surgeon experience.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"114"},"PeriodicalIF":2.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295029","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":"Associations between clinical, biochemical, and nutritional factors in kidney stone formation and recurrence.","authors":"Kulsoom, Saleem Ahmad, Urwa, Irfan Ali Khan, Awais, Razvan Pricope, Bhavna Singla, Shivam Singla, Andreea Cazacu, Fatima Rahman, Valisher Sapayev Odilbek Uglu, Mukhayya Xusinovna Djumaniyazova, Zainab Saba, Wajahat Ali","doi":"10.1007/s00240-025-01784-3","DOIUrl":"https://doi.org/10.1007/s00240-025-01784-3","url":null,"abstract":"<p><p>This case-control study investigated the relationship between dietary habits and kidney stone development and recurrence at District Headquarters (DHQ) Hospital in Pakistan over a 12-month period. The study included 600 patients with a history of kidney stones and 50 healthy controls aged 18-65. Dietary patterns were evaluated using a 24-hour dietary recall and a semi-quantitative food frequency questionnaire (FFQ), with emphasis on oxalates, calcium, animal protein, fluid consumption, and other nutritional factors. Urinary and serum biomarkers-such as calcium, oxalate, citrate, sodium, potassium, pH, phosphate, magnesium, uric acid, and parathyroid hormone (PTH)-were also analyzed. Results indicated strong dietary links to kidney stone risk. Increased oxalate intake (*p* = 0.004), insufficient calcium consumption (*p* = 0.017), and high animal protein intake (*p* = 0.021) were significantly associated with stone formation. Elevated serum uric acid (> 6 mg/dL) was particularly linked to uric acid stones (*p* = 0.008). Urinary analysis revealed common abnormalities, including hyperoxaluria (80%), hypocitraturia (65%), and hypercalciuria (42%). Additionally, altered serum calcium and PTH levels in stone formers suggested secondary hyperparathyroidism as a potential contributing factor. Multivariate logistic regression identified several significant risk factors: high oxalate intake, low fluid consumption, hypocitraturia, and increased serum calcium and uric acid levels. These findings highlight the critical role of diet and metabolic factors in kidney stone formation and recurrence. Further studies are required to establish whether preventive strategies focusing on diet modification and biochemical management may help reduce the incidence and recurrence of kidney stones.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"112"},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276021","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":"Fluoroscopy- free modified RIRS in pediatric patients: evaluating safety, efficacy and methodological challenges.","authors":"Irem A Teke, K Serefhan Erten, O Serhat Gurocak, M Ozgur Tan","doi":"10.1007/s00240-025-01786-1","DOIUrl":"https://doi.org/10.1007/s00240-025-01786-1","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"113"},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276022","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":"Comprehensive Mendelian randomization analysis and experimental investigation identifies the causal relationship between immunity and kidney stone disease.","authors":"Meng Gao, Minghui Liu, Liang Tang, Zewu Zhu, Hequn Chen, Tao Guo, Feng Zeng","doi":"10.1007/s00240-025-01782-5","DOIUrl":"https://doi.org/10.1007/s00240-025-01782-5","url":null,"abstract":"<p><p>This study investigated the causal relationship between immunity and kidney stone disease (KSD) by utilizing a Mendelian Randomization (MR) framework. We conducted a proteome-wide analysis to identify proteins associated with kidney stone disease risk using data from 4907 plasma proteins. Additionally, genetic instruments were employed to assess the impact of immune traits, including circulating inflammatory proteins, immune cell traits, immune-mediated diseases, and mRNA expression on kidney stone disease. Immunofluorescence staining was also performed to confirm gene expression patterns in kidney tissues affected by Randall's Plaque (RP). The results of the inverse variable weighting method showed that 174 plasma proteins were positively associated with KSD [ P < 0.05, odds ratio (OR) > 1]; 48 plasma proteins were negatively associated with KSD (P < 0.05, OR < 1). Subsequently, GO and KEGG analysis showed significant enrichment in immune pathways. Notably, elevated levels of inflammatory proteins such as CCL19 (OR per SD, 1.084; 95% CI = 1.006-1.167), OSM (OR per SD, 1.120; 95% CI = 1.023-1.227), and FGF5 (OR per SD, 1.077; 95% CI = 1.020-1.136) were associated with an increased risk of KSD. We also observed positive associations between 20 certain immune cell traits and KSD, while others 11 showed a negative correlation. Additionally, immune-mediated diseases, including psoriasis, Crohn's disease, and rheumatoid arthritis, were found to increase the risk of KSD (P < 0.05, OR > 1). Finally, summary-data-based MR analysis identified HLA-C, C4A and MICA as key immune system genes in blood and kidney eQTL data. Immunofluorescence staining verified the differential expression of HLA - C and C4A in clinical RP tissues.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"110"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267316","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":"Associations of obesity, sarcopenia, and sarcopenic obesity with the risk of kidney stones in the U.S. Adult: results from NHANES 2011-2018.","authors":"Ruixiang He, Pei Li, Ye Lang, Bo Zhu, Xiaoyue Yang, Jiongming Li","doi":"10.1007/s00240-025-01783-4","DOIUrl":"https://doi.org/10.1007/s00240-025-01783-4","url":null,"abstract":"<p><p>Kidney stones (KS), a globally prevalent urological disorder, are linked to metabolic abnormalities and inflammation. Sarcopenia, characterized by progressive skeletal muscle loss and functional decline, frequently coexists with metabolic dysregulation. Sarcopenic obesity (SO), defined by reduced muscle mass and/or function combined with excessive adiposity, may synergistically exacerbate health risks beyond isolated sarcopenia or obesity. However, current studies investigating the relationship between obesity, sarcopenia, SO and KS are limited to single-factor analyses, with limited exploration of inflammatory mediation. This study aims to examine the associations of obesity, sarcopenia, and SO with KS, and for the first time, evaluate the mediating effects of inflammatory biomarkers within these relationships. A total of 10, 043 participants aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) were included. Obesity was defined by body mass index and sarcopenia was assessed using the appendicular muscle index (AMI). SO was defined as the coexistence of sarcopenia and obesity. KS was identified through responses to the \"Kidney Conditions-Urology\" questionnaire. Weighted multivariable-adjusted logistic regression was used to evaluate the correlation between obesity, sarcopenia, SO and the risk of KS. Mediation models were constructed to assess the mediating role of inflammatory biomarkers. In the U.S. adult population, the prevalence of obesity, sarcopenia, and SO were 35.68%, 7.19%, and 5.27%, respectively. Among the population included in this study, the incidence rates of KS among individuals with obesity, sarcopenia, and SO were 9.77%, 10.92%, and 11.95%, respectively. Multiple regression analysis demonstrated significant independent positive associations between all three body composition disorders and KS incidence after comprehensive adjustment for potential confounding variables. Mediation analyses revealed that neutrophil mediated 11.38% (P = 0.0100), 13.60% (P = 0.0200), and 15.55% (P = 0.0120) of the potential effects of obesity, sarcopenia, and SO on KS formation, respectively. Obesity, sarcopenia, and SO were all positively associated with KS risk in U.S. adults. Neutrophil plays a critical mediating role in the relationship between obesity, sarcopenia, SO and KS.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"111"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267315","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":"L-arginine role for stone lower ureter: A randomized controlled trial.","authors":"Ahmed Mahmoud Mohammed Ahmed Elsherief, Ahmed Mahmoud Riyad, Emad Abdellah Ali, Amr Alam-Eldin Ahmed, Hassan Ali Gad, Ahmed Mamdouh Abd Elhameid","doi":"10.1007/s00240-025-01768-3","DOIUrl":"10.1007/s00240-025-01768-3","url":null,"abstract":"<p><p>This study aims to evaluate the effects of L-arginine 1000 mg once daily as a medical expulsive therapy (MET) for lower ureteral stones. This prospective, randomized controlled study was conducted on 162 patients with ureteral stones; 9 patients were excluded due to loss to follow-up, and the remaining 153 patients were divided into three groups. Group I (control) included 51 patients who received a placebo. Group II included 51 patients who received 1000 mg of L-arginine once daily. Group III included 51 patients who received tamsulosin 0.4 mg once daily. There was a highly statistically significant difference between the studied groups regarding ultrasound (U/S) and plain urinary tract (PUT) findings after 4 weeks. Spontaneous stone expulsion rates (SER) in the control, L-arginine, and tamsulosin groups were 6 (11.8%), 48 (94.1%), and 16 (31.4%), respectively (p < 0.001). The mean ± SD of stone expulsion time in the control, L-arginine, and tamsulosin groups was 19.6 ± 5.85, 19.02 ± 5, and 20.58 ± 5.78 days, respectively (p < 0.001). There was no statistically significant difference between the groups regarding the number of daily colic episodes and total analgesic dosage required. However, a statistically significant difference was noted regarding stone density and hydronephrosis. It is concluded that L-arginine is more effective than tamsulosin in increasing the SER and reducing stone expulsion time, with better pain control, making it a safe and effective MET for ureteral stones.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"109"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267317","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":"Perioperative changes of blood routine in daytime transurethral ureteroscopic laser lithotripsy and construction of a risk prediction model for delayed discharge.","authors":"Huadi Yuan, Liyan Gao, Lina Chou, Zhazha Lin, Jiarong Sun, Hao Zhang, Wenjun Gao, Bohan Wang","doi":"10.1007/s00240-025-01770-9","DOIUrl":"10.1007/s00240-025-01770-9","url":null,"abstract":"<p><p>Day surgery is critical for efficient healthcare delivery, but delayed discharge remains a key quality metric. This study investigates perioperative blood index changes during transurethral ureteroscopic laser lithotripsy (TULL) and constructs a risk prediction model for delayed discharge. A retrospective analysis of 526 TULL day surgery patients (2017-2021) compared normal (n = 412) and delayed discharge groups (n = 114). Blood indicators (WBC, Hb, Lymph#, Mono#, Neut#, Eos#) and clinical variables were analyzed. Logistic regression and ROC curves evaluated predictive factors. Delayed discharge was linked to longer operation time (OR = 1.024) and higher urine WBC (OR = 1.001), while Mono# showed protective effects (OR = 0.127). The model achieved an AUC of 0.710 (95% CI: 0.637-0.787), with strong calibration. The model enables early identification of high-risk patients, guiding interventions to reduce delayed discharge and improve day surgery management.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"53 1","pages":"108"},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249817","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":"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}