Accurate Assessment of Interval Change in Stone Burden Among Patients with Medullary Sponge Kidney: A Volumetric Approach.

Medullary sponge kidney (MSK) and nephrocalcinosis (NC) are radiographically characterized by the formation of innumerable intrarenal concretions. Accurate determination of disease progression is challenging given the large and typically sporadic calcific burden, limiting the utility of traditional manual linear measurements on non-contrast computerized tomography (NCCT). Progression of stone size or quantity is an important predictor of morbidity in recurrent stone formers.

Ureteral Stricture Occurrence after Transmural Ureteroscopic Ureteral Injury: A Previously Undocumented Concern.

Although the reported incidence of ureteral strictures following ureteroscopy (URS) is low (0.3%-3%), we hypothesize the risk may rise as the depth of ureteral injury increases. Between 2018 and 2022, 550 patients underwent URS for upper tract calculi; each of these patients had a postureteroscopic lesion scale (PULS) grading and follow-up imaging 3-6 months after a surgical procedure.

Ureteral Wall Thickness Measurement and Spontaneous Stone Passage A Narrative Review.

Purpose Of Review: There is a high number of acute renal colic cases that present to the emergency department, and it is crucial to have reliable parameters that can accurately predict the likelihood of spontaneous stone passage. In this narrative review, we examined the latest data from the literature regarding the relationship between ureteral wall thickness and the probability of spontaneous stone passage.

Recent Findings: The thickness of a normal ureteral wall ranges between 0.

MONARCH™ Robotic-Assisted Combined Mini-Percutaneous Nephrolithotomy and Flexible Ureteroscopic Lithotripsy: A Step-By-Step Guide.

The following video atlas summary comprehensively reviews all technical aspects of the standardized set-up, patient positioning, electromagnetic-guided renal access, integrated irrigation-aspiration system use, and robotic lithotripsy of the novel MONARCH (Johnson & Johnson MedTech, Redwood City, CA) combined mini-percutaneous nephrolithotomy and flexible ureteroscopy platform.

Warm irrigation fluid effect on Thulium fiber laser (TFL) ablation of uroliths.

Prior laser studies have demonstrated that as the temperature of a medium increases, the amount of energy delivered to the target increases. We sought to investigate the role of irrigation fluid temperature on Thulium fiber laser (TFL) urolith ablation. 360 calculi were divided in vitro according to chemical composition: calcium oxalate monohydrate (COM), cystine (CYS), struvite (STR), calcium phosphate (CAP), uric acid (UA), and calcium oxalate dihydrate (COD).

Prospective Evaluation of Ureteral Wall Thickness as a Means to Predict Spontaneous Stone Passage: Is It Beneficial?

Ureteral wall thickness (UWT) was proposed as a potential predictor for spontaneous stone passage (SSP). In earlier studies, the effect could not be isolated from stone size. Accordingly, we sought to determine whether UWT, alone or combined with stone size, could enhance SSP predictability.

Preoperative Immersive Virtual Reality Applied to Percutaneous Nephrolithotomy: A Prospective Randomized Clinical Study of Surgical Planning and Clinical Outcomes.

Purpose: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for the management of complex or large renal stones. A major challenge for the surgeon, however, is the need to assimilate the nearly 2000 static images from a CT scan into a functional mental image to enable surgical planning. Accordingly, we investigated the potential of immersive virtual reality (iVR) to enhance surgical planning and its impact on the outcomes among patients undergoing PCNL.

Clinical determination of the natural distensibility of the human ureter: initial study.

Objectives: To define the natural distensibility of the human ureter and evaluate the impact of other possibly favourable factors on ureteric distensibility.

Patients And Methods: A total of 101 patients undergoing ureteroscopic stone removal or percutaneous nephrolithotomy underwent ureteric sizing using sequential passage of 37-cm urethral dilators in 2-F increments while attached to a unique force sensor. Insertion forces were limited to 6 N.

Initial Clinical Experience With a Novel Robotically Assisted Platform for Combined Mini-Percutaneous Nephrolithotomy and Flexible Ureteroscopic Lithotripsy.

Purpose: We sought to evaluate the technical feasibility of performing a combined robotically assisted mini-percutaneous nephrolithotomy (PCNL) and flexible ureteroscopy (URS) procedure by a single urologist using the MONARCH Platform, Urology (Johnson & Johnson MedTech, Redwood City, California).

Material And Methods: In this prospective, first-in-human clinical trial, 13 patients underwent robotically-assisted PCNL for renal calculi at the University of California-Irvine, Department of Urology. Successful completion of the procedure was assessed as the primary endpoint.

Development and Initial Evaluation of a Cost-Effective Force Sensor for Ureteroscopic Application.

Retrograde intrarenal surgery is the gold-standard treatment for most kidney stones. During ureteroscopy, ureteral access sheath insertion at forces greater than 8.0 Newtons (N) risks high-grade ureteral injury.

Surgical Force: Initial Study and Clinical Implications in the Assessment of Ureteral Access Sheath Induced Injury.

Ureteral access sheaths (UAS) pose the risk of severe ureteral injury. Our prior studies revealed forces ≤6 Newtons (N) prevent ureteral injury. Accordingly, we sought to define the force urologists and residents in training typically use when placing a UAS.

Alkaline Water: Help or Hype for Uric Acid and Cystine Urolithiasis?

Purpose: The consumption of alkaline water, water with an average pH of 8 to 10, has been steadily increasing globally as proponents claim it to be a healthier alternative to regular water. Urinary alkalinization therapy is frequently prescribed in patients with uric acid and cystine urolithiasis, and as such we analyzed commercially available alkaline waters to assess their potential to increase urinary pH.

Materials And Methods: Five commercially available alkaline water brands (Essentia, Smart Water Alkaline, Great Value Hydrate Alkaline Water, Body Armor SportWater, and Perfect Hydration) underwent anion chromatography and direct chemical measurements to determine the mineral contents of each product.

Surgical Artificial Intelligence: Endourology.

Endourology is ripe with information that includes patient factors, laboratory tests, outcomes, and visual data, which is becoming increasingly complex to assess. Artificial intelligence (AI) has the potential to explore and define these relationships; however, humans might not be involved in the input, analysis, or even determining the methods of analysis. Herein, the authors present the current state of AI in endourology and highlight the need for urologists to share their proposed AI solutions for reproducibility outside of their institutions and prepare themselves to properly critique this new technology.

Efficient and Accurate Computed Tomography-Based Stone Volume Determination: Development of an Automated Artificial Intelligence Algorithm.

Purpose: Given the shortcomings of current stone burden characterization (maximum diameter or ellipsoid formulas), we sought to investigate the diagnostic accuracy and precision of a University of California, Irvine-developed artificial intelligence (AI) algorithm for determining stone volume determination.

Materials And Methods: A total of 322 noncontrast CT scans were retrospectively obtained from patients with a diagnosis of urolithiasis. The largest stone in each noncontrast CT scan was designated the "index stone.

Evaluation of Renal Function and Stent Durability Following Resonance Stent Placement for Benign Disease.

The metal-based Resonance stent (RS) has traditionally been placed in patients with malignant ureteral obstruction; as such, the long-term utility of RS among patients with benign ureteral obstruction (BUO) remains underinvestigated. We retrospectively reviewed our database for patients with BUO who underwent RS placement between 2010 and 2020. The impact of chronic RS placement on renal function was evaluated by estimated serum creatinine-based glomerular filtration rate (eGFR), furosemide renal scan, and CT-based renal parenchymal volume measurement.

Heterogeneity of Platelet Derived Growth Factor Pathway Gene Expression Profile Defines Three Distinct Subgroups of Renal Cell Carcinomas.

Background/aim: We previously described four different vascular patterns (reticular, diffuse, fasciculate, and trabecular) in renal cell carcinoma (RCC) suggesting an early and heterogeneous acquisition of perivascular cells most probably due to a particular PDGF pathway gene expression profile. The aim of the study was to study PDGF pathway gene expression profiles, separately for each vascular pattern.

Materials And Methods: TaqMan assay for the PDGF pathway was performed on twelve cases of ccRCC previously evaluated by histopathology, immunohistochemistry, and RNAscope.

Urinary Microbiota-Are We Ready for Prime Time? A Literature Review of Study Methods' Critical Steps in Avoiding Contamination and Minimizing Biased Results.

Within the last few years, there have been an increased number of clinical studies involving urinary microbiota. Low-biomass microbiome sequencing (e.g.