Impact of stone disease: chronic kidney disease and quality of life.

This article reviews the impact of stone disease on chronic kidney disease and renal function; evaluating the natural progression of disease as well as the impact of surgical interventions. The impact of stone disease, medical therapy, and surgical therapy for stones on quality of life is discussed.

Gout, stone composition and urinary stone risk: a matched case comparative study.

Purpose: We established the most common stone composition, and serum and urinary biochemical features in patients with gout and urolithiasis.

Materials And Methods: We retrospectively searched for the records of patients diagnosed with gout among all those in our stone registry. A matched case cohort of stone formers was generated from our registry who had the same age, gender and body mass index.

Absolute Hounsfield unit measurement on noncontrast computed tomography cannot accurately predict struvite stone composition.

Background: The purpose of our study was to determine, in vivo, whether single-energy noncontrast computed tomography (NCCT) can accurately predict the presence/percentage of struvite stone composition.

Methods: We retrospectively searched for all patients with struvite components on stone composition analysis between January 2008 and March 2012. Inclusion criteria were NCCT prior to stone analysis and stone size ≥4 mm.

Microwave thermotherapy for benign prostatic hyperplasia.

Background: Transurethral resection of the prostate (TURP) has been the gold-standard treatment for alleviating urinary symptoms and improving urinary flow in men with symptomatic benign prostatic hyperplasia (BPH). However, the morbidity of TURP approaches 20%, and less invasive techniques have been developed for treating BPH. Preliminary data suggest that microwave thermotherapy, which delivers microwave energy to produce coagulation necrosis in prostatic tissue, is a safe, effective treatment for BPH.

Flexible ureteroscopy and holmium:YAG laser lithotripsy for stone disease in patients with bleeding diathesis: a systematic review of the literature.

Introduction And Objectives: The management of urolithiasis in patients on anticoagulants presents a challenge to the endourologist. Due to multiple comorbidities, it may be impossible to safely discontinue the anticoagulant treatment. Other modalities such as shock wave lithotripsy and PCNL are contraindicated in these patients, so ureteroscopic treatment may be the only option.

Ureteroscopic management of chronic unilateral hematuria: a single-center experience over 22 years.

Objective: To analyze the short and long term safety and efficacy of ureteroscopic evaluation and management of chronic unilateral hematuria.

Methods: We retrospectively reviewed patients with chronic unilateral hematuria from 1987 to 2008. The distal to middle ureter was evaluated with a semi-rigid ureteroscope without a guidewire.

Flexible ureteroscopy and laser lithotripsy for stones >2 cm: a systematic review and meta-analysis.

Background And Purpose: Urinary stones >2 cm are traditionally managed with percutaneous nephrolithotomy (PCNL). Recently, flexible ureteroscopy and laser lithotripsy) (FURSL) has been used to manage them with comparable results. In a comparative study of renal stones between 2 and 3 cm, FURSL was reported to need less second-stage procedures and be just as effective as PCNL.

Safety and efficacy of a novel ureteral occlusion device.

Objective: To evaluate the safety of a novel ureteral occlusion device and compare its performance with that of other devices and guidewires.

Methods: The XenX (Xenolith Medical) was tested in an ex vivo porcine model to determine the percentage of denuded urothelium because of manipulation within the ureter, the capacity to prevent stone migration during laser lithotripsy, stent compatibility, and the ability to be used for stent placement. Comparative evaluations of the insertion forces and maneuverability were conducted in an in vitro ureter model with the XenX, Stone Cone (Boston Scientific), NTrap (Cook Urological), HiWire (Cook Urological), Roadrunner (Cook Urological), and Sensor (Boston Scientific).

Safety and efficacy of ureteroscopic lithotripsy for stone disease in obese patients: a systematic review of the literature.

Objective: To look at the role and safety of ureteroscopy for stone management in obese patients.

Methods: We searched MEDLINE, PubMed and the Cochrane Library from January 1990 to June 2011 for results of ureteroscopy and stone treatment in obese patients. Inclusion criteria were all English language articles reporting on ureteroscopy in patients with morbid obesity.

Prospective investigation of second-trimester thrombin activation and preterm birth.

Objective: We sought to determine if second-trimester amniotic fluid thrombin-antithrombin (TAT) complexes concentration correlates with subsequent preterm birth.

Study Design: A cohort of 550 women with singleton nonanomalous pregnancies undergoing second-trimester genetic amniocentesis was followed up to delivery and analyzed as a nested case-control study. Cases of preterm birth (n = 52) were compared with 104 term control subjects.

Association of Randall plaque with collagen fibers and membrane vesicles.

Purpose: Idiopathic calcium oxalate kidney stones develop by calcium oxalate crystal deposition on Randall plaque. The mechanisms involved in Randall plaque formation are still unclear. We hypothesized that Randall plaque formation is similar to that of vascular calcification, involving components of extracellular matrix, including membrane bound vesicles and collagen fibers.

Systematic evaluation of hybrid guidewires: shaft stiffness, lubricity, and tip configuration.

Objective: To conduct a comparison of physical and mechanical properties for 5 commonly used guidewires to assess advantages of wires for specific applications.

Methods: Tests on guidewires (0.035" diameter; straight, flexible tip) included tip bending, shaft buckling, lubricity, and tip puncture measurements.

Systematic evaluation of a novel foot-pump ureteroscopic irrigation system.

Introduction: To evaluate forces exerted on a stone with different ureteroscopic irrigation systems.

Methods: A 3 mm steel simulated stone was welded to a 3F stone basket and inserted into the working channel of a 4.5F Wolf semirigid ureteroscope.

Population standards of birth weight underestimate fetal growth abnormalities in diabetic pregnancies.

The objective of this study was to compare the frequency of abnormal fetal growth in women with diabetes mellitus (DM) using population-based birth weight (pop BW) percentiles compared with customized birth weight (cust BW) percentiles, which include adjustments for maternal race, parity, height, weight, and fetal sex. The study design comprised a retrospective cohort of singleton DM pregnancies delivered over a 1-year period (June 2007 to May 2008) from a single tertiary care university-based medical center. Inclusion criteria were gestational age >20 weeks at delivery, live birth, and absence of major chromosomal/structural abnormalities.

Catheter design for effective manual bladder irrigation.

Purpose: We compared the efficiency of clearance of a simulated clot from a bladder model using a 6-hole irrigation catheter, a traditional Malecot catheter and a modified Malecot catheter with additional side holes.

Materials And Methods: Latex balloons 12 inches in diameter served as the bladder model. They were filled with 300 cc Jell-O® gelatin, which had been partially solidified for 8 hours at 36F.

New metallic ureteral stents: improved tensile strength and resistance to extrinsic compression.

Background And Purpose: Extrinsic ureteral compression challenges a ureteral stent's ability to facilitate urinary drainage and to protect the kidney. Our purpose was to evaluate the performance of new metallic coil-based ureteral stents in terms of tensile strength and radial compression force.

Materials And Methods: Three stent designs tested from Prosurg Inc included Passage 7.

Omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid in the management of hypercalciuric stone formers.

Objective: To investigate the use of fish oil in the dietary management of hypercalciuric stone formers. Prostaglandins have been linked to urinary calcium excretion, suggesting a role for omega-3 fatty acids in the treatment of hypercalciuric urolithiasis.

Methods: We retrospectively studied a cohort of patients treated at our stone clinics from July 2007 to February 2009.

Instrumentation in endourology.

Success with endourological procedures requires expertise and instrumentation. This review focuses on the instrumentation required for ureteroscopy and percutaneous nephrolithotomy, and provides a critical assessment of in vitro and clinical studies that have evaluated the comparative effectiveness of these medical devices.

Correlation between stress and kidney stone disease.

Background And Purpose: Prevalence of kidney stone disease is increasing worldwide, and several factors may be involved. We aimed to establish a correlation between stress and kidney stones.

Patients And Methods: We prospectively evaluated 200 patients with a diagnosis of kidney stone disease having them self-respond to a validated questionnaire to measure stress (Perceived Stress Scale-10 [PSS-10]).

A dual-channel flexible ureteroscope: evaluation of deflection, flow, illumination, and optics.

Background And Purpose: Despite the evolution and progressive improvements of ureteroscopes, problems related to visibility and maneuverability can still hinder the goals of surgical intervention. We evaluate the attributes of a dual-channel flexible ureteroscope compared with a single-channel device and discuss the implications for expanded techniques afforded by this new technology.

Materials And Methods: In vitro measurements of active deflection, irrigant flow through the working channel, luminescence, and optical resolution were performed between the single-channel Wolf Viper and the dual-channel Wolf Cobra ureteroscopes.