Recent Advances in Understanding and Managing Urolithiasis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 10023

Special Issue Editor

Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
Interests: onco-urology; Bladder cancer; UTUC; robotic surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Stone surgery is one of the most innovative fields in urology. In recent years, we have witnessed the emergence of many new technologies, as well as new devices, each more promising than the last. Nevertheless, stone disease is still one of the most frequent pathologies in urology and many studies, with their subsequent advances, are still currently awaited.

This Special Issue aims to provide our readers with some of the hottest topic reviews in the field of stone devices, as well as high-quality clinical research. We also want to provide some experimental and basic science research in the field of laser surgery for stone disease.

We hope that this Special Issue will give you the most up-to-date overview of recent advances in urolithiasis as well as high-quality studies that will become the benchmark for the coming years.

Dr. Benjamin Pradere
Guest Editor

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Keywords

  • stone
  • laser surgery
  • disposable
  • ureteroscopy
  • cystoscopy
  • devices
  • stent

Published Papers (4 papers)

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Research

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9 pages, 975 KiB  
Article
Relevance of Adopting a Hybrid Strategy Mixing Single-Use and Reusable Ureteroscopes for Stones Management: An Economic Study to Support the Best Strategy
by Fanny Monmousseau, Julien Ramillon, Sophie Dubnitskiy-Robin, Benjamin Faivre d’Arcier, Martine Le Verger, Tanguy Le Fol, Franck Bruyère, Emmanuel Rusch, Solène Brunet-Houdard and Benjamin Pradère
J. Clin. Med. 2021, 10(12), 2593; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10122593 - 11 Jun 2021
Cited by 5 | Viewed by 1676
Abstract
Endoscopic procedures such as ureteroscopy (URS) have seen a recent increase in single-use devices. Despite all the advantages provided by disposable ureteroscopes (sURSs), their cost effectiveness remains questionable, leading most teams to use a hybrid strategy combining reusable (rURS) and disposable devices. Our [...] Read more.
Endoscopic procedures such as ureteroscopy (URS) have seen a recent increase in single-use devices. Despite all the advantages provided by disposable ureteroscopes (sURSs), their cost effectiveness remains questionable, leading most teams to use a hybrid strategy combining reusable (rURS) and disposable devices. Our study aimed to create an economic model that estimated the cut-off value of rURS procedures needed to support the profitability of a hybrid strategy (HS) for ureteroscopy. We used a budget impact analysis (BIA) model that estimated the financial impact of an HS compared to 100% sURS use. The model included hospital volume, sterilization costs and the private or public status of the institution. Although the hybrid strategy generally remains the best economic and clinical option, a predictive BIA model is recommended for the decision-making. We found that the minimal optimal proportion of rURS procedures in an HS was mainly impacted by the activity volume and overall number of sterilization procedures. Private and public institutions must consider these variables and models in order to adapt their HS and remain profitable. Full article
(This article belongs to the Special Issue Recent Advances in Understanding and Managing Urolithiasis)
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10 pages, 1344 KiB  
Article
The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years
by Toshifumi Takahashi, Shinya Somiya, Katsuhiro Ito, Toru Kanno, Yoshihito Higashi and Hitoshi Yamada
J. Clin. Med. 2021, 10(7), 1336; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10071336 - 24 Mar 2021
Cited by 3 | Viewed by 1452
Abstract
Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. [...] Read more.
Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely. Full article
(This article belongs to the Special Issue Recent Advances in Understanding and Managing Urolithiasis)
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Review

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11 pages, 2346 KiB  
Review
Managing Urolithiasis with Thulium Fiber Laser: Updated Real-Life Results—A Systematic Review
by Olivier Traxer and Mariela Corrales
J. Clin. Med. 2021, 10(15), 3390; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10153390 - 30 Jul 2021
Cited by 31 | Viewed by 3027
Abstract
Thirty-three years ago, pulsed lasers marked the beginning of a new era in endoscopic lithotripsy, and the one that was highlighted because of its potential was the Holmium: YAG laser, which became and still is the gold standard in endourology. Recently, a new [...] Read more.
Thirty-three years ago, pulsed lasers marked the beginning of a new era in endoscopic lithotripsy, and the one that was highlighted because of its potential was the Holmium: YAG laser, which became and still is the gold standard in endourology. Recently, a new laser technology has been accepted for clinical use in lithotripsy: the thulium fiber laser (TFL), showing appealing characteristics not seen before in several preclinical studies. A review of the literature was performed and all relevant in vitro studies and clinical trials until April 2021 were selected. The search came back with 27 clinical experiences (7 full-text clinical trials and 20 peer-reviewed abstracts) and 33 laboratory studies (18 full-text articles and 15 peer-reviewed abstracts). The clinical experiences confirmed the clinical safety of using the wide parameter range of the TFL. This technology demonstrated the performance at a higher ablation speed, the higher ablation efficiency, and the better dust quality of the TFL, as well as reduced stone retropulsion, thus helping to maintain an optimal visibility. No thermal or radiation damage was found. Given the current evidence, we may be facing the future gold standard laser in endoscopic lithotripsy. Full article
(This article belongs to the Special Issue Recent Advances in Understanding and Managing Urolithiasis)
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12 pages, 17771 KiB  
Review
Endoscopic Papillary Abnormalities and Stone Recognition (EPSR) during Flexible Ureteroscopy: A Comprehensive Review
by Christophe Almeras, Benjamin Pradere, Vincent Estrade, Paul Meria and on behalf of the Lithiasis Committee of the French Urological Association
J. Clin. Med. 2021, 10(13), 2888; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10132888 - 29 Jun 2021
Cited by 4 | Viewed by 3259
Abstract
Introduction: The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation (morphological and infrared). Before the stone destruction, the urologist has the opportunity to analyze the [...] Read more.
Introduction: The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation (morphological and infrared). Before the stone destruction, the urologist has the opportunity to analyze the stone and the papillary abnormalities endoscopically (endoscopic papillary recognition (EPR) and endoscopic stone recognition (ESR)). Our objective was to evaluate the value for those endoscopic descriptions. Methods: The MEDLINE and EMBASE databases were searched in February 2021 for studies on endoscopic papillary recognition and endoscopic stone recognition. Results: If the ESR provided information concerning the main crystallization process, EPR provided information concerning the origin of the lithogenesis and its severity. Despite many actual limitations, those complementary descriptions could support the preventive care of the stone formers in improving the diagnosis of the lithogenesis mechanism and in identifying high-risk stone formers. Conclusion: Until the development of an Artificial Intelligence recognition, the endourologist has to learn EPSR to minimize the distortion effect of the new lasers on the stone analysis and to improve care efficiency of the stone formers patients. Full article
(This article belongs to the Special Issue Recent Advances in Understanding and Managing Urolithiasis)
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