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    - UROLOGY, NEPHROLOGY AND ANDROLOGY (151 journals)

UROLOGY, NEPHROLOGY AND ANDROLOGY (151 journals)                     

Showing 1 - 144 of 144 Journals sorted alphabetically
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Hybrid Journal   (Followers: 15)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access   (Followers: 1)
African Journal of Urology     Open Access   (Followers: 8)
AJP Renal Physiology     Hybrid Journal   (Followers: 8)
Aktuelle Urologie     Hybrid Journal   (Followers: 4)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 53)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 31)
Andrologia     Hybrid Journal   (Followers: 3)
Andrology     Hybrid Journal   (Followers: 4)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 8)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 2)
Arab Journal of Urology     Open Access   (Followers: 7)
Archives of Clinical Nephrology     Open Access   (Followers: 2)
Archivio Italiano di Urologia e Andrologia     Open Access   (Followers: 1)
Archivos Españoles de Urología     Open Access   (Followers: 1)
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Asian Pediatric Nephrology Association     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 19)
BJUI Compass     Open Access   (Followers: 1)
BMC Nephrology     Open Access   (Followers: 9)
BMC Urology     Open Access   (Followers: 13)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 7)
Canadian Urological Association Journal     Open Access   (Followers: 1)
Cancer Urology     Open Access   (Followers: 1)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 6)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 7)
Case Reports in Urology     Open Access   (Followers: 11)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 5)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 24)
Clinical Kidney Journal     Open Access   (Followers: 5)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Cuadernos de Cirugía     Open Access  
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 12)
Current Opinion in Urology     Hybrid Journal   (Followers: 11)
Current Urology     Open Access   (Followers: 10)
Current Urology Reports     Hybrid Journal   (Followers: 5)
Der Nephrologe     Hybrid Journal  
Der Urologe     Hybrid Journal   (Followers: 1)
Diabetic Nephropathy     Open Access  
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Hybrid Journal   (Followers: 22)
European Urology Focus     Hybrid Journal   (Followers: 3)
European Urology Oncology     Hybrid Journal  
European Urology Open Science     Open Access   (Followers: 8)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Hellenic Urology     Open Access   (Followers: 4)
IJU Case Reports     Open Access  
Indian Journal of Nephrology     Open Access   (Followers: 2)
Indian Journal of Urology     Open Access   (Followers: 5)
International Brazilian Journal of Urology     Open Access   (Followers: 5)
International Journal of Nephrology     Open Access   (Followers: 2)
International Journal of Nephrology and Renovascular Disease     Open Access   (Followers: 2)
International Journal of Urology     Hybrid Journal   (Followers: 10)
International Urology and Nephrology     Hybrid Journal   (Followers: 6)
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 1)
Journal of Clinical Urology     Hybrid Journal   (Followers: 12)
Journal of Endoluminal Endourology     Open Access  
Journal of Endourology     Hybrid Journal   (Followers: 2)
Journal of Endourology Case Reports     Hybrid Journal  
Journal of Genital System & Disorders     Hybrid Journal   (Followers: 1)
Journal of Integrative Nephrology and Andrology     Open Access   (Followers: 2)
Journal of Kidney Cancer and VHL     Open Access  
Journal of Lower Genital Tract Disease     Hybrid Journal  
Journal of Nephrology     Hybrid Journal   (Followers: 5)
Journal of Nephrology Research     Open Access   (Followers: 2)
Journal of Pediatric Nephrology     Open Access   (Followers: 3)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 8)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 28)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 2)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 38)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Urology & Nephrology     Open Access  
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 52)
Kidney International Reports     Open Access   (Followers: 6)
Kidney Medicine     Open Access   (Followers: 1)
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access  
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 29)
Nature Reviews Urology     Full-text available via subscription   (Followers: 9)
Nefrología     Open Access  
Nefrología (English Edition)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 26)
Nephron     Hybrid Journal   (Followers: 4)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 3)
Nephron Experimental Nephrology     Full-text available via subscription   (Followers: 4)
Nephron Extra     Open Access   (Followers: 1)
Nephron Physiology     Full-text available via subscription   (Followers: 4)
Neurourology and Urodynamics     Hybrid Journal   (Followers: 1)
OA Nephrology     Open Access   (Followers: 2)
Open Access Journal of Urology     Open Access   (Followers: 6)
Open Journal of Nephrology     Open Access   (Followers: 4)
Open Journal of Urology     Open Access   (Followers: 6)
Open Urology & Nephrology Journal     Open Access  
Paediatric Nephrology Journal of Bangladesh     Open Access   (Followers: 4)
Portuguese Journal of Nephrology & Hypertension     Open Access   (Followers: 1)
Progrès en Urologie     Full-text available via subscription  
Progrès en Urologie - FMC     Full-text available via subscription  
Prostate Cancer and Prostatic Diseases     Hybrid Journal   (Followers: 4)
Renal Failure     Open Access   (Followers: 11)
Renal Replacement Therapy     Open Access   (Followers: 3)
Research and Reports in Urology     Open Access   (Followers: 4)
Revista de Nefrología, Diálisis y Trasplante     Open Access   (Followers: 1)
Revista Mexicana de Urología     Open Access  
Revista Urologia Colombiana     Open Access  
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 6)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 6)
Therapeutic Advances in Urology     Open Access   (Followers: 3)
Translational Research in Urology     Open Access   (Followers: 1)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Urine     Open Access  
Uro-News     Hybrid Journal  
Urolithiasis     Hybrid Journal   (Followers: 1)
Urologia Internationalis     Full-text available via subscription   (Followers: 1)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 3)
Urologic Nursing     Full-text available via subscription   (Followers: 3)
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 26)
Urology Case Reports     Open Access   (Followers: 3)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access  
World Journal of Nephrology and Urology     Open Access   (Followers: 5)
World Journal of Urology     Hybrid Journal   (Followers: 10)

           

Similar Journals
Journal Cover
Urolithiasis
Journal Prestige (SJR): 0.899
Citation Impact (citeScore): 2
Number of Followers: 1  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 2194-7228 - ISSN (Online) 2194-7236
Published by Springer-Verlag Homepage  [2469 journals]
  • MOSES™ pulse modulation technology versus conventional pulse delivery
           technology: the effect on irrigation fluid temperature during flexible
           ureteroscopy

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      Abstract: Abstract To compare the effect of MOSES™ modulation technology to conventional pulse delivery technology on the irrigation fluid temperature (IFT) under different irrigation conditions during flexible ureteroscopy (FURS) in a live-anesthetized porcine model. For this experiment was used one female pig. A percutaneous access was obtained and a 30Fr sheath was placed inside the upper calyceal system. A thermocouple was inserted through the sheath to the upper calyx to record the effect on IFT during FURS. A Lumenis 120H Ho:YAG laser was used and the IFT was recorded during laser activation for 30 s at a laser power of 20 W, 40 W and 60 W under gravity and manual pump irrigation using MOSES™ and conventional pulse delivery technology. In the highest power settings the maximum IFT was achieved in 18 s under gravity irrigation (66.4 °C). It seems that there is no significant difference on IFT between MOSES and conventional mode on the IFT under different irrigation conditions during FURS at 20 W, 40 W and 60 W power settings. Furthermore, our results indicate that under manual pumping even high-power settings (40 W, 60 W) can be performed with safety. In the in vivo model, the MOSES™ pulse delivery technology does not have a significant difference in the maximal IFT in comparison to conventional pulse delivery technology during FURS in the same power settings. Manual pumping should be used to keep the IFT within safe limits.
      PubDate: 2022-06-30
       
  • Predicting narrow ureters before ureteroscopic lithotripsy with a neural
           network: a retrospective bicenter study

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      Abstract: Abstract In some patients, the passage of semi-rigid ureteroscopes up the ureter is impossible due to narrow ureteral lumen. We established a neural network to predict the inability of the ureter to accommodate the semi-rigid ureteroscope and the need for active or passive dilatation using non-contrast computed tomography (CT) images. Data were collected retrospectively from two centers of 1989 eligible patients who underwent ureteroscopic lithotripsy with ureteral stones. Patients were categorized into two groups: control and narrow ureter. The network was designed and trained for predicting a narrow ureter during initial ureteroscopic lithotripsy, which integrated multi-scale features of the ureter. The predictive efficacy of neural networks DenseNet3D, ResNet3D, ResNet3D MC, and TimeSformer was compared. Furthermore, a previous ureteroscopy or a history of double-J stent placement, ureteral wall thickness and Hounsfield unit (HU) density of the ureter under the stone were compared. Model performance was assessed based on the accuracy, area under the receiver operating characteristic curve (AUC ROC), etc. The DenseNet3D-based network achieved an AUC ROC score of 0.884 and an accuracy of 85.29%, followed by the ResNet3D-based network, the ResNet3D MC-based network, and the TimeSformer-based network. The DenseNet3D-based network significantly outperformed other candidate predictors. Furthermore, the networks were validated in an external test set. Decision curve analysis showed the clinical utility of the neural network. The neural network provides an individualized preoperative prediction of narrow ureter based on non-contrast CT images, which could be employed as part of a surgical decision-making support system.
      PubDate: 2022-06-23
       
  • Comparison of flexible ureteroscopy and mini-percutaneous nephrolithotomy
           in the treatment for renal calculi larger than 2 cm: a matched-pair
           analysis

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      Abstract: Abstract To compare the effectiveness and safety of flexible ureteroscopy and mini-percutaneous nephrolithotomy for renal calculi > 2 cm and perform subgroup analysis of stone length and age. Patients received mini-percutaneous nephrolithotomy or flexible ureteroscopy in Qilu Hospital of Shandong University from 2016.01 to 2021.03 with renal calculi > 2 cm were retrospectively analyzed. Propensity score matching was performed to get comparable patients. The postoperative hospital days, operation time, complication rate, and stone free rate were compared. The age and stone length were analyzed by subgroup. 162 in 313 patients were finally included. Each group had 81 cases. Outcomes such as intraoperative transfusion, stone free rate show no difference either. Flexible ureteroscopy had shorter postoperative hospital days (3.2 days vs 7.2 days, P < 0.001) and fewer complications (9, 11.1% vs 25, 30.9%, P = 0.002) compared to mini-percutaneous nephrolithotomy. The postoperative hospital days, and complication of the flexible ureteroscopy were significantly lower than those in the mini-percutaneous nephrolithotomy for renal stones ≤ 2.5 cm; when the stone length > 2.5 cm, the stone free rate of flexible ureteroscopy was lower than that of the mini-percutaneous nephrolithotomy group, but not statistically significant. The complications of flexible ureteroscopy in the young group (18–39 years old) were significantly lower than those in the mini-percutaneous nephrolithotomy group. For 2–2.5 cm renal stones, flexible ureteroscopy can achieve a similar stone free rate with shorter hospital stay, and lower complications. For larger stones, flexible ureteroscopy performed poorly. Flexible ureteroscopy may be a better option for younger patients with fewer complications.
      PubDate: 2022-06-15
       
  • Decision-making and improvements in health-related quality of life in
           patients with kidney stones: comparing surgery versus observation using a
           mixed methods analysis

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      Abstract: Abstract The experience of patients who choose observation or surgery for kidney stones has not been well established. We compared these patients using qualitative interviews, the Wisconsin Quality of Life questionnaire (WISQOL), and the Cambridge Renal Stone Patient Reported Outcome Measure (CReSP). Adult patients with upper tract urinary calculi for whom observation or intervention were options underwent qualitative interviews at baseline and at 2 months. WISQOL and CReSP were administered at baseline, and at 6–16 weeks post operatively if surgery was selected. Comparisons in patient experiences and quality of life measures were performed between groups. Among 15 patients who opted for surgery and 10 patients who opted for observation, we identified major themes in patient experiences related to context, health care episodes, patient responses, and perceived outcomes. A conceptual framework for the domains of patient experience during kidney stone disease was developed, which can be used by clinicians and patients to shape discussion. Baseline standardized WISQOL and CReSP scores were comparable between groups. In the surgery group, both WISQOL and CReSP scores improved after surgery (WISQOL 58 to 83, higher is better, p = 0.003; CReSP 31 to 23, lower is better, p = 0.009). Patients who underwent surgery for kidney stones reported improvements in quality of life after treatment via WISQOL and CReSP. A conceptual framework was developed for the patient experience of kidney stones which provides a common language for patients and clinicians.
      PubDate: 2022-06-14
       
  • Evaluating perceptions and usage of natural remedies, herbal medicine, and
           dietary supplements for kidney stones among a diverse, international,
           urban patient population

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      Abstract: Abstract Our goal was to assess the use and perceptions of complementary and alternative medicine (CAM) for kidney stones among a diverse, urban population. This was a cross-sectional study of patients treated for kidney stones in the Bronx, NY. We assessed demographic information, personal history of kidney stones, as well as knowledge and use of CAM for kidney stones. Patient demographics and responses were analyzed using chi-squared, t tests, and binomial logistic regression. 113 patients were surveyed. 90% identified as non-white, of whom 58% indicated Hispanic, 46% Latinx, and 23% Black. 56% of patients were born outside the United States. 56% of patients had heard of CAM for kidney stones and 44% had used CAM for kidney stones. The most common CAM were fruits (N = 42, 84%). Recurrent stone formers were more likely than first-time stone formers to have heard of CAM (68 vs 44% p = 0.013) and to have used CAM (56 vs 30%, p = 0.008). Those identifying as Hispanic were more likely to have both heard of and tried CAM for kidney stones (p = 0.036 and 0.022, respectively) compared to non-Hispanic patients. CAM are commonly used among our diverse, urban patient population. While some remedies are high in citrate and alkali (i.e., lemon, cranberry), others are high in oxalate (i.e., beets) and could potentially contribute to stone formation. These findings underpin the importance that medical providers educate themselves on the CAM used in their specific patient populations and discussing use with patients. Providers should aim to identify and reconcile therapeutics that oppose goals of treatment.
      PubDate: 2022-06-11
       
  • Primary hyperoxaluria and genetic linkages: an insight into the disease
           burden from Pakistan

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      Abstract: Abstract Autosomal recessive disorders are prevalent in Pakistan, a developing South Asian country where consanguineous marriages are common. This study seeks to determine the prevalence of monogenic causes in children presenting with nephrocalcinosis and nephrolithiasis at a dialysis and transplant center in Karachi, Pakistan. A retrospective analysis was conducted in children aged 1–18 years presenting with nephrocalcinosis, between 2010 and 2019. Demographic information, clinical profile, laboratory parameters and stone analysis were collected, on a pre-designed questionnaire. One hundred and twenty-six children were included, with 11 and 3 diagnosed with renal tubular acidosis and Bartter’s syndrome respectively. Next-generation sequencing and Sanger sequencing was performed on 112 children. Eighty-seven patients were diagnosed with primary hyperoxaluria, with mutations in alanine–glyoxylate-aminotransferase gene found in 73, followed by glyoxylate reductase/hydroxy-pyruvate reductase in 13, and 4-hydroxy-2-oxaloglutarate aldolase in 1. Twenty-five patients reported negative for mutations. Sixty-four percent were males, with a statistically significant difference (p < 0.05). History of parental consanguineous marriage was found in 98% of the cohort. Fifty-four and 40 patients presented to the clinic with Chronic Kidney Disease Stage 1 and Stage 5, respectively, with a statistically significant difference p = 0.007. Mutations noted in our cohort are different and more severe than those reported in the developed world. The disease poses a major disease burden in developing world context with the only treatment option of combined liver–kidney transplantation not available in Pakistan.
      PubDate: 2022-06-09
       
  • Complications and outcomes of tubeless versus nephrostomy tube in
           percutaneous nephrolithotomy: a systematic review and meta-analysis of
           randomized clinical trials

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      Abstract: Abstract We aimed to perform a systematic review of randomized trials to summarize the evidence on the safety and stone-free rate after Tubeless percutaneous nephrolithotomy (PCNL) (ureteral stent/catheter, no nephrostomy) compared to Standard PCNL (nephrostomy, with/without ureteral stent/catheter) to evaluate if the tubeless approach is better. The inverse variance of the mean difference with a random effect, 95% Confidence Interval (CI), and p values was used for continuous variables. Categorical variables were assessed using Cochran–Mantel–Haenszel method with the random effect model, and reported as Risk Ratio (RR), 95% CI, and p values. Statistical significance was set at p < 0.05 and a 95% CI. 26 studies were included. Mean operative time was significantly shorter in the Tubeless group (MD—5.18 min, 95% CI − 6.56, − 3.80, p < 0.00001). Mean postoperative length of stay was also significantly shorter in the Tubeless group (MD—1.10 day, 95% CI − 1.48, − 0.71, p < 0.00001). Incidence of blood transfusion, angioembolization for bleeding control, pain score at the first postoperative day, the number of patients requiring postoperative pain medication, fever, urinary infections, sepsis, perirenal fluid collection, pleural breach, hospital readmission, and SFR did not differ between the two groups. Incidence of postoperative urinary fistula was significantly lower in the Tubeless group (RR 0.18, 95% CI 0.07, 0.47, p = 0.0005). This systematic review shows that tubeless PCNL can be safely performed and the standout benefits are shorter operative time and hospital stay, and a lower rate of postoperative urinary fistula.
      PubDate: 2022-06-08
       
  • Efficacy of PCNL in the resolution of symptoms of nephrolithiasis

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      Abstract: Abstract Patients undergo Percutaneous Nephrolithotomy (PCNL) for the resolution of pain, but at times, other symptoms such as hematuria, dysuria, nausea, emotional distress, and anxiety are also the presenting symptoms. While pain resolution after successful surgery is generally the focus, the resolution rate of other symptoms after surgery is not described. Our study aims to determine the efficacy of PCNL for the resolution of other symptoms. Patients aged > 18 years who underwent PCNL from September 2019 to 2021 were interviewed face-to-face and asked questions regarding their symptoms before and 3 months after the surgery. Their response was noted on an 11-point Numerical-Rating-Scale (NRS) of 0–10. The primary outcome was symptom resolution rate at 3 months after PCNL. The secondary outcomes were rate of resolution of gross hematuria, dysuria, anorexia and nausea, emotional distress and anxiety, work interference, and daily routine activities. Only patients who had complete stone clearance in a single sitting were included. Of the total 110 patients, almost half (45.45%) of the patients reported having one or more symptoms at or after 3 months of surgery. The reduction in proportion of patients and mean difference in preoperative and postoperative NRS scores of symptoms were statistically significant. Symptoms that persisted were mild and posed slight discomfort to the patient. Complete resolution of all the symptoms may not be achieved even in patients who have complete clearance after PCNL, and a few symptoms can persist, however, only mild. Appropriate preoperative counselling of the patients is, therefore, essential.
      PubDate: 2022-06-08
       
  • Comparison of stone retropulsion between Moses mode and virtual basket
           mode: an in vitro study using artificial stones

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      Abstract: Abstract This study aimed to evaluate stone retropulsion in various laser pulse modes in both Moses mode (MM) and virtual basket mode (VBM). Experiments were performed using a channel-shaped rubber rail and artificial stones. We compared short pulse mode and long pulse mode in both MM and VBM with the laser tip positioned so that it was touching and at 1 and 2 mm distances from the stone surface. Stone retropulsion was measured after the laser fired for 10 s in three different laser settings: 0.5 J/8 Hz, 0.8 J/8 Hz and 1.0 J/8 Hz. When the laser tip was touching the artificial stone, stone retropulsion in MM was significantly shorter than that in VBM in all laser settings (P < 0.01, P = 0.02 and P = 0.02, respectively). At 1-mm distance, stone retropulsion in MM was significantly shorter than that in VBM in 0.8 J/8 Hz and 1.0 J/8 Hz settings (P < 0.01 and P = 0.01, respectively). At 2-mm distance, however, there were no differences between MM and VBM in stone retropulsion in any laser settings. Stone retropulsion was not significantly different between the laser settings at 1-mm distance in MM, or when touching in VBM. In conclusion, stone retropulsion distance in MM can be shorter than that in VBM. Stone retropulsion in MM and VBM may be differently influenced by laser settings and laser tip position.
      PubDate: 2022-06-07
       
  • The combination of mean and maximum Hounsfield Unit allows more accurate
           prediction of uric acid stones

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      Abstract: Abstract Based on mean Hounsfield Unit (HuMean), we aimed to evaluate the additional use of standard deviation of Hounsfield Unit (HuStd), minimum Hounsfield Unit (HuMin), and maximum Hounsfield Unit (HuMax) in noncontrast computed tomography (NCCT) to evaluate uric acid (UA) stones more accurately. The data of patients who underwent the NCCT examination and infrared spectroscopy in our hospital from August 2017 to December 2021 were analyzed retrospectively. Based on CT scans, the HuMean, HuStd, HuMin, and HuMax of all patients were measured. The patients were divided into groups according to the stone composition. The attenuation value of mixed stones was in the middle of their pure stones. Except for Str, statistically significant differences between UA stones and other pure stones were observed for HuMean, HuStd, HuMin, and HuMax. A moderate correlation was found between HuMean, HuStd, HuMin, and HuMax and UA stones (rs showed −0.585, −0.409, −0.492, and −0.577, respectively). Receiver operator characteristic (ROC) curve showed that the area under the curve (AUC) of HuMean and HuMax were higher than those of HuStd and HuMin (AUC = 0.896, AUC = 0.891 vs. AUC = 0.777, AUC = 0.833). Higher AUC (0.904), specificity (0.899) and positive predictive value (PPV) (0.712) can be obtained by combining HuMean and HuMax in the diagnosis of UA stones. In conclusion, HuMean and HuMax can better predict UA stones than HuStd and HuMin. The combined use of HuMean and HuMax can lead to higher accuracy.
      PubDate: 2022-06-06
       
  • Predictors of successful emergency shock wave lithotripsy for acute renal
           colic

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      Abstract: Abstract The role of emergency shockwave lithotripsy (SWL) in persistent pain control in patients with ureteral stones is not well established. The aim of this study is to evaluate efficacy as well as the predicting variables for successful early SWL patients with symptomatic ureteral stones. Eighty-six patients with a persistent renal colic secondary to single ureteral stone (6–12 mm) were prospectively enrolled in this study. SWL was performed within 24 h of the onset of flank pain. Pain control and stone-free rate after emergency SWL session were 58.1% and 44.2%, respectively. Seven patients required post-SWL ureteroscopy and ureteral stent placement for uncontrolled pain. The overall 3-month stone-free rate after SWL monotherapy was 83.7%. On multivariate analysis, predictors for pain relief after emergency SWL were lower Hounsfield (HU) stone density, mild hydronephrosis (HN) at presentation and presentation during the first colic episode. Lower HU stone density was the single predictor of successful stone clearance after single emergency SWL session on multivariate analysis. In conclusion, early SWL is feasible and effective in management of ureteral stones presented by renal colic with low HU.
      PubDate: 2022-06-03
       
  • Renal puncture access via a nonpapillary track in percutaneous
           nephrolithotomy: an in vitro porcine kidney experience

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      Abstract: Abstract Recently, an increasing number of investigators have debated the wide rule of the puncture to renal papilla in PCNL. We evaluated the effect of renal papillary and nonpapillary puncture on bleeding in an in vitro porcine kidney experience, with the aim of determining the safe puncture sites of collecting system in PCNL. A total of 70 fresh porcine kidneys were selected and subjected to nephrostomy. We performed a puncture through a renal papilla, infundibulum, renal column, or minor calyceal neck (including the front, back, up, and down). The primary outcome was the amount of bleeding. The results showed that the papillary puncture group yielded minimal bleeding (1.59 ± 1.01 ml/min) compared with the infundibular puncture group (6.25 ± 4.46 ml/min, P < .001), renal column puncture group (4.24 ± 3.79 ml/min, P = 0.001), and minor calyceal neck puncture group (2.27 ± 1.35 ml/min, P = 0.011). However, after stratifying by orientation, the up (1.75 ± 0.80 ml/min, P = 0.501) or down (1.77 ± 0.72 ml/min, P = 0.437) minor calyceal neck puncture group and papillary puncture group yielded comparable bleeding. In summary, nonpapillary puncture must be carefully considered. Infundibular and renal column punctures were inferior to papillary puncture, and up or down minor calyceal neck puncture may be a prudent choice in specific situations.
      PubDate: 2022-06-01
       
  • How the diagnosis and the management of genetic renal phosphate leak
           impact the life of kidney stone formers'

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      Abstract: Abstract Genetic renal phosphate leak is one of the rare disorders in recurrent stone formers with absorptive hypercalciuria. Diagnosis and appropriate management may change the life of patients. To provide answers on how and when to make the diagnosis of genetic renal phosphate leak and how medical management prevents the recurrences and changes patients’ life, we conducted a retrospective study including nine patients with recurrent nephrolithiasis and a confirmed genetic mutation of a phosphate transporter between 2008 and 2019 in our multidisciplinary center at the Pitié Salpetriere Hospital, Paris, France. We compared the number and the annual rate of urological intervention before and after the diagnosis and management using the Wilcoxon test. A qualitative survey was done to evaluate the quality of life of patients. A total of 9 patients were included in this study. Patient baseline characteristics and elements supporting the diagnosis are described. We showed an effective decrease in urological intervention number (p = 0.0078) and annual rate (p = 0.0117) after the diagnosis and the appropriate management, and an improvement in the patients’ quality of life. The diagnosis and the appropriate management of genetic renal phosphate leak disorder improve the quality of life by preventing stone recurrence and decreasing the number of surgical intervention.
      PubDate: 2022-06-01
       
  • Needle-perc-assisted endoscopic surgery for patients with complex renal
           stones: technique and outcomes

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      Abstract: Abstract Our aim was to investigate the safety and efficacy of needle-perc-assisted percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS), namely, needle-perc-assisted endoscopic surgery (NAES), in a series of patients with large and/or complex renal stones. From May 2018 to August 2021, a total of 119 patients underwent NAES at our institute. Among them, 94 patients underwent needle-perc-assisted standard PCNL in prone position and 25 underwent needle-perc-assisted RIRS in the Galdakao-modified supine Valdivia position or prone split-leg position. Clinical factors including age, sex, medical history, and stone characteristics were collected. Intraoperative and postoperative outcomes were retrospectively evaluated. The patients’ mean age ± standard deviation was 50.3 ± 14.3 years. The mean stone size was 7.6 ± 3.7 and 1.7 ± 0.8 cm for needle-perc-assisted PCNL and RIRS, respectively. Of the 119 patients, 51 had staghorn stones, 16 had solitary kidneys, 17 had a history of ipsilateral renal surgery, and 6 had calyceal diverticular stones. The mean operative time was 83.4 ± 25.9 min for needle-perc-assisted PCNL and 66.3 ± 21.8 min for needle-perc-assisted RIRS. The stone-free rate (SFR) for needle-perc-assisted PCNL was 77.7% after the first treatment and 88.3% after auxiliary treatments. The SFR for needle-perc-assisted RIRS was 88.0% and no auxiliary treatments were carried out in this group. Eleven (11.7%) patients who underwent needle-perc-assisted standard PCNL developed Clavien–Dindo grade I or II complications. Three (12.0%) patients who underwent needle-perc-assisted RIRS developed a fever (grade I). The overall complication rate for NAES was 11.8%, with no urosepsis, angioembolization, or other grade III to V complications. In conclusion, NAES is a safe and effective procedure for one-step complete resolution of large and/or complex renal stones with no additional procedure-related complications.
      PubDate: 2022-06-01
       
  • Ultramini-percutaneous nephrolithotomy versus retrograde intrarenal
           surgery in the treatment of 10–30 mm calculi: a randomized controlled
           trial

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      Abstract: Abstract The surgical management of renal stones 10–30 mm is usually performed with percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). Standard form of percutaneous nephrolithotomy has paved the way for miniaturized PCNL in many centres. We wanted to evaluate the efficacy, safety and the cost-effectiveness of ultramini-percutaneous nephrolithotomy (UMP) versus RIRS in the treatment of renal stones with stone burden 10–30 mm. Patients with renal stone burden 10–30 mm were prospectively randomized into either UMP or RIRS. The demographic data, stone characteristic, operative time and cost of the equipment were recorded. The stone free status, analgesic requirement, deterioration of the renal function and hemoglobin and the postoperative complications as per Clavein–Dindo grade were recorded. One hundred and fifty patients met inclusion criteria. Out of these 98 underwent UMP and 46 RIRS. Six withdrew the consent before the procedure. Mean stone size was comparable in either of the groups. Mean laser time and stone extraction time was significantly less for UMP compared to RIRS (41.17 min versus 73.58 min p < 0.0001). Mean consumable costs in the UMP group were considerably less at US$45.73 compared to the RIRS group at $423.11 (p < 0.0001). The stone free rates at 1 month of follow-up were 100% for UMP group and 73% for RIRS group. There were insignificant changes to mean hemoglobin and glomerular filtration rate (GFR) in all patients and the average length of the stay was similar in both the groups. The postoperative complications revealed Grade I and II rate of 10% in the UMP group and 35% in the RIRS group, respectively. We concluded that UMP to be safe, effective and more economical to the RIRS for renal stones up to 3 cm in size. Trial registered with ISRCTN registry ID ISRCTN20935105, Retrospective.
      PubDate: 2022-06-01
       
  • Neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) and
           lymphocyte–monocyte ratio (LMR) in predicting systemic inflammatory
           response syndrome (SIRS) and sepsis after percutaneous nephrolithotomy
           (PNL)

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      Abstract: Abstract The objective of this prospective observational study was to assess the clinical significance of neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) and lymphocyte–monocyte ratio (LMR) as potential biomarkers to identify post-PNL SIRS or sepsis. Demographic data and laboratory data including hemoglobin (Hb), total leucocyte count (TLC), serum creatinine, urine microscopy and culture were collected. The NLR, LMR and PLR were calculated by the mathematical division of their absolute values derived from routine complete blood counts from peripheral blood samples. Stone factors were assessed by non-contrast computerized tomography of kidneys, ureter and bladder (NCCT KUB) and included stone burden (Volume = L × W × D × π × 0.167), location and Hounsfield value and laterality. Intraoperative factors assessed were puncture site, tract size, tract number, operative time, the need for blood transfusion and stone clearance. Of 517 patients evaluated, 56 (10.8%) developed SIRS and 8 (1.5%) developed sepsis. Patients developing SIRS had significantly higher TLC (10.4 ± 3.5 vs 8.6 ± 2.6, OR 1.19, 95% CI 1.09–1.3, p = 0.000002), higher NLR (3.6 ± 2.4 vs 2.5 ± 1.04, OR 1.3, 95% CI = 1.09–1.5, p = 0.0000001), higher PLR (129.3 ± 53.8 vs 115.4 ± 68.9, OR 1.005, 95% CI 1.001–1.008, p = 0.005) and lower LMR (2.5 ± 1.7 vs 3.2 ± 1.8, OR 1.18, 95% CI 1.04–1.34, p = 0.006). Staghorn stones (12.8 vs 3.24%, OR 4.361, 95% CI 1.605–11.846, p = 0.008) and long operative times (59.6 ± 14.01 vs 55.2 ± 16.02, OR 1.01, 95% CI 1.00–1.03, p = 0.05) had significant association with postoperative SIRS. In conclusion, NLR, PLR and LMR can be useful independent, easily accessible and cost-effective predictors for early identification of post-PNL SIRS/sepsis.
      PubDate: 2022-06-01
       
  • Is there a place for extracorporeal shockwave lithotripsy (ESWL) in the
           endoscopic era'

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      Abstract: Abstract This retrospective study aimed to evaluate whether there was still a place for ESWL therapy in the endourological era. From 1988 to 2018, ESWL therapy was performed with 3 successive types of lithotripters in our hospital. From 1988 to 1998, the electrohydraulic lithotripter NS-15 was used, and the electromagnetic lithotripter HK-V was put to use in 1999. Since 2010, the electromagnetic lithotripter HK-Vm has been used. Over the 30-year period, 16,969 urolithiasis patients underwent ESWL therapy, including 124 paediatric cases and 178 special cases. The stone clearance rate (SCR) and postoperative complications in the 3 lithotripter groups were recorded and analysed. The SCR was estimated by ultrasonography or plain X-ray, while the complications were recorded by the modified Clavien grading system. The primary stone clearance rate (pSCR) of ureteral and renal stones was significantly improved in the HK-Vm group compared with the NS-15 and HK-V groups. The final stone clearance rate (fSCR) of lower calyx stones was considerably higher in the HK-Vm group (55.9%) than in the NS-15 (41.1%) and HK-V (44.1%) groups. Most complications were grade I and II, while the incidence of grade III and above complications was less than 3%. Additionally, the fSCR in paediatric and special cases ranged from 66.5% to 83.5%, with no record of severe complications. As our data showed, ESWL was effective and safe for most urolithiasis patients, including paediatric patients and special cases. Therefore, ESWL is still the major treatment option in the current endourological era.
      PubDate: 2022-06-01
       
  • Comparative functional analysis of the urinary tract microbiome for
           individuals with or without calcium oxalate calculi

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      Abstract: Abstract Individuals with urinary stone disease (USD) exhibit dysbiosis in the urinary tract and the loss of Lactobacillus that promote urinary tract health. However, the microbial metabolic functions that differentiate individuals with USD from healthy individuals are unknown. The objective of the current study was to determine the microbial functions across prokaryotic, viral, fungal, and protozoan domains that are associated with calcium oxalate (CaOx) stone formers through comparative shotgun metagenomics of midstream, voided urine samples for a small number of patients (n = 5 CaOx stone formers, n = 5 healthy controls). Results revealed that CaOx stone formers had reduced levels of genes associated with oxalate metabolism, as well as transmembrane transport, proteolysis, and oxidation–reduction processes. From 17 draft genomes extracted from the data and > 42,000 full length reference genomes, genes enriched in the Control group mapped overwhelming to Lactobacillus crispatus and those associated with CaOx mapped to Pseudomonas aeruginosa and Burkholderia sp. The microbial functions that differentiated the clinical cohorts are associated with known mechanisms of stone formation. While the prokaryotes most differentiated the CaOx and Control groups, a diverse, trans-domain microbiome was apparent. While our sample numbers were small, results corroborate previous studies and suggest specific microbial metabolic pathways in the urinary tract that modulate stone formation. Future studies that target these metabolic pathways as well as the influence of viruses, fungi, and protozoa on urinary tract physiology is warranted.
      PubDate: 2022-06-01
       
  • Risk factors for concomitant positive midstream urine culture in patients
           presenting with symptomatic ureterolithiasis

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      Abstract: Abstract In patients with symptomatic ureterolithiasis, immediate treatment of concomitant urinary tract infection (UTI) may prevent sepsis. However, urine cultures require at least 24 h to confirm or exclude UTI, and therefore, clinical variables may help to identify patients who require immediate empirical broad-spectrum antibiotics and surgical intervention. Therefore, we divided a consecutive cohort of 705 patients diagnosed with symptomatic ureterolithiasis at a single institution between 2011 and 2017 into a training (80%) and a testing cohort (20%). A machine-learning-based variable selection approach was used for the fitting of a multivariable prognostic logistic regression model. The discriminatory ability of the model was quantified by the area under the curve (AUC) of receiver-operating curves (ROC). After validation and calibration of the model, a nomogram was created, and decision curve analysis (DCA) was used to evaluate the clinical net-benefit. UTI was observed in 40 patients (6%). LASSO regression selected the variables elevated serum CRP, positive nitrite, and positive leukocyte esterase for fitting of the model with the highest discriminatory ability. In the testing cohort, model performance evaluation for prediction of UTI showed an AUC of 82 (95% CI 71.5–95.7%). Model calibration plots showed excellent calibration. DCA showed a clinically meaningful net-benefit between a threshold probability of 0 and 80% for the novel model, which was superior to the net-benefit provided by either one of its singular components. In conclusion, we developed and internally validated a logistic regression model and a corresponding highly accurate nomogram for prediction of concomitant positive midstream urine culture in patients presenting with symptomatic ureterolithiasis.
      PubDate: 2022-04-20
       
  • Differences in renal cortex transcriptional profiling of wild-type and
           novel type B cystinuria model rats

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      Abstract: Abstract Cystinuria is a genetic disorder of cystine transport that accounts for 1–2% of all cases of renal lithiasis. It is characterized by hyperexcretion of cystine in urine and recurrent cystine lithiasis. Defective transport of cystine into epithelial cells of renal tubules occurs because of mutations of the transport heterodimer, including protein b0,+AT (encoded by SLC7A9) and rBAT (encoded by SLC3A1) linked through a covalent disulfide bond. Study generated a novel type B cystinuria rat model by artificially deleting 7 bp of Slc7a9 gene exon 3 using the CRISPR-Cas9 system, and those Slc7a9-deficient rats were proved to be similar with cystinuria in terms of genome, transcriptome, translation, and biologic phenotypes with no off-target editing. Subsequent comparisons of renal histopathology indicated model rats gained typical secondary changes as medullary fibrosis with no stone formation. A total of 689 DEGs (383 upregulated and 306 downregulated) were differentially expressed in the renal cortex of cystinuria rats. In accordance with the functional annotation of DEGs, the potential role of glutathione metabolism processes in the kidney of cystinuria rat model was proposed, and KEGG analysis results showed that knock-out of Slc7a9 gene triggered more biological changes which has not been studied. In short, for the first time, a rat model and its transcriptional database that mimics the pathogenesis and clinical consequences of human type B cystinuria were generated.
      PubDate: 2022-04-13
      DOI: 10.1007/s00240-022-01321-6
       
 
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