Kidney Stones

A sizable proportion of opioid-naïve patients who undergo stone surgery become chronic opioid users, according to a study conducted by urologists from Emory University, Atlanta.

In this interview, Thomas Chi, MD, discusses how he performs PCNL, explains why he uses ultrasound instead of fluoroscopy, and offers advice to urologists looking to gain more experience with the procedure.

"We must better identify patients with higher risk factors for recurrence and follow them more effectively," writes Stephen Y. Nakada, MD.

Many urologists don't follow guidelines calling on them to image their patients after ureteroscopic stone disease treatment, researchers say.

These videos demonstrate significant advances in percutaneous nephrolithotomy technique that can serve to optimize outcomes, reduce OR time, and help achieve optimal results.

A mobile app for stone metaphylaxis and an algorithm defining specific indications for stent omissions were among the other highlights in endourology/stones at AUA 2018.

An elderly male with hypertension, lumbar spinal stenosis, morbid obesity, and ED presents with acute right-sided worsening of his chronic back pain. A distal right ureteral stone is found on CT and his symptoms respond well to medical therapy, but he later develops severe right flank pain.

Findings of a retrospective study confirm that unplanned encounters are common after ureteroscopy.

A recent study "revealed that inadequate pain control, presence of a ureteral stent, and a first-time stone treatment were the most common reasons for unplanned utilization of health care services [following ureteroscopy]," writes Brian R. Matlaga, MD, MPH.

A 42-year-old female undergoes right percutaneous nephrolithotomy (PCNL) for a complete staghorn calculus. As a routine after PCNL, a chest-x-ray was obtained using fluoroscopy. What abnormality is seen?

When treating kidney stones, debate continues over the use of dusting versus basketing. In this interview, Olivier Traxer, MD, describes both methods, lists his preferred laser settings, and explains why he changed the way he uses ureteral access sheaths.

A study analyzing stone-free rates after ureteroscopy suggests that urologists might consider applying refined patient selection criteria in order to achieve better outcomes.

A preliminary analysis of data from a randomized controlled trial supports the efficacy of a low-oxalate diet for reducing urinary oxalate excretion in patients with idiopathic hyperoxaluria, but shows little or no benefit for daily dietary supplementation with vitamin B6 25 mg/magnesium 400 mg or a diet-supplement combination.

Videos demonstrating ureteroscopy techniques, the debate over medical expulsive therapy, and research into ureteroscopy's possible effect on erectile function were among our most-read stone disease articles of 2017.

A 61-year-old female complains of acute-onset right-sided flank and abdominal pain. She describes associated nausea, but denied urinary symptoms, hematuria, fever, or chills.

Flexible ureteroscopy using a digital single-use flexible ureteroscope known as PUSEN achieves stone-free rates on par with reusable flexible ureteroscopes, with a total surgery time averaging 45 minutes.

Other products and services discussed in this round-up include a biosimilar for cancer, an American College of Surgeons manual on quality initiatives, a kidney cancer microsite, and more.

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.

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 or shock wave lithotripsy for urinary stone disease is a step towards helping urologists understand cost reduction opportunities.

Men and women with gout are at 60% greater risk for nephrolithiasis than adults without gout, according to a study looking at not only the chronic kidney condition’s incidence but also potential risk factors for first-time nephrolithiasis in people with and without gout.

Other pipeline developments include an agent to control pain in IC/BPS patients, an antibody to treat prostate and bladder cancer, an injectable OAB treatment, and more.

Other products discussed include cancer tests, an app to connect patients with specialists, a revenue management system, and more

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.

Other pipeline developments include a new company formed to develop OAB treatments, a phase III urothelial cancer study meeting its primary endpoint, the formation of a partnership to study RCC treatment, and more.

Badar M. Mian, MD, discusses a recent study about the use of external physical vibration lithecbole for treating residual stones after retrograde intrarenal surgery.

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.

Other pipeline developments include efficacy results for a bladder and prostate cancer drug, an infertility tool to predict sperm quality, the initiation of an immunotherapy combination for mUC, and more.

Urology Times reached out to four urologists (selected randomly) and asked them each the following question: How concerned are you about radiation exposure?

The results could have major diagnostic and treatment implications for pediatric kidney stone patients, a researcher says.