Comparative Analysis of Safety and Efficacy Between Anterior and Posterior Calyceal Entry in Supine Percutaneous Nephrolithotomy.

One advantage of supine percutaneous nephrolithotomy (sPCNL) is the ability to access anterior as well as posterior calyces, but the safety and efficacy of anterior calyceal entry has never been investigated to our knowledge. We prospectively evaluated patients scheduled for sPCNL comparing anterior and posterior calyceal access. After Institutional Review Board approval, we prospectively enrolled 100 consecutive patients undergoing sPCNL from February to September 2023.

Extreme Percutaneous Nephrolithotomy: A Case Series of Procedures Requiring Five or More Access Tracts.

Percutaneous nephrolithotomy (PCNL) remains the gold standard treatment for patients with complete staghorn stones, for which multiple access tracts may be required. In this study, we describe a series of patients undergoing PCNL with a minimum of five dilated access tracts. We performed a multi-institutional retrospective review of 10 patients with complete staghorn stones who underwent PCNL requiring five or more access tracts.

Review of efficacy and safety of same-day discharge after percutaneous nephrolithotomy.

Purpose: Prior literature reviews have assessed the efficacy and safety of outpatient percutaneous nephrolithotomy (PCNL) with "outpatient" defined as discharge within twenty-four hours of surgery. To our knowledge, this is the first literature review analyzing ambulatory PCNLs (aPCNL) defined as hospital discharge on the same day as surgery. This review aims to assess the efficacy and safety of same-day discharge after PCNL.

Comparison of metabolic parameters between pure-uric acid and mixed-uric acid kidney stone formers.

Purpose: We seek to compare clinical and 24-h urine parameters between pure-uric acid (UA) and UA-CaOx stone formers in our practice and explore how any differences in metabolic profiles could suggest different prevention strategies between the two groups.

Methods: We retrospectively reviewed patients with either pure- or mixed-UA nephrolithiasis from 2020 to 2023 at a tertiary care center. We included patients with a 24-h urine collection and a stone analysis detecting any amount of UA.

Evaluation of the Current Status of Artificial Intelligence for Endourology Patient Education: A Blind Comparison of ChatGPT and Google Bard Against Traditional Information Resources.

Artificial intelligence (AI) platforms such as ChatGPT and Bard are increasingly utilized to answer patient health care questions. We present the first study to blindly evaluate AI-generated responses to common endourology patient questions against official patient education materials. Thirty-two questions and answers spanning kidney stones, ureteral stents, benign prostatic hyperplasia (BPH), and upper tract urothelial carcinoma were extracted from official Urology Care Foundation (UCF) patient education documents.

Comprehensive analysis of factors associated with significant blood loss during percutaneous nephrolithotomy.

Introduction: The objective of this study is to conduct a thorough investigation of the risk factors associated with blood loss during PCNL, within the setting of a US urban tertiary care center.

Materials And Methods: We conducted a retrospective analysis of our endourology database to identify adult patients who underwent PCNL for stone extraction at our tertiary stone center between October 2014 and December 2022. Patients were categorized into two groups based on the extent of blood loss: significant blood loss (SBL) and no significant blood loss (NSBL).

Drivers of calcium oxalate stone formation in the octogenarian population.

Introduction: American Urological Association (AUA) guidelines suggest metabolic testing via 24-h urine studies in high-risk, interested first-time stone formers, and recurrent stone formers. If metabolic testing is not available or otherwise not feasible, clinicians may need to utilize empiric therapy. Debility and social barriers, particularly in the elderly population, may limit the practicality of metabolic testing, and therefore, empiric therapy is of particular importance.

Adjuvant intraluminal therapies for upper tract urothelial carcinoma.

Upper urinary tract urothelial carcinomas (UTUCs) are often identified and first treated endoscopically. After proper risk stratification, adjuvant treatment may be recommended. Consequently, as adjuvant therapy becomes more common place in the oncological armamentarium, we seek to better characterize its existing and future therapeutic landscape.

Opioid-free percutaneous nephrolithotomy: an initial experience.

Introduction: The opioid epidemic in the United States is an ongoing public health crisis that is in part fueled by excessive prescribing by physicians. Percutaneous nephrolithotomy (PCNL) is a procedure that conventionally involves opioid prescriptions for adequate post-operative pain control. We aimed to evaluate the feasibility of a non-opioid pain regimen by evaluating post-operative outcomes in PCNL patients discharged without opioids.

Selecting an Endourology Society Fellowship Program: The Candidates' Perspectives.

Understanding the factors that influence the decision of urology residents to pursue an Endourology Society (ES) fellowship and the criteria used by applicants to rank programs may help residents and program directors (PDs) optimize the match process. In the present study, we surveyed current ES fellows to gain better insight surrounding their decision-making process. A survey was emailed to all ES fellows, comprising Endourology and Stone Disease (ESD), Laparoscopic and Robotic Surgery (MIS), and combination of ESD/MIS (COM) programs.

Reverse Trendelenburg Positioning Minimizes Stone Retropulsion During Ureteroscopic Laser Lithotripsy: A Prospective Randomized Study.

Retropulsion of stone fragments during ureteroscopic laser lithotripsy (URSLL) remains a challenge for urologists and is associated with increased operative time and reduced stone-free rate (SFR). In this study, we compared the rate of retropulsion of ureteral stones during URSLL between the standard dorsal lithotomy (SDL) position and dorsal lithotomy position with reverse Trendelenburg (RT). Patients with ureteral stones requiring surgical intervention between May 2019 and January 2022 were randomized to undergo URSLL in either SDL or RT positions.

The effects of continuing aspirin on blood loss and postoperative outcomes in percutaneous nephrolithotomy.

Background: Percutaneous nephrolithotomy (PCNL) is an effective surgery for complex kidney stones yet with inherent bleeding risks. It remains unclear whether aspirin should be discontinued prior to PCNL. We aimed to further substantiate the safety of continuing aspirin during PCNL surgery and to determine whether aspirin status affects postoperative outcomes following PCNL.

Displacement of Lower Pole Stones During Retrograde Intrarenal Surgery Improves Stone-free Status: A Prospective Randomized Controlled Trial.

Purpose: Lower pole renal stones are associated with the lowest stone-free status of any location in the urinary tract during retrograde intrarenal surgery. Prior work has suggested displacing lower pole stones to a more accessible part of the kidney to improve stone-free status. We sought to prospectively compare the efficacy of laser lithotripsy in situ vs after displacement during retrograde intrarenal surgery for lower pole stones.

Predicting Septic Shock After Emergent Ureteral Stenting in Stone-Related Obstruction and Presumed Infections.

Systemic inflammatory response syndrome (SIRS) criteria have long been used to predict septic shock. The sequential organ failure assessment and quick sequential organ failure assessment (qSOFA) scores have been suggested to be more accurate predictors. This study aims to compare SIRS and qSOFA for predicting of septic shock in the setting of retrograde ureteral stenting for obstructing stones and concomitant urinary tract infection.

In vitro assembly of cubic RNA-based scaffolds designed in silico.

The organization of biological materials into versatile three-dimensional assemblies could be used to build multifunctional therapeutic scaffolds for use in nanomedicine. Here, we report a strategy to design three-dimensional nanoscale scaffolds that can be self-assembled from RNA with precise control over their shape, size and composition. These cubic nanoscaffolds are only approximately 13 nm in diameter and are composed of short oligonucleotides, making them amenable to chemical synthesis, point modifications and further functionalization.