Cardiovascular risk improvement after laparoscopic adrenalectomy in patients with cortisol-secreting adrenal adenoma, a retrospective cohort study.

Background: Cushing syndrome increases morbidity and mortality, which is mainly caused by cardiovascular disorders. This study reports the cardiovascular risk outcomes at 3, 6, and 12 months after unilateral laparoscopic adrenalectomy in cortisol-secreting adrenal tumor and to identify the preoperative parameters predicting the resolution of cardiovascular risk factors after surgery.

Methods: All clinical data of patients with unilateral cortisol-secreting adrenal tumors who underwent laparoscopic adrenalectomy in King Chulalongkorn Memorial Hospital between 2001-2022 were retrospectively reviewed.

Unraveling the role of gut microbiota by fecal microbiota transplantation in rat model of kidney stone disease.

Emerging research on the microbiome highlights the significant role of gut health in the development of kidney stones, indicating that an imbalance in gut bacteria or dysbiosis can influence the formation of stones by altering oxalate metabolism and urinary metabolite profiles. In particular, the overabundance of specific bacteria such as Enterococcus and Oxalobacter spp., which are known to affect oxalate absorption, is observed in patients with urolithiasis.

Maternal family history of urolithiasis is associated with earlier age of onset of stone disease.

Purpose: To evaluate the impact of detailed family history on the severity of disease and age of onset in patients with urolithiasis.

Methods: Prospectively collected data from a single institution between October 2015 and December 2020 were analyzed. Our primary endpoint was the number of patients experiencing at least one recurrent stone during the follow-up period.

Laparoscopic transperitoneal adrenalectomy in the large adrenal tumor from single center experience.

Background: The role of laparoscopic adrenalectomy (LA) in a large adrenal tumor is controversial due to the risk of malignancy and technical difficulty. In this study, we compared the perioperative outcomes and complications of LA on large (≥ 6 cm) and (< 6 cm) adrenal tumors.

Methods: We retrospectively reviewed all clinical data of patients who underwent unilateral transperitoneal LA in our institution between April 2000 and June 2019.

Leiomyosarcoma of the renal pelvis diagnosed by percutaneous endoscopic resection.

We present a case of leiomyosarcoma arising from the renal pelvis, which is a rare clinical entity. A percutaneous endoscopic resection led to the final histopathological diagnosis. The patient underwent radical nephrectomy and did not receive adjuvant therapy.

Fatty acid-binding protein 4 downregulation drives calcification in the development of kidney stone disease.

Nephrolithiasis is a significant source of morbidity, and its incidence has increased significantly over the last decades. This rise has been attributed to concurrent increasing rates of obesity, associated with a 3-time risk of developing NL. To date, the mechanism by which obesity is linked to stone formation has not been elucidated.

Ultrasound-guided Access and Dilation for Percutaneous Nephrolithotomy in the Supine Position: A Step-by-Step Approach.

Introduction: Ultrasound guidance for percutaneous nephrolithotomy (PCNL) has gained acceptance amongst urologists given its numerous advantages over fluoroscopy. While traditionally performed in the prone position, this video demonstrates a step-by-step approach to performing PCNL in the supine position, solely under ultrasound guidance.

Materials And Methods: Once in the modified supine (Galdakao-modified Valdivia) position, important anatomic landmarks are identified.

Influence of Socioeconomic Factors on Stone Burden at Presentation to Tertiary Referral Center: Data From the Registry for Stones of the Kidney and Ureter.

Objective: To determine social factors associated with advanced stone disease (defined as unilateral stone burden >2 cm) at time of presentation to a regional stone referral center. Little is known about social determinants of urolithiasis. We hypothesize that socioeconomic factors impact kidney stone severity at intake to referral centers.

Computed Tomography Radiation Exposure Among Referred Kidney Stone Patients: Results from the Registry for Stones of the Kidney and Ureter.

Kidney stone patients routinely have CT scans during diagnostic work-up before being referred to a tertiary center. How often these patients exceed the recommended dose limits for occupational radiation exposure of >100 mSv for 5 years and >50 mSv in a single year from CT alone remains unknown. This study aimed to quantify radiation doses from CTs received by stone patients before their evaluation at a tertiary care stone clinic.

The Urological Association of Asia clinical guideline for urinary stone disease.

The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries.

Low Income and Nonwhite Race are Strongly Associated with Worse Quality of Life in Patients with Nephrolithiasis.

Purpose: Kidney stones are a source of significant morbidity which have been shown to negatively impact health related quality of life. We sought to understand the association between health related quality of life, socioeconomic status and race among patients with kidney stones.

Materials And Methods: Patients with stones at a total of 11 stone centers across the United States completed the WISQOL (Wisconsin Stone Quality of Life questionnaire).

Increasing Body Mass Index Steepens the Learning Curve for Ultrasound-guided Percutaneous Nephrolithotomy.

Objective: To define how the learning curve for success in ultrasound-guided percutaneous nephrolithotomy (PCNL) is impacted by body mass index (BMI). Previous research has shown ultrasound-guided PCNL to be an effective method of nephrolithiasis treatment comparable to fluoroscopy-guided PCNL. A common concern for the ultrasound-guided approach is potential imaging difficulty in the obese patient population.

The Morbidity of Ureteral Strictures in Patients with Prior Ureteroscopic Stone Surgery: Multi-Institutional Outcomes.

Purpose: Nephrolithiasis is an increasingly common ailment in the United States. Ureteroscopic management has supplanted shockwave lithotripsy as the most common treatment of upper tract stone disease. Ureteral stricture is a rare but serious complication of stone disease and its management.

Ultrasound for Intraoperative Confirmation of Antegrade Ureteral Stent Placement During Laparoscopic Pyeloplasty.

Objective: To describe our ultrasound technique for confirming intraoperative, antegrade-placed ureteral stent position during laparoscopic pyeloplasty.

Background: Disadvantages of retrograde stent placement include the need to reposition the patient into and out of the lithotomy position. Antegrade stent placement can reduce procedure time but requires confirming appropriate distal placement into the bladder with cystoscopy, percutaneous drain placement, or instillation of methylthioninium chloride or indigo carmine.

Micro-Costing Analysis Demonstrates Comparable Costs for LithoVue Compared to Reusable Flexible Fiberoptic Ureteroscopes.

Introduction: Reusable ureteroscope durability and need for repair are significant sources of expense and inefficiency for patients and urologists. Utilization of LithoVue™, a disposable flexible digital ureteroscope, may address some of these concerns. To identify its economic impact on clinical care, we performed a micro-cost comparison between flexible reusable fiberoptic ureteroscopes (URF-P6™) and LithoVue.

Identifying factors associated with need for flexible ureteroscope repair: a Western Endourology STone (WEST) research consortium prospective cohort study.

Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability.

Clinical Outcomes for Cystinuria Patients with Unilateral Versus Bilateral Cystine Stone Disease.

Introduction: Cystinuria is a genetic disorder marked by elevated urinary cystine excretion and recurrent cystine nephrolithiasis. Interestingly, despite seemingly similar contralateral renal anatomy, a subset of cystinuric patients consistently form stones in only one kidney. The aim of this study is to evaluate clinical outcomes in unilateral vs bilateral cystine stone formers.

Variation in Radiologic and Urologic Computed Tomography Interpretation of Urinary Tract Stone Burden: Results From the Registry for Stones of the Kidney and Ureter.

Objective: To compare the measured stone burden recorded between urologists and radiologists, and examine how these differences could potentially impact stone management. As current urologic stone surgery guideline recommendations are based on stone size, accurate stone measurements are crucial to direct appropriate treatment. This study investigated the discrepant interpretation that often exists between urologic surgeons and radiologists' estimation of patient urinary stone burden.

Defining the Costs of Reusable Flexible Ureteroscope Reprocessing Using Time-Driven Activity-Based Costing.

Purpose: Careful decontamination and sterilization of reusable flexible ureteroscopes used in ureterorenoscopy cases prevent the spread of infectious pathogens to patients and technicians. However, inefficient reprocessing and unavailability of ureteroscopes sent out for repair can contribute to expensive operating room (OR) delays. Time-driven activity-based costing (TDABC) was applied to describe the time and costs involved in reprocessing.

Contrast Enhanced Ultrasound as a Radiation-Free Alternative to Fluoroscopic Nephrostogram for Evaluating Ureteral Patency.

Purpose: We compared contrast enhanced ultrasound and fluoroscopic nephrostography in the evaluation of ureteral patency following percutaneous nephrolithotomy.

Materials And Methods: This prospective cohort, noninferiority study was performed after obtaining institutional review board approval. We enrolled eligible patients with kidney and proximal ureteral stones who underwent percutaneous nephrolithotomy at our center.

Optimizing RNA Extraction of Renal Papilla Biopsy Tissue in Kidney Stone Formers: A New Methodology for Genomic Study.

Introduction: Endoscopic tools have provided versatile examination and treatment for kidney stone procedures. Despite endourologists researching urinary stone disease using endoscopes to collect tissue, this tissue collection method is limited. Endoscopically removed tissues are small in size, restricting the types of genome-based examination possible.

A Prospective Case-Control Study Comparing LithoVue, a Single-Use, Flexible Disposable Ureteroscope, with Flexible, Reusable Fiber-Optic Ureteroscopes.

Objective: LithoVue™ is a novel, single-use, digital flexible ureteroscope that was released to the US market in January 2016. There are scant data regarding its performance in humans. Procedural outcomes comparing LithoVue with reusable ureteroscopes are presented in patients undergoing ureteroscopy for upper urinary tract pathology.

Feasibility of Antegrade Contrast-enhanced US Nephrostograms to Evaluate Ureteral Patency.

Purpose To demonstrate the feasibility of contrast material-enhanced ulrasonographic (US) nephrostograms to assess ureteral patency after percutaneous nephrolithotomy (PCNL) in this proof-of-concept study. Materials and Methods For this HIPAA-compliant, institutional review board-approved prospective blinded pilot study, patients undergoing PCNL provided consent to undergo contrast-enhanced US and fluoroscopic nephrostograms on postoperative day 1. For contrast-enhanced US, 1.