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Development of Prediction Models for Severe Pain and Urinary Symptoms After Ureteroscopy With Ureteral Stent Placement: Results From the STENTS Study and Initial Validation of Pain Interference.
J Urol
December 2024
Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Purpose: We developed prediction models for severe pain and urinary symptoms after ureteroscopy with ureteral stent placement.
Materials And Methods: The development cohort included 424 adults and adolescents enrolled in the multicenter STENTS prospective cohort study who underwent ureteroscopy with stent placement for urinary stones. The validation cohort was an independent prospective cohort of 115 adults.
Predictors of Persistent Residual Stones After Second Look Percutaneous Nephrolithotomy.
J Endourol
January 2025
UT Southwestern Medical School, Dallas, Texas, USA.
Article Synopsis
- Second look flexible nephroscopy (SLFN) is performed after percutaneous nephrolithotomy (PCNL) in patients with residual fragments (RFs) to assess and potentially remove any remaining stones.
- In a study involving 201 patients, the final stone-free rate after SLFN was found to be 60.7%, despite many still having RFs post-procedure, with factors like bilateral stones and larger stone burdens linked to persistent fragments.
- The study highlights that even with aggressive removal efforts during both PCNL and SLFN, some patients may still retain stone fragments, though the risk of complications from these fragments is currently unclear.
Predicting urinary stone recurrence: a joint model analysis of repeated 24-hour urine collections from the MSTONE database.
Urolithiasis
November 2024
Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
To address the limitations in existing urinary stone recurrence (USR) models, including failure to account for changes in 24-hour urine (24U) parameters over time and ignoring multiplicity of stone recurrences, we presented a novel statistical method to jointly model temporal trends in 24U parameters and multiple recurrent stone events. The MSTONE database spanning May 2001 to April 2015 was analyzed. A joint recurrent model was employed, combining a linear mixed-effects model for longitudinal 24U parameters and a recurrent event model with a dynamic first-order Autoregressive (AR(1)) structure.
View Article and Find Full Text PDFA Patient-Prioritized Research Agenda for Clinical Trials in Kidney Stone Disease.
J Urol
January 2025
Division of Urology, Department of Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Purpose: To ensure that research on kidney stones provides meaningful impact for the kidney stone community, patients and caregivers should be engaged as stakeholders in clinical trial design, starting at study inception. This project aimed to elicit, refine, and prioritize research ideas from kidney stone stakeholders to develop a patient-centered research agenda for clinical trials.
Materials And Methods: The Kidney Stone Engagement Core, a group of patients, caregivers, advocates, clinicians, and researchers, executed an iterative process of surveys and focus groups to elicit and refine research themes, which were then translated into research questions.
Work absence and productivity loss of patients undergoing a trial of spontaneous passage for ureteral stones.
Urolithiasis
August 2024
Department of Urology, Duke Clinical Research Institute, Duke Cancer Institute, Margolis Center for Health Policy, Duke University Medical Center, Duke University School of Medicine, Duke University School of Medicine, Duke University, Durham, NC, USA.
Patients with ureteral stones are often managed with a spontaneous trial of passage. While cost effective, the current literature has not examined the effects of a trial of passage on patients' work productivity. In this study, we aim to characterize work absence and productivity losses in a cohort of patients undergoing a trial of passage for ureteral stones.
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