Patients with elements of metabolic syndrome are more likely to develop highly acidic urine, increasing their risk of forming uric-acid kidney stones, researchers reported. READ>>
Patients with elements of metabolic syndrome are more likely to develop highly acidic urine, increasing their risk of forming uric-acid kidney stones, researchers reported.
This study is the first to demonstrate a relationship between the metabolic syndrome and low urine pH that is independent of age, gender, body weight, type 2 diabetes, and renal function, Naim Maalouf, M.D., of the University of Texas Southwestern Medical Center here, and colleagues, reported in the September issue of the Clinical Journal of the American Society of Nephrology.
A new single-use digital flexible ureteroscope (LithoVue) compares favorably in performance to reusable scopes, at least for routine urteroscopy, with a possible advantage of being more economical.
The experience of two institutions using the single-use ureteroscope was reported at the AUA annual meeting in Boston.
This case study examines a 61-year-old female patient with recurrent kidney stone infections. The patient presented with a large calcium phosphate stone burden in the upper right pole. Dr. Shah shares his procedural techniques, including his laser lithotripsy strategy and preferred settings, to remove the large stone ureteroscopically.
Lipid metabolism abnormalities could fuel kidney stone formation in children, although changes in diet might help affected patients, according to a recent study.
Children with kidney stones and hypercalciuria have marked increases in urinary excretion of apolipoproteins and fatty acid binding proteins, which are proteins involved in lipid metabolism and transport, according to the study’s lead author Larisa Kovacevic, MD, of the Pediatric Stone Clinic in the department of pediatric urology at Children’s Hospital of Michigan in Detroit and Michigan State University, East Lansing.
Findings of a study investigating biomechanical stresses on the urologist while performing flexible ureteroscopy indicate that reusable and single-use digital ureteroscopes have a more favorable ergonomic profile than a reusable fiberoptic instrument.
A study analyzing variation in spending for patients undergoing ureteroscopy (URS) or shock wave lithotripsy (SWL) for urinary stone disease is a step towards helping urologists understand cost reduction opportunities as they face the possibility of payment bundling for these outpatient procedures, according to researchers from the University of Michigan, Ann Arbor.
An impacted ureteral calculus is a common and difficult situation for a urologist. Dr. Abbott discusses considerations aimed at decreasing complications and improving outcomes when removing an impacted stone. He shares his techniques and technology used for this procedural challenge.
Stone disease has become prevalent in children, requiring pediatric care providers to understand disease process, diagnosis, and management.
Among ED visits within 30 days of elective ureteroscopy over the 6-month span, pain was the presenting complaint in about 60% of patients, Scott and White Medical Center researchers report.
Pain is the most common reason for emergency department (ED) visits in the 30 days following ureteroscopy, according to a 6-month review of cases conducted at Scott and White Medical Center, Temple, TX.
The safety and viability of outpatient percutaneous nephrolithotomy and predictors of success after shock wave lithotripsy were among the research highlights in endourology/stones at the AUA annual meeting.
Dr. Sur discusses the procedural challenges of removing a complete staghorn renal calculus from a middle-aged morbidly obese man. He describes the patient’s complications during a PCNL, why the procedure was abandoned, and how multiple ureteroscopy (URS) procedures using a dusting technique led to a successful outcome. Dr. Sur also highlights the importance of patient communication and establishing realistic expectations early.
Children with asthma are 4 times more likely to have kidney stones than those without asthma, and vice versa, according to a study published online in the medical journal PLoS One.1
“We evaluated children with kidney stones and children with asthma,” says co-investigator Serpil Erzurum, MD, chair of the Lerner Research Institute at the Cleveland Clinic, Cleveland, Ohio. “In either case, asthma and kidney stones are associated with each other.”
Other key stone disease/endourology topics from the 2016 AUA annual meeting included the use of aspirin in percutaneous nephrolithotomy patients as well as the continuing debate over the benefit of medical expulsive therapy. The stone disease/endourology take-home messages were presented by Jodi Antonelli, MD, of the University of Texas Southwestern Medical Center, Dallas.
External physical vibration lithecbole (EPVL) may be the ideal adjunct to retrograde ureteroscopic treatment of renal stones in trying to render patients free of stone fragments.
Dr. Jaffe discusses flexible ureteroscope maneuvers that enable access into difficult-to-reach parts of the kidney. He highlights enabling direct visualization, laser lithotripsy and basket retrieval in patients with stenosis and stones in hard-to-reach angles and areas within the collecting system.
In this interview, Brian R. Matlaga, MD, MPH, discusses factors to consider in the decision to utilize ureteroscopy versus shock wave lithotripsy, how to counsel patients on the optimal approach, how to minimize the morbidity of each modality, and why younger urologists are more likely to perform ureteroscopy.
Whether or not medical expulsive therapy (MET) is a sound recommendation for patients with kidney or ureteral stones is a matter of debate.
Researchers from the Endourology Disease Group for Excellence research consortium compared the techniques in 152 patients at several stone centers.
The rise of laser lithotripsy has revolutionized the treatment of larger kidney stones, but there’s been a big mystery: Is it better to pulverize the stone into bits and leave them in the kidney (“dusting”) or pull the fragments out via ureteroscope (“basketing”)? Dusting is quicker and possibly less damaging, while basketing gets rid of remnants that could cause trouble later.
Addition of anticholinergic to alpha-blocker ‘fails to provide any benefit’
Madison, WI—Adding an anticholinergic medication to an alpha-blocker does not appear to improve ureteral stent-related discomfort compared to monotherapy with an alpha-blocker alone, according to research presented by investigators from the University of Wisconsin, Madison.
One of our urologists billed out a 52318 for a litholapaxy. The operative report reads: “It is estimated there are approximately seven to eight stones total. Most stones measure approximately 1.5 to 2 cm in size in maximum dimension. The remainder of the bladder appears normal.” When questioning the physician about billing 52317, rather than 52318, he replied: “As far as I know, it is always based on overall or total stone burden. Treating several 2-cm stones to equal a total stone burden of 6 cm is different and requires more work, more OR time, etc. than treating a single stone of 2 cm.
Dr. Stoller discusses the surgical challenges of removing a highly encrusted stent, including setting expectations with patients. He also covers selecting a strategy and stone clearance objective for various potential approaches and ensuring the most appropriate equipment is available to treat the patient in a productive fashion.
Dr. Chew discusses the importance of strategic device selection to gain access through a ureter obstructed by a stone.
Highlights include specific maneuvers required and different types of catheters and wires necessary for performing these difficult cases.
San Diego—Researchers who are investigating burst-wave lithotripsy, a potential alternative treatment for kidney stones, report that magnetic resonance imaging and ultrasound scans hold promise as tools to help scientists analyze related kidney injuries.