Mini-Percutaneous Nephrolithotomy Less Injurious to the Kidney?

Percutaneous nephrolithotomy (PCNL) technique trends have shifted toward smaller caliber access sheaths, leading to a varied array of miniPCNL (mPCNL) systems. Urinary biomarkers have been validated as noninvasive direct markers of renal cellular injury. Our objective was to assess changes in biomarkers levels in the perioperative setting, comparing mPCNL suction (s-mPCNL), non-suction (ns-mPCNL), and standard PCNL (sPCNL) systems.

World-wide variation in percutaneous nephrolithotomy practices: evaluation based on training, experience, and region.

Introduction: Percutaneous nephrolithotomy (PCNL) has undergone numerous technological innovations recently that make it even less invasive, but global adoption of these innovations remains unclear. This study sought to compare the effect of region and education on the penetrance of recent advances in PCNL worldwide.

Methods: An anonymous 32-item survey was developed and distributed via the Endourological Society's Twitter/X account in November 2023.

Utility of enhanced quantitative urine culture technique for isolation of uro-pathogens in children.

Background: Urinary tract infections (UTIs) are the most common bacterial infection worldwide. Symptoms of UTI in children is vague & non-specific and mostly underdiagnosed Standard urine culture (SUC) is the gold standard for detecting uropathogens but the clinical correlation and its implication in initiating antimicrobial therapy continue to be a question for decision-making. Enhanced quantitative urine culture (EQUC) was developed to overcome these limitations.

Increased Risk of Kidney Stones in Transgender Women and Gender-Diverse Adults on Gender-Affirming Hormone Therapy: Insights from a Large Database Study.

Transgender and gender-diverse (TGD) individuals represent a growing yet underrepresented group in medical literature. Estrogen and antiandrogens are essential in feminizing gender-affirming hormone therapy (f-GAHT) for individuals assigned male at birth (AMAB). This study examines f-GAHT effects on nephrolithiasis risk in TGD individuals AMAB.

Evaluating blood and urinary markers for prediction of spontaneous ureteral stone passage.

Objectives: The predictive value of blood and serum markers for spontaneous ureteral stone passage (SSP) has been investigated, with no substantial conclusion about their reliability. Therefore, we aim to evaluate the predictive potential of blood and urine laboratory tests for ureteral stone passage.

Methods: This prospective, single-center observational study included patients with a solitary obstructing ureteral stone <10 mm diagnosed via non-contrast computerized tomography (NCCT).

Randomized Controlled Trial of Nonsteroidal Anti-Inflammatory Drugs as a Safe and Effective Alternative to Opioids for Pain Relief Following Percutaneous Nephrolithotomy.

This randomized controlled trial aims to demonstrate the noninferiority of nonsteroidal anti-inflammatory drugs (NSAIDs) compared with narcotics for postoperative pain management after percutaneous nephrolithotomy (PCNL), in an era where opioids are commonly utilized. After institutional review board approval, 85 patients scheduled for PCNL at our institution between May 2023 and January 2025 were consented and randomized to receive either oxycodone (OXY) or ketorolac (KET) for postoperative pain management at home. Inclusion criteria were unilateral, single-access standard PCNL, whereas exclusion criteria included abnormal anatomy, contraindications to KET/OXY, and preexisting stents or nephrostomy tubes.

Evaluation of a fluoroscopy-free, ureteral access sheath-free, and stent-free approach to retrograde intrarenal surgery.

Purpose: We sought to evaluate the safety and efficacy of an approach attempting no fluoroscopy (F), ureteral sheaths (US), or stents (S) during retrograde intrarenal surgery (NoFUSS-RIRS) and to compare it to conventional RIRS (C-RIRS).

Methods: We prospectively collected data on the first 75 NoFUSS-RIRS procedures in patients with 5-20 mm renal stones and compared them to a cohort of 75 prior patients undergoing C-RIRS which involved fluoroscopy and stent placement. Baseline characteristics, safety outcomes (including Clavien-Dindo complications, ED visits, and readmissions), and CT-determined stone-free rates were compared.

Is Totally Tubeless Percutaneous Nephrolithotomy a Safe and Efficacious Option for Caliceal Diverticular Calculi?

Percutaneous nephrolithotomy (PCNL) is a common treatment for caliceal diverticular calculi and provides excellent stone-free outcomes. Because of a concern for urinary stasis in the setting of a dilated nephrostomy tract, an indwelling ureteral stent and/or nephrostomy tube (NT) was traditionally left in the collecting system. The rationale for investigating totally tubeless PCNL (tt-PCNL) for the treatment of caliceal diverticula was to determine whether the advantages attributed to tt-PCNL for normal collecting system stones, such as shorter hospital stay and reduced morbidity, would extend to PCNL of caliceal diverticula.

Harnessing Artificial Intelligence to Predict Spontaneous Stone Passage: Development and Testing of a Machine Learning-Based Calculator.

We sought to use artificial intelligence (AI) to develop and test calculators to predict spontaneous stone passage (SSP) using radiographical and clinical data. Consecutive patients with solitary ureteral stones ≤10 mm on CT were prospectively enrolled and managed according to American Urological Association guidelines. The first 70% of patients were placed in the "training group" and used to develop the calculators.

High-Power Lasers Induce Dose-Dependent Acute Kidney Injury.

High-powered lasers have been hypothesized to cause kidney injury; however, no human studies have confirmed or quantified this damage. Our objective was to identify and quantify damage and explore factors affecting degree of injury in patients undergoing retrograde intrarenal surgery (RIRS) with thulium fiber laser (TFL) and Holmium:YAG (Ho:YAG) lasers. Patients undergoing RIRS for unilateral nonobstructing renal stones were randomized to receive lithotripsy with either a 60 W SuperPulse TFL or 120 W pulse-modulated Ho:YAG laser.

Does having an asymptomatic renal stone increase morbidity after radical cystectomy?

Background: Asymptomatic renal stones identified before radical cystectomy (RC) and urinary diversion (UD) pose a potential treatment dilemma. This study aims to evaluate the outcomes of these asymptomatic stones managed by observation and their natural history after surgery.

Methods: This longitudinal cohort study included patients referred for RC and UD between 2015 and 2023 at a single institution.

Evaluation of various diagnostic modalities for detection of bacterial vaginosis and aerobic vaginitis: An underdiagnosed entity among women of the reproductive age group.

Background: Bacterial vaginosis (BV) and aerobic vaginitis (AV) have been encountered as the most common vaginal infections among women of the reproductive age group. Bedside diagnosis of BV can be made by Amsel's criteria or modified Amsel's criteria by clinicians. However, Nugent scoring is the recommended method for its diagnosis.

Patients Who Catastrophize Pain Experience Increased Pain after Ureteroscopic Laser Lithotripsy with Stent Placement.

Pain after ureteroscopic laser lithotripsy with stent placement (URSLL+stent) varies widely between patients. Although stent-specific factors are known to influence symptoms, patient-specific factors remain elusive. The pain catastrophizing scale (PCS) is a validated questionnaire quantifying the degree to which an individual catastrophizes painful stimuli.

Understanding the clinical genetics of kidney stone disease using the Natera Renasight panel.

We aimed to characterize the underlying genetics of kidney stone disease (KSD) in an urban and diverse population using the Natera Renasight genetic panel. This was a single-center prospective study of high-risk KSD patients, defined as recurrent stone formers or those with a family history with KSD. Buccal saliva DNA samples were collected with the commercially available Natera Renasight genetic panel and were analyzed using next-generation sequencing.

Is Outpatient Totally Tubeless Standard Percutaneous Nephrolithotomy Safe and Efficacious?

Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for large, complex intrarenal stones. Tubeless PCNL (t-PCNL) where no nephrostomy tube is placed and totally tubeless PCNL (tt-PCNL) in selected patients have been well described. There has been no study to our knowledge discharging patients the same day totally tubeless.

Evaluation of diagnostic methods for detection of trichomoniasis in symptomatic women with vaginal discharge.

Introduction: Vaginal discharge is a common gynecological condition among reproductive age women. Common infections include bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomoniasis. Prevalence of trichomoniasis varies with geographical area and the diagnostic techniques used.

Pushing the Envelope: Ambulatory Percutaneous Nephrolithotomy for Patients with Complex Renal Calculi.

Ambulatory percutaneous nephrolithotomy (PCNL) has grown in popularity for patients with smaller stone burdens and few comorbidities. Its feasibility in patients with complex renal calculi is less clear. In this study, we evaluate the safety of same-day discharge after PCNL for patients with complex renal stones when compared with those admitted after surgery.

Assessment of the Antibacterial Properties and Cytocompatibility of Implant Coatings Incorporating Antimicrobial Agents: An Study.

Objective: This study evaluates the antibacterial efficacy and cytocompatibility of titanium implants coated with silver, chitosan, and antibiotics.

Materials And Methods: Antibacterial properties were tested using inhibition zones against , and . The cytocompatibility was assessed through cell viability, adhesion, and proliferation by using human osteoblast-like cells (MG-63).

Is There a Winner? Prospective Randomized Controlled Trial Comparing SuperPulse Thulium Fiber Laser vs Pulse-Modulated High-Power Holmium:YAG Laser for Retrograde Intrarenal Surgery.

Purpose: Pulse-modulated holmium:YAG (Ho:YAG) and SuperPulse thulium fiber laser are high-power laser systems used for retrograde intrarenal surgery. We conducted a prospective randomized trial to compare lithotripsy efficiency, complications, and stone-free rates.

Materials And Methods: Patients with CT-confirmed intrarenal stones between 5 and 20 mm were randomly assigned to pulse-modulated Ho:YAG (Moses 2.

Does Mini-Percutaneous Nephrolithotomy Cause Increased Intrarenal Pressure During Percutaneous Nephrolithotomy and is This Mitigated by a Suctioning Sheath? A Randomized Control Trial.

Intrarenal pressure (IRP) generated during percutaneous nephrolithotomy (PCNL) may have the potential to cause renal damage and/or sepsis. It has been suggested that mini-PCNL (mPCNL) can further increase IRP but that a suctioning sheath may mitigate this elevation. We sought to measure IRP throughout the PCNL process, randomizing patients getting mPCNL to receiving two different mPCNL sheaths, one suctioning and the other nonsuctioning, and then comparing them with patients undergoing standard PCNL (sPCNL) using a 24F sheath.

Office-Based Endoscopic Urological Procedures Under Local Anesthesia: Prospective Evaluation of Feasibility, Pain, and Patient Preference.

Several diagnostic and therapeutic endoscopic urological procedures, such as stent placement, ureteroscopy, and bladder stone lithotripsy, can be performed in a hospital, an ambulatory surgery center, in the office with IV sedation, or in the office using only topical anesthesia. The potential benefits of performing procedures in the office setting using topical anesthesia include efficiency and cost reduction. The potential harms are failure to achieve the desired outcome and patient pain.

Improved feature reduction framework for sign language recognition using autoencoders and adaptive Grey Wolf Optimization.

Automatic Sign Language Recognition Systems (ASLR) offers smooth communication between hearing-impaired and normal-hearing individuals, enhancing educational opportunities for impaired. However, it struggles with "curse of dimensionality" due to excessive features resulting in prolonged training time and exhaustive computational demand. This paper proposes technique that integrates machine learning and swarm intelligence to effectively address this issue.

Gestational diabetes mellitus - Neonatal and maternal outcomes in women treated with insulin or diet: A propensity matched analysis.

Aims: Pregnant women worldwide face the risk of developing gestational diabetes mellitus (GDM), if left untreated, can cause complications. The study explores factors influencing the choice between diet control and insulin therapy for pregnant women with GDM. It aims to understand how these choices impact maternal and neonatal outcomes.