Hybrid guidewires: Analysis and comparison of the mechanical properties and safety profiles.

Introduction: Hybrid guidewires are commonly used in urology due to the advantage of an atraumatic hydrophilic tip, which facilitates negotiating tight areas, coupled with an unkinkable nitinol core shaft that is easy to work over due to the Teflon coating. Our aim was to compare the physical and mechanical properties of five commercially available hybrid guidewires to assess their characteristics and functionality.

Methods: In vitro testing was performed on the following straight-tipped 0.

Urine kidney injury markers do not increase following gastric bypass: a multi-center cross-sectional study.

Introduction: To determine if markers of kidney injury correlate with urinary oxalate excretion. If so, such biomarkers might be early predictors of oxalate nephropathy. Gastric bypass surgery for obesity is known to be associated with postoperative hyperoxaluria, which can lead to urolithiasis and kidney damage.

Mini Versus Standard Percutaneous Nephrolithotomy: The Impact of Sheath Size on Intrarenal Pelvic Pressure and Infectious Complications in a Porcine Model.

Objective: To determine how sheath and endoscope size affect intrarenal pelvic pressures and risk of postoperative infectious complications comparing "Mini" vs "Standard" percutaneous nephrolithotomy (PCNL).

Materials And Methods: Uropathogenic Escherichia coli were grown and 10 of them were instilled into the porcine renal pelvis through retrograde access for 1 hour. Percutaneous access utilized a 14/16F 20 cm ureteral access sheath for the Mini arm and a 30F sheath for the Standard arm.

Inflammatory Cytokines in the Papillary Tips and Urine of Nephrolithiasis Patients.

Introduction: Intrarenal inflammation has been implicated in the pathogenesis of nephrolithiasis, with prior work showing increased urine levels of IL-6, IL-8, and CCL-2 in stone patients. However, no studies have assessed for inflammation in the renal papillae. We sought to characterize novel papillary tip and urinary biomarkers in stone patients.

American Urological Association Antibiotic Best Practice Statement and Ureteroscopy: Does Antibiotic Stewardship Help?

Purpose: To determine compliance with the American Urological Association (AUA) antimicrobial prophylaxis best practice statement and whether the use of postoperative antibiotics is associated with lower rates of postoperative urinary tract infection (UTI) in patients with nephroureterolithiasis and a negative preoperative urine culture undergoing ureteroscopy.

Materials And Methods: A retrospective review of all adult patients undergoing ureteroscopy from 2013 to 2014 for stone disease with a negative preoperative urine was conducted. Patients who did and did not receive postoperative oral antibiotics beyond 24 hours of surgery were identified.

Can a Simplified 12-Hour Nighttime Urine Collection Predict Urinary Stone Risk?

Objective: To determine if there is correlation between nighttime 12-hour and traditional 24-hour urine collection in regard to chemistry values and the supersaturations of calcium oxalate, calcium phosphate, and uric acid for the metabolic evaluation of nephrolithiasis.

Materials And Methods: Ninety-five patients were prospectively enrolled from 2013 to 2015. Patients >18 years of age who presented to a tertiary stone clinic and who would normally be counseled for 24-hour urine collection were eligible for the study.

Current practice of antibiotic utilization for renal colic in the emergency room.

Introduction: Urinalysis (UA) in the emergency setting for patients with nephrolithiasis produces potentially confusing results leading to treatment of presumed urinary tract infections (UTIs). Our objective was to evaluate the use of antibiotics in patients with nephrolithiasis in a large network of emergency departments (EDs).

Methods: A retrospective analysis of all ED visits associated with an ICD-9 diagnosis of nephrolithiasis and a CT scan between 2010 and 2013 was performed.

Tipless Nitinol Stone Baskets: Comparison of Penetration Force, Radial Dilation Force, Opening Dynamics, and Deflection.

Objective: To evaluate 5 commercially available tipless nitinol baskets (2.2F) in 4 performance factors: penetration force, radial dilation force, opening dynamics, and deflection limitation.

Materials And Methods: The 2.

Clinical Predictors of 30-Day Emergency Department Revisits for Patients with Ureteral Stones.

Purpose: Patients with ureteral stones frequently present to the emergency department for an initial evaluation with pain and/or nausea. However, a subset of these patients subsequently return to the emergency department for additional visits. We sought to identify clinical predictors of emergency department revisits.

Assessing Transplant Attitudes: Understanding Minority Men's Perspectives on the Multifarious Barriers to Organ Donation.

African Americans comprise 11 % of living organ donors, yet constitute 34 % of the kidney transplant waiting list. There are many barriers to organ donation among minorities that include decreased awareness of transplantation, cultural mistrust of the medical community, financial concerns, and fear of the transplant operation. This study investigates the societal misconceptions and demographic health factors that correlate with minority participation in organ and tissue donation.

Preoperative Prediction and Postoperative Surgeon Assessment of Volume Preservation Associated With Partial Nephrectomy: Comparison With Measured Volume Preservation.

Objective: To evaluate whether surgeons can predict the percent parenchymal mass that will be preserved by partial nephrectomy (PN) based on preoperative imaging, which could have potential utility for preoperative surgical planning and patient counseling. The proportion of preserved viable parenchyma following PN is the primary determinant of functional recovery. However, direct measurement of parenchymal volume preservation (VP) can be complex and time consuming.

Medical Expulsive Therapy is Underused for the Management of Renal Colic in the Emergency Setting.

Purpose: Although the 2007 AUA (American Urological Association) guidelines established it as first line therapy for ureteral stones less than 10 mm, widespread adoption of medical expulsive therapy has been low. We determined the current penetrance of medical expulsive therapy guideline recommendations and the efficacy of medical expulsive therapy in reducing the requirement for urological procedures after emergency department visits for ureteral stones.

Materials And Methods: In a retrospective analysis of patients seen in the emergency department we included 2,105 emergency department visits associated with an ICD-9 diagnosis of urolithiasis in which computerized tomography abdomen/pelvis scan was performed.

Flexible ureteroscopy with a ureteral access sheath: when to stent?

Objective: To compare intra- and postoperative data of patients who underwent ureterorenoscopy (URS) with an access sheath, with and without postoperative stenting.

Methods: We retrospectively identified patients who underwent flexible URS with a ureteral access sheath between January 2102 and January 2013. Two surgeons performed all cases; one who routinely stents after flexible ureteroscopy and a second who selectively stents.

Oxalobacter colonization in the morbidly obese and correlation with urinary stone risk.

Objective: To establish the baseline preoperative prevalence of Oxalobacter formigenes (OF) colonization in a cohort of obese patients scheduled for Roux-en-Y gastric bypass (RYGB) and determine the effect of OF colonization on urinary oxalate excretion. It has been proposed that loss of OF colonization after RYGB may contribute to the development of hyperoxaluria.

Methods: Adult patients scheduled to undergo RYGB were requested to provide a stool specimen and 24-hour urine collection before surgery.

Durability of reusable holmium:YAG laser fibers: a multicenter study.

Purpose: Single use and reusable variants of holmium:YAG laser fibers are available to treat calculi during ureteroscopic procedures. In this prospective, multicenter study we evaluated a series of reusable holmium:YAG laser optical fibers. We hypothesized that reusable fibers provide a cost advantage over single use variants.

Hyperoxaluria is a long-term consequence of Roux-en-Y Gastric bypass: a 2-year prospective longitudinal study.

Background: Recent studies suggest that patients undergoing Roux-en-Y gastric bypass (RYGB) for morbid obesity are at risk for hyperoxaluria, nephrolithiasis, and oxalate nephropathy. Our objective was to conduct a long-term prospective longitudinal study to establish the incidence, clinical progression, and severity of hyperoxaluria after RYGB.

Study Design: Patients undergoing RYGB between December 2005 and April 2007 provided 24-hour urine collections for comprehensive stone risk analysis 1 week before and 3 months and 1 and 2 years after surgery.

Durability of the next-generation flexible fiberoptic ureteroscopes: a randomized prospective multi-institutional clinical trial.

Objectives: To evaluate the durability of 4 next-generation flexible ureteroscopes in a randomized, multi-institutional, prospective study.

Methods: Patients at 3 institutions were randomized to 1 of 4 flexible ureteroscopes: the Wolf Viper, Olympus URF-P5, Gyrus-ACMI DUR-8 Elite (DUR-8E), and Stryker FlexVision U-500. Each center used 1 scope from each manufacturer until it needed major repair (primary endpoint).

Celecoxib in the management of acute renal colic: a randomized controlled clinical trial.

Objectives: To evaluate the efficacy of celecoxib as an analgesic and medical expulsive agent in acute renal colic.

Methods: A prospective randomized double-blind study was conducted on patients presenting with an obstructing ureteral calculus < 10 mm in largest diameter. Patients were randomized to 400 mg of celecoxib, followed by 200 mg every 12 hours for 10 days, or to placebo.

Comparative analysis of lighted ureteral stents: lumination and tissue effects.

Purpose: The objectives of the present study were to compare the luminescence of three types of ureteral illuminated stents and analyze their effects on urothelial histology.

Materials And Methods: Three types of illuminating ureteral stents; the Cook single illuminating catheter, Cook double illuminating catheter and Stryker illumination system stent were laparoscopically placed in nine female white pigs (50 kg), under general anesthesia. After leaving the stents illuminated for 3 hours, during which time peritoneal insufflation was maintained at 18 mm Hg, the ureter was transected and the intraluminal temperature of the ureter was measured with a digital thermometer.

Alfuzosin to relieve ureteral stent discomfort: a prospective, randomized, placebo controlled study.

Purpose: We assessed the impact of alfuzosin on ureteral stent discomfort.

Materials And Methods: A total of 66 patients scheduled for unilateral retrograde ureteroscopy with stent placement provided consent for the study. Patients were randomized between placebo and the study medication, and investigators and patients were blinded to the randomization scheme.

Estimation of size of distal ureteral stones: noncontrast CT scan versus actual size.

Objectives: To determine the accuracy of stone size determination by computed tomography (CT) for distal ureteral calculi.

Methods: A total of 76 patients who presented with distal ureteral stone were evaluated with CT. Of the 76 patients, 41 successfully passed the stone spontaneously and intact.

Roux-en-Y gastric bypass is associated with early increased risk factors for development of calcium oxalate nephrolithiasis.

Background: Patients treated for obesity with jejunoileal bypass (JIB) experienced a marked increased risk of hyperoxaluria, nephrolithiasis, and oxalate nephropathy developing. Jejunoileal bypass has been abandoned and replaced with other options, including Roux-en-Y gastric bypass (RYGB). Changes in urinary lithogenic risk factors after RYGB are currently unknown.

Alfuzosin stone expulsion therapy for distal ureteral calculi: a double-blind, placebo controlled study.

Purpose: We evaluated the efficacy of alfuzosin as medical expulsive therapy for distal ureteral stone passage.

Materials And Methods: A total of 76 patients with a distal ureteral calculus provided consent for the study. Patients were randomized between placebo and study medication, and investigators and patients were blinded to the randomization scheme.