Kidney Stones

"The devices, telemedicine and remote care, and outpatient surgery risk us losing the human connection we had with the patient, as time spent with them is at a premium today," writes Gopal H. Badlani, MD.

“The main question we were interested in answering was what the impact of future climate under different scenarios of climate change would have on the incidence of kidney stone disease, using South Carolina as a model state,” says Jason Kaufman.

"Our analysis suggests that a warming planet will likely cause an increased burden of kidney stone disease on health care systems,” says Gregory E. Tasian, MD, MSc, MSCE.

Investigators evaluated data from the Continuous National Health and Nutrition Examination Survey.

“Going into this study, we thought that potentially patients who had a stent placed with the string left in place were at higher risk of having a complication…But we found that they weren't at higher risk of a complication,” says Amy E. Krambeck, MD.

In a cohort of nearly 30,000 patients, more than half had cystoscopy-based stent removal within 6 months post ureteroscopy, investigators reported.

“I currently make regular use of a peripheral nerve block during PCNL…with the intent of, of limiting my patients exposure to and the need for opioids,” says Jared S. Winoker, MD.

“[Kidney stones] really seems like something that we should be devoting significant resources and effort to trying to figure out the root causes and also better treatments and therapies for,” says Jonathan E. Shoag, MD.

“We should really try to adapt, know what we're doing to the specific patient based on their risk factors, prepare them appropriately, and understand that it's a dangerous complication. We should do everything we can to prevent it,” says Naeem Bhojani, MD, FRCSC.

“The most notable finding unquestionably was that peripheral nerve blocks have the ability to significantly reduce opioid requirements without compromising any pain control,” says Jared S. Winoker, MD.

In 2 recent studies led by Naeem Bhojani, MD, FRCSC, and Ben H. Chew, MD, MSc, investigators performed a meta-analysis to identify predictors of sepsis as well as the cost of sepsis for patients with stone disease.

“Ideally…we have a technology that's noninvasive that we can use in the clinic, where they don't require any anesthesia to…break the stones and make them smaller,” says Mathew D. Sorensen, MD, MS, FACS.

"Each bill that is submitted for reimbursement must have a code for both the service performed and a reason for the service," writes Jonathan Rubenstein, MD, and Mark Painter.

Get ready for the 2021 AUA annual meeting with this preview of non-malignant topics.

In this interview, Nicole L. Miller, MD, discusses her institution’s enhanced recovery after surgery protocol for ureteroscopy, which eliminates the use of opioids in patients undergoing this common procedure.

Amy E. Krambeck, MD, discusses her recent trial comparing the efficacy of Trilogy and ShockPulse-SE lithotripters used in percutaneous nephrolithotomy.

“For harder, more aggressive stones, I'm more likely to use the Trilogy based on the results of the study. If I have a softer, easier stone, I prefer the lightness of the ShockPulse," said lead study investigator Amy E. Krambeck, MD.

The FDA approved lumasiran in November 2020 as the first drug for the treatment of patients with primary hyperoxaluria type 1.

Kyle Wood, MD, discusses the different types of hyperoxaluria, the urologist’s role in managing the condition, and the treatments for it.

“While patient facing apps hold great potential to support self-management behaviors, particularly in stone disease, thoughtful consideration across an array of domains should really be taken prior to supporting or even recommending one of these apps to a patient,” says Jared S. Winoker, MD.

"If we can’t get the emergency rooms physicians to apply a bit of common sense to medicine, maybe we should require that they all have a ureteral stent placed for a few weeks during their residency so that they have a better idea of what these patients go through," writes Henry Rosevear, MD.

The study also confirms the growing popularity of ureteroscopy as a stone management tool.

Review of nearly 5600 patients found a 5% pooled incidence of postoperative urosepsis.

Here is what is recommended for fluid intake and dietary changes.

North American urologists analyzing outcomes from their initial experience treating urolithiasis with the high-power super pulse thulium fiber laser (Soltive) are encouraged by the results.

Analyses of data collected in a prospectively maintained database support the recommendation for urologists to consider the minimally invasive version of mini-percutaneous nephrolithotomy for stone removal in patients with medium-sized stones (10-20 mm).

"Everything comes down to patient selection and location of the stones," says one urologist.

The goal of the study is to establish real-world efficacy evidence of using the Soltive Laser System for laser lithotripsy.

Reza Z. Goharderakhshan, MD, discusses how patient compliance for recommended studies increased from less than 10% to 82% following implementation of the program.

Existing evidence does not clarify which patients with acute ureteral colic would benefit most from early surgical intervention.