UrolithiasisPub Date : 2024-06-14DOI: 10.1007/s00240-024-01566-3
Xiaodong Hao, Zefeng Wang, Shuo Zheng, Zheng Chao, Yanan Wang, Chunyu Zhang, Weimin Yu, Haojie Shang, Qiugong Xiao, Jianbing Du, Zhiqiang Chen, Le Li
{"title":"Comparison of conventional (basketing + dusting) and Moses (pop-dusting) holmium lasers during flexible ureteroscopy in the treatment of renal stones between 2 and 3 cm: a randomized clinical trial.","authors":"Xiaodong Hao, Zefeng Wang, Shuo Zheng, Zheng Chao, Yanan Wang, Chunyu Zhang, Weimin Yu, Haojie Shang, Qiugong Xiao, Jianbing Du, Zhiqiang Chen, Le Li","doi":"10.1007/s00240-024-01566-3","DOIUrl":"10.1007/s00240-024-01566-3","url":null,"abstract":"<p><p>To investigate the feasibility of conventional (basketing + dusting) and Moses (pop-dusting) holmium lasers during flexible ureteroscopy (FURS) in the treatment of 2-3 cm renal calculi and to compare the efficiency and safety of the two methods, a total of 230 patients with 2-3 cm kidney stones who underwent FURS were randomly divided into the conventional group and the Moses group. The mode of lithotripsy in the conventional group was fragmentation and dusting. The mode of lithotripsy in the Moses group was dusting and pop-dusting. Clinical and perioperative variables and complications were compared between the two cohorts. Multivariate analyses of factors contributing to the stone-free rate (SFR) and operation time were performed. No statistically significant differences were found in the demographics, renal stone-related data, SFR, or complications between the cohorts. The laser energy was higher in the Moses cohort than in the conventional cohort (119.3 ± 15.2 vs. 92.8 ± 15.1 kJ; P < 0.001), and the operation time was shorter in the Moses cohort than in the conventional cohort (99.5 ± 18.9 vs. 105.3 ± 13.7 min; P = 0.009). When there was isolated stone, the operation time was shorter in the Moses cohort than in the conventional cohort (99.6 ± 17.5 vs. 111.4 ± 10.7 min; P < 0.001), while there was no significant difference between the two cohorts when there were multiple stones (99.5 ± 20 vs. 101.2 ± 14 min; P = 0.415). Multivariate analyses found that an increase in stone volume can decrease the SFR and prolong the operation time, and use of a Moses laser can shorten the operation time. Both holmium laser modes during FURS can effectively treat 2-3 cm renal calculi. The Moses mode is recommended as the first choice for the treatment of isolated 2-3 cm renal stones. When treating multiple stones, the efficiency of these two laser modalities is the same. TRIAL REGISTRATION: ChiCTR2200056091.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"89"},"PeriodicalIF":2.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318447","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}
UrolithiasisPub Date : 2024-06-14DOI: 10.1007/s00240-024-01588-x
Ziyun Li, Zhaocun Zhang, Peng Yu, Yongliang Ni
{"title":"Microbial communities, antibiotic resistance genes, and virulence factors in urinary infectious stone-associated urinary tract infections.","authors":"Ziyun Li, Zhaocun Zhang, Peng Yu, Yongliang Ni","doi":"10.1007/s00240-024-01588-x","DOIUrl":"https://doi.org/10.1007/s00240-024-01588-x","url":null,"abstract":"<p><p>Urinary infectious stones are challenging due to bacterial involvement, necessitating a comprehensive understanding of these conditions. Antibiotic-resistant urease-producing bacteria further complicate clinical management. In this study, analysis of urine and stone samples from urinary tract infection (UTI) patients revealed microbial shifts, gene enrichment in stones, and metabolic pathway disparities; antibiotic resistance gene trends were phylum-specific, urease-producing bacteria are at risk of acquiring AMR carried by Enterobacteriaceae under antibiotic, emphasizing potential AMR dissemination between them; Correlations of key pathogenic species in kidney stone and urine microbial communities highlight the need for targeted therapeutic strategies to manage complexities in UTIs; Stones and urine contain a variety of deleterious genes even before antibiotic use, and piperacillin/tazobactam better reduced the abundance of antibiotic resistance genes in stones and urine. The presence of diverse antibiotic resistance and virulence genes underscores challenges in clinical management and emphasizes the need for effective treatment strategies to mitigate risks associated with UTIs and urinary infectious stone formation. Ongoing research is vital for advancing knowledge and developing innovative approaches to address these urological conditions.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"88"},"PeriodicalIF":3.1,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318448","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":"Monitoring Intrarenal temperature changes during Ho: YAG laser lithotripsy in patients undergoing retrograde intrarenal surgery: a novel pilot study.","authors":"Ertugrul Kose, Yakup Bostanci, Murat Gulsen, Fevzi Sahin, Onur Kalayci, Ender Ozden, Yarkin Kamil Yakupoglu, Saban Sarikaya","doi":"10.1007/s00240-024-01592-1","DOIUrl":"https://doi.org/10.1007/s00240-024-01592-1","url":null,"abstract":"<p><p>Ho: YAG laser lithotripsy is widely used for urinary stone treatment, but concerns persist regarding its thermal effects on renal tissues. This study aimed to monitor intrarenal temperature changes during kidney stone treatment using retrograde intrarenal surgery with Ho: YAG laser. Fifteen patients were enrolled. Various laser power settings (0.8 J/10 Hz, 1.2 J/12 Hz) and irrigation modes (10 cc/min, 15 cc/min, 20 cc/min, gravity irrigation, and manual pump irrigation) were used. A sterile thermal probe was attached to a flexible ureterorenoscope and delivered into the calyceal system via the ureteral access sheath. Temperature changes were recorded with a T-type thermal probe with ± 0.1 °C accuracy. Laser power significantly influenced mean temperature, with a 4.981 °C difference between 14 W and 8 W laser power (p < 0.001). The mean temperature was 2.075 °C higher with gravity irrigation and 2.828 °C lower with manual pump irrigation (p = 0.038 and p = 0.005, respectively). Body mass index, laser power, irrigation model, and operator duty cycle explained 49.5% of mean temperature variability (Adj. R<sup>2</sup> = 0.495). Laser power and operator duty cycle positively impacted mean temperature, while body mass index and specific irrigation models affected it negatively. Laser power and irrigation rate are critical for intrarenal temperature during Ho: YAG laser lithotripsy. Optimal settings and irrigation strategies are vital for minimizing thermal injury risk. This study underscores the need for ongoing research to understand and mitigate thermal effects during laser lithotripsy.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"86"},"PeriodicalIF":3.1,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311807","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}
UrolithiasisPub Date : 2024-06-13DOI: 10.1007/s00240-024-01583-2
Christine M Van Horn, Gregory Iovanel, Britney Atwater, Rachel Engelberg, Ahmed Sobieh, Igor Sorokin
{"title":"Perinephric fat stranding is associated with increased age and stone size but not with serum creatinine in patients with obstructing ureterolithiasis.","authors":"Christine M Van Horn, Gregory Iovanel, Britney Atwater, Rachel Engelberg, Ahmed Sobieh, Igor Sorokin","doi":"10.1007/s00240-024-01583-2","DOIUrl":"https://doi.org/10.1007/s00240-024-01583-2","url":null,"abstract":"<p><p>Previous reports show increased severity of perinephric fat stranding (PFS) with elevated serum creatinine in obstructing ureterolithiasis. We sought to investigate this association with our institution's patient population.We reviewed charts of patients diagnosed with obstructive ureterolithiasis or nephrolithiasis in our emergency department between January and October 2018. Patient demographics, lab results, and computed tomography (CT) imaging were reviewed. A blinded radiologist reviewed all CTs and graded hydronephrosis and PFS. Subjects were stratified by degree of PFS and compared via paired t-test, chi-squared test, univariate analysis, and multivariate analysis.We identified 141 patients; 114 had no-mild (Group 1) PFS, while 27 had moderate-severe (Group 2) PFS. Group 1 had a mean age of 56 (SD = 16.1) and mean stone size of 7.3 mm (SD = 4.22); 77% of the cohort had symptoms under 24 h. Group 2 was older with a mean age of 65 (SD = 16.2, p = 0.01) and mean stone size of 10.1 mm (SD = 6.07, p < 0.01); 50% had symptoms less than 24 h (p = 0.01). PFS did not correlate with change in serum creatinine. Univariate and multivariate analysis showed increasing age increased the odds of moderate-severe PFS by 3.5% (OR = 1.035, p < 0.05) while increased stone size increased the odds of moderate-severe PFS by 13.7% (OR = 1.137, p = 0.01).Although increased PFS correlated with increased age and stone size, no correlation was found with presenting creatinine or change in creatinine. Degree of PFS is likely a poor predictor of renal disease severity in acute ureterolithiasis.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"87"},"PeriodicalIF":3.1,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311808","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 effect of endoscopic renal and ureteral stone surgeries on renal blood flow in children: a prospective trial.","authors":"Fevzi Batuhan Topbas, Cagri Akin Sekerci, Efe Soydemir, Ozge Yapici, Serkan Akbas, Selcuk Yucel, Tufan Tarcan, Yiloren Tanidir","doi":"10.1007/s00240-024-01578-z","DOIUrl":"10.1007/s00240-024-01578-z","url":null,"abstract":"<p><strong>Aim: </strong>To assess the impact of endoscopic stone surgeries on renal perfusion and blood flow in children.</p><p><strong>Materials and methods: </strong>Children who underwent percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), ureterorenoscopy (URS), endoscopic combined intrarenal surgery (ECIRS) were included to the study. Renal Doppler ultrasonography (RDUS) was performed one day before the operation, and on the postoperative 1st day and 1st month. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured, and resistive index (RI) was calculated with the (PSV-EDV)/PSV formula. RDUS parameters were compared before and after surgery and between ipsilateral and contralateral kidneys.</p><p><strong>Results: </strong>A total of 45 children with a median age was 8 (2-17) years were included (15 (33.3%) girls, 30 (66.7%) boys). PCNL was performed in 13 children (28.9%), RIRS 11 (24.4%), URS 12 (26.7%), and ECIRS 9 (20%). There was no significant difference in renal and segmental PSV, EDV and RI values of operated kidney in the preoperative, postoperative periods. There was no significant difference between RDUS parameters of the ipsilateral and contralateral kidneys in preoperative or postoperative periods. PSV and EDV values were significantly higher in the 1st postoperative month in the group without preoperative DJ stent than in the group with DJ stent (p = 0,031, p = 0,041, respectively). However, RI values were similar. The mean RI were below the threshold value of 0.7 in each period.</p><p><strong>Conclusion: </strong>RDUS parameters didn't show a significant difference in children. Endoscopic surgeries can be safely performed in pediatric stone disease.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"84"},"PeriodicalIF":2.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284868","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}
UrolithiasisPub Date : 2024-06-05DOI: 10.1007/s00240-024-01581-4
Yusuf Arikan, Mithat Eksi, Ubeyd Sungur, Mehmet Yoldas, Mehmet Zeynel Keskin
{"title":"Correction: Variation coefficient of stone density and renal cortical thickness: the parameters evaluating non-contrast computed tomography imaging for predict extracorporeal shock wave lithotripsy success.","authors":"Yusuf Arikan, Mithat Eksi, Ubeyd Sungur, Mehmet Yoldas, Mehmet Zeynel Keskin","doi":"10.1007/s00240-024-01581-4","DOIUrl":"https://doi.org/10.1007/s00240-024-01581-4","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"83"},"PeriodicalIF":3.1,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248686","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}
UrolithiasisPub Date : 2024-06-04DOI: 10.1007/s00240-024-01580-5
Çağdaş Bildirici, Taha Çetin, Mehmet Yiğit Yalçın, Mert Hamza Özbilen, Erkin Karaca, Mahmut Can Karabacak, Mehmet Çağlar Çakıcı, Tufan Süelözgen, Gökhan Koç
{"title":"Comparison of standard percutaneous nephrolithotomy and total tubeless percutaneous nephrolithotomy in the supine position.","authors":"Çağdaş Bildirici, Taha Çetin, Mehmet Yiğit Yalçın, Mert Hamza Özbilen, Erkin Karaca, Mahmut Can Karabacak, Mehmet Çağlar Çakıcı, Tufan Süelözgen, Gökhan Koç","doi":"10.1007/s00240-024-01580-5","DOIUrl":"https://doi.org/10.1007/s00240-024-01580-5","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy, safety and advantages of the total tubeless (TT) percutaneous nephrolithotomy (PCNL) and standard PCNL in the supine position.</p><p><strong>Methods: </strong>This study was carried out at İzmir Tepecik Health Application and Research Center. A total of 87 patients were examined. Forty-three patients who underwent TT procedure were defined as Group 1, and 44 patients who underwent standard procedure with a nephrostomy tube were defined as Group 2. Two techniques were evaluated with demographic data and outcome parameters. Univariate regression analyses were performed in these data sets for the parameters that predicted the TT procedure.</p><p><strong>Results: </strong>The demographic data of the groups and all characteristics of the stones were similar. When the results were examined, the stone-free rates detected by non-contrast computed tomography (CT) in the postoperative 1st month were similar between the groups. Complication rates and secondary intervention rates were similar. Operation and fluoroscopy times were shorter in group 1, which were not statistically significant. Postoperative hemoglobin decreased, and creatinine values were similar. In Group 1, mean postoperative visual analog scale (VAS) scores and the percentage of VAS reporting > 5 points for pain level measurement were lower and statistically significant. In the univariate analysis of the factors predicting the TT procedure, no significant results were found in any parameter.</p><p><strong>Conclusion: </strong>Performing TT PCNL in the supine position in selected patients reduces postoperative pain without affecting the complication rates as in prone PCNL. Our study is the first to compare TT and standard PCNL in supine position.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"82"},"PeriodicalIF":3.1,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238021","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}
UrolithiasisPub Date : 2024-06-01DOI: 10.1007/s00240-024-01574-3
Hammad Ather
{"title":"Obituary-Niels Peter Noor Buchholz 1957-2024.","authors":"Hammad Ather","doi":"10.1007/s00240-024-01574-3","DOIUrl":"https://doi.org/10.1007/s00240-024-01574-3","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"81"},"PeriodicalIF":3.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187066","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}
UrolithiasisPub Date : 2024-05-31DOI: 10.1007/s00240-024-01584-1
Amit Shemesh, Orit Raz, Hanan Goldberg, Amir Cooper, Dor Golomb
{"title":"Exploring the economic landscape of ureteric stones: impact of age and gender on direct healthcare costs.","authors":"Amit Shemesh, Orit Raz, Hanan Goldberg, Amir Cooper, Dor Golomb","doi":"10.1007/s00240-024-01584-1","DOIUrl":"https://doi.org/10.1007/s00240-024-01584-1","url":null,"abstract":"<p><strong>Objectives: </strong>To assess whether age or gender affects ureteric stone management costs, in patients presenting to the Emergency Department (ED) with CT proven ureteric stones.</p><p><strong>Patients and methods: </strong>A retrospective examination was conducted on patients admitted to the ED who were diagnosed with a ureteric stone through CT scans. Data encompassing clinical, laboratory, and imaging parameters were gathered, alongside information on admissions, ED readmissions, surgical procedures, and the overall treatment cost. Comparative analyses were performed on various cost rates in relation to different stone parameters, patient clinical presentations, laboratory results, and personal histories of urolithiasis.</p><p><strong>Results: </strong>From January 2018 to January 2020, 805 patients underwent abdominal CT scans at a single institution's ED and were diagnosed with ureteric stones. Among them, 773 patients met the inclusion criteria, with 78% (609) being males and 22% (169) females. The mean ages for males and females were 49.4 (SD 14.4) and 51.6 (SD 15.7), respectively (p = 0.08). Treatment costs exhibited a direct relationship with age, amounting to 4,025, 5,116, 6,058, and 9,225 US dollars (USD) in the 18-30, 31-50, 51-70, and over 70 age groups, respectively. Female gender was associated with higher treatment costs, averaging 6,831 USD, compared to 5,450 USD in males (p = 0.03). However, there were no significant differences between genders in terms of the type of surgical procedure (p = 0.4) or hospital stay duration (p = 0.1).</p><p><strong>Conclusions: </strong>Age and gender exerted a significant impact on treatment costs, revealing that advanced age and female gender were both correlated with higher direct treatment costs in the care of ureteric stones.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"79"},"PeriodicalIF":3.1,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180872","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}