Complex system modelling reveals oxalate homeostasis is driven by diverse oxalate-degrading bacteria.

Decades of research have made clear that host-associated microbiomes touch all facets of health. However, effective therapies that target the microbiome have been elusive given its inherent complexity. Here, we experimentally examined diet-microbe-host interactions through a complex systems framework, centered on dietary oxalate.

Retrograde intrarenal surgery with or without ureteral access sheath: a systematic review and meta-analysis of randomized controlled trials.

Introduction: The ureteral access sheath (UAS) is a medical device that enables repeated entrance into the ureter and collecting system during retrograde intrarenal surgery (RIRS). Its impact on stone-free rates, ureteral injuries, operative time, and postoperative complications remains controversial. Therefore, we performed a systematic review and meta-analysis comparing RIRS with versus without UAS for urolithiasis management.

Ureteroscopy vs laparoscopic ureterolithotomy for large proximal ureteric stone: a randomised trial.

Objective: To compare the outcomes of retrograde flexible ureteroscopy (fURS) with retroperitoneal laparoscopic ureterolithotomy (RLU) for large proximal ureteric stones.

Patients And Methods: A prospective randomised trial was conducted from January 2018 through December 2022 including patients with impacted proximal ureteric stones of 15-25 mm. Patients underwent fURS or RLU.

Artificial Intelligence in Endourology: Maximizing the Promise Through Consideration of the Principles of Diffusion of Innovation Theory.

Diffusion of Innovation Theory explains how ideas or products gain momentum and diffuse (or spread) through specific populations or social systems over time. The theory analyzes primary influencers of the spread of new ideas, including the innovation itself, communication channels, time, and social systems. The current study reviewed published medical literature to identify studies and applications of artificial intelligence (AI) in endourology and used E.

The Application of Next-Generation Sequencing in Preoperative Evaluation for Urologic Stone Surgery.

Next-generation sequencing (NGS) is a new molecular technique for identifying microorganisms. Treating bacteriuria in patients undergoing stone removal procedures is important for preventing postoperative urinary tract infection (UTI). The objective of this study is to assess the usefulness of preoperative urine NGS testing by comparing NGS with standard urine culture in predicting postoperative UTI after ureteroscopic lithotripsy (URSL) and percutaneous nephrolithotomy (PCNL).

URS for de-novo urolithiasis after kidney transplantation: a systematic review of the literature.

Introduction: There is a gap in the available literature and guidelines concerning the optimal approach for treating allograft stones, which currently include external shockwave lithotripsy, ureteroscopy and laser lithotripsy, or percutaneous nephrolithotomy. The objective of this systematic review was to evaluate the safety and effectiveness of URS as a treatment option for patients in this scenario.

Evidence Acquisition: A comprehensive search of the literature was conducted until August 2023.

What is the definition of stone dust and how does it compare with clinically insignificant residual fragments? A comprehensive review.

Purpose: During endoscopic stone surgery, Holmium:YAG (Ho:YAG) and Thulium Fiber Laser (TFL) technologies allow to pulverize urinary stones into fine particles, ie DUST. Yet, currently there is no consensus on the exact definition of DUST. This review aimed to define stone DUST and Clinically Insignificant Residual Fragments (CIRF).

Percutaneous Nephrolithotomy for Urolithiasis After Kidney Transplantation: A Systematic Review of the Literature.

Renal transplantation is the treatment for end-stage renal disease that offers better quality of life and survival. Among the possible complications that might affect allografts, urolithiasis might have severe consequences, causing acute kidney injury (AKI) or septic events in immunocompromised patients. Allograft stones might be treated with percutaneous nephrolithotomy (PCNL).

Thulium Fiber Laser Versus Holmium:Yttrium Aluminum Garnet for Lithotripsy: A Systematic Review and Meta-analysis.

Context: Thulium fiber laser (TFL) emerged as a competitor of holmium:yttrium aluminum garnet (Ho:YAG) laser for the treatment of urinary stones.

Objective: To compare the efficacy between Ho:YAG and TFL for laser lithotripsy of renal and ureteral stones.

Evidence Acquisition: A literature search was conducted using PubMed/Medline, Embase, and Web of Science databases to identify reports published until May 2023.

Can Perioperative Antibiotic Choice Impact Rates of Infectious Complications After Percutaneous Nephrolithotomy? A Single-Blind, Prospective Randomized Trial.

National guidelines recommend periprocedural antibiotics before percutaneous nephrolithotomy (PCNL), yet it is not clear which is superior. We conducted a randomized trial to compare two guideline-recommended antibiotics: ciprofloxacin (cipro) cefazolin, on PCNL outcomes, focusing on the development of systemic inflammatory response syndrome (SIRS) criteria. Adult patients who were not considered high risk for surgical or infectious complications and undergoing PCNL were randomized to receive either cipro or cefazolin perioperatively.

Endoscopic Stone Composition Identification: Is Accuracy Improved by Stone Appearance During Laser Lithotripsy?

Objective: To evaluate if videos during laser lithotripsy increase accuracy and confidence of stone identification by urologists compared to still pictures.

Methods: We obtained representative pictures and videos of 4 major stone types from 8 different patients during ureteroscopy with holmium laser lithotripsy. A REDCap survey was created and emailed to members of the Endourological Society.

Sustainability in Urology: Ideas for a Greener Future.

Sustainability in urology can be achieved via conscientious practices that minimize the negative impact of our services while achieving ethical and responsible patient care. We highlight novel and actionable ideas that could pave the path towards healthier, greener urological practice.

Identifying underweight in infants and children using growth charts, lookup tables and a novel "MAMI" slide chart: A cross-over diagnostic and acceptability study.

Malnutrition is a leading cause of preventable deaths in infants and children. To benefit from treatment and prevention programmes, malnourished children must first be identified. Low weight-for-age is an anthropometric indicator of malnutrition which is gaining much recent attention because it is particularly effective at identifying children at highest risk of death.

Erector spinae plane blocks for analgesia after percutaneous nephrolithotomy A pathway to reduce opioids.

Introduction: Despite its minimally invasive nature, percutaneous nephrolithotomy (PCNL ) may be associated with significant pain. Challenges in pain control may prevent timely discharge (and expose patients to adverse effects of opioid use). We sought to evaluate whether our patients who underwent erector spinae plane (ESP) regional blocks experienced improved postoperative pain control and decreased opioid use after PCNL (compared with those who did not receive blocks).

Shockwave Lithotripsy for De-Novo Urolithiasis after Kidney Transplantation: A Systematic Review of the Literature.

Background: Allograft urolithiasis is an uncommon, challenging, and potentially dangerous clinical problem. Treatment of allograft stones includes external shockwave lithotripsy (SWL), flexible ureteroscopy and lasertripsy (fURSL), or percutaneous nephrolithotomy (PCNL). A gap in the literature and guidelines exists regarding the treatment of patients in this setting.

Suction in Percutaneous Nephrolithotripsy: Evolution, Development, and Outcomes from Experimental and Clinical studies. Results from a Systematic Review.

Context: Controversy exists regarding the therapeutic benefit of suction use during percutaneous nephrolithotripsy (PCNL).

Objective: To review and highlight the options available in the use of suction for PCNL, and to discuss their strengths and limitations.

Evidence Acquisition: A systematic literature search was performed using Scopus, EMBASE, and PubMed.

Automated Exposure Notification for COVID-19.

In the current COVID-19 pandemic, various Automated Exposure Notification (AEN) systems have been proposed to help quickly identify potential contacts of infected individuals. All these systems try to leverage the current understanding of the following factors: transmission risk, technology to address risk modeling, system policies and privacy considerations. While AEN holds promise for mitigating the spread of COVID-19, using short-range communication channels (Bluetooth) in smartphones to detect close individual contacts may be inaccurate for modeling and informing transmission risk.

Prevalence of Stone Disease and Procedure Trends in the United States.

Objective: To evaluate the prevalence of stone disease and procedure trends among US commercial and Medicare populations.

Methods: Retrospective analyses for a US commercial population and Medicare population were conducted using the Merative MarketScan Commercial Database and Medicare Standard Analytic File (5% sample), respectively. Patients aged 18+ were included if they had an encounter in any setting with a primary stone diagnosis or stone procedure (ureteroscopy [URS], percutaneous nephrolithotomy (PCNL), or shockwave lithotripsy [SWL]) between 2011 and 2019.

Long-term follow-up on dusting versus basketing during ureteroscopy: a prospective multicenter trial from the EDGE Research Consortium.

In 2018, the Endourology Disease Group for Excellence (EDGE) published a prospective trial comparing dusting versus basketing during ureteroscopy. One hundred fifty-nine patients were included in the original analysis, which found no difference in stone-free rate at 3 months. We report the intermediate and long-term outcomes of patients included in the original trial.

Sepsis prevalence and associated hospital admission and mortality after ureteroscopy in employed adults.

Objective: To determine 30-day inpatient mortality, intensive care unit (ICU) admissions, inpatient admissions/readmissions, and yearly trends in sepsis prevalence and inpatient mortality after ureteroscopy (URS) in employed adults.

Materials And Methods: We performed a retrospective analysis of the IBM MarketScan Commercial Database to identify employed adults aged 18-64 years who underwent URS between 2015 and 2019. Patients were categorized as having no sepsis (controls), non-severe sepsis, or severe sepsis within 30 days of URS.