Ureteroscopy Tech & Devices

Patients with ureteral stents are rarely lost to follow-up, but the risk is increased when patients are stented in an emergent setting rather than as part of an elective procedure, Yale University urologists reported at the 2018 World Congress of Endourology in Paris.  

A study examining opiate use after ureteroscopy found that younger age and greater number of preoperative opiate prescriptions were associated with the filling of additional opiate prescriptions.

In this interview, Andrew Portis, MD, discusses his experience with ureteral access sheaths and describes an algorithm for their selection and use. 

"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.

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.

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.

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.

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.

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.

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.

In these videos, high-volume stone surgeons demonstrate novel approaches to classification, visualization, and treatment of stones.

Patients undergoing ureteroscopy while remaining on anticoagulant therapy may be at increased risk for bleeding complications, including significant bleeding events and unplanned returns to the operating room, according to a retrospective study

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.

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.

In this edition of "Coding Q&A," Ray Painter, MD, and Mark Painter also discuss the use of the –59 modifier when instilling mitomycin after TURBT, and whether you can charge for a establishing a treatment on the same day for a patient on whom you have just performed a cystoscopy.

This question points out the importance of understanding each description as you select the appropriate code for services provided.

Although percutaneous nephrolithotomy (PCNL) comprises only 4% to 6% of all stone surgeries, it behooves the urologist with an interest in stone disease to be facile in this treatment modality in order to offer patients the most appropriate and effective treatment for their stones.