Ian Metzler, MD, highlights recent advances in kidney stone technology

Technology for kidney stone surgery is rapidly evolving. In a recent interview with Urology Times®, Ian Metzler, MD, MTM, highlights some of the recent advancements that he finds exciting in the field.

“One of the big reasons I love my job and I'm so excited about endourology and kidney stone treatment is all the toys we get to play with. There are increasing levels of technology throughout every aspect of kidney stone therapy,” Metzler said.

The first that comes to mind, he says, is all of the development related to kidney stone imaging. Dual-energy CT scans, for example, can be used to better predict stone type non-invasively. Metzler predicts that as the field becomes more AI-focused, we may start to see more of these prediction algorithms in clinical practice.

Another development in kidney stone imaging is the increased resolution of ultrasound imaging.

He notes, “That's really important in terms of our ability to detect stones and have better sensitivity using imaging with non-ionizing radiation. There [are] great studies out there that show that ultrasound really should be first-line in evaluation for renal colic.”

Metzler is an assistant professor of urology at Oregon Health & Science University School of Medicine in Portland, Oregon.

Other advancements in stone disease include new forms of shock wave lithotripsy, less invasive ways to fragment stones and help them pass, and new developments in disposable ureteroscopes.

On the last point, Metzler noted, “With the advent of these scopes, we're seeing much slimmer designs [and] more functionality—including embedded suction and multi-channels and different ergonomic designs. That's really exciting because we want to be able to customize our treatment to the patient and the stone that we're treating. It also decreases, theoretically, the risk of sepsis."

Metzler concluded by highlighting novel suction sheaths, which he believes are a game-changer.