J Endourol
August 2025
Flexible ureteroscopy (FURS) using the flexible and navigable suction ureteral access sheath (FANS) is a novel technique for treatment of kidney stones. We aimed to compare outcomes of FURS with FANS in the sitting vs standing position. We analyzed adult patients from 21 centers who underwent FURS with FANS, divided according to whether the surgeon operated in a sitting or standing position.
View Article and Find Full Text PDFIntroduction: Pre-stenting remains a subject of debate, and its influence on FANS assisted ureteroscopy is unclear. The global FANS collaborative group aims to address the influence of pre-stenting on FANS-assisted ureterorenoscopy (URS).
Material And Methods: This prospective multicentre study assesses the outcomes of 394 patients undergoing FANS-assisted ureteroscopy for renal stones.
Purpose: The SMART Stone Multidisciplinary Team (MDT) recommendations aim to provide guidance on the role of the MDT in the early identification, referral and assessment of adult high-risk recurrent kidney stone formers to advance patient care.
Methods: Recommendations were developed by the expert Steering Committee (SC) comprising of three Urologists, one Nephrologist, and two Biochemists/Geneticists from the UK, Spain, Germany, and Italy. These recommendations were voted on by invited specialists via an online survey to determine their level of agreement, from 'strongly agree' to 'strongly disagree'.
Background: Flexible and navigable suction ureteral access sheaths (FANS) have proven to be effective in reducing operative time and infectious complications and in increasing stone-free rate during retrograde intrarenal surgery (RIRS). FANS may reduce intrarenal pressure, thus reducing parenchymal renal damage. The aim of the present study was to assess acute kidney injury (AKI) rate following RIRS with FANS.
View Article and Find Full Text PDFJ Endourol
April 2025
The cost of imaging and interventions in the surgical field varies between countries and sometimes within different regions of the same country. Procedural cost takes into account equipment, consumables, operating room, surgical, anesthetic and nursing teams, radiology, medications, and hospital stay. Health care systems therefore face an incredible burden related to investigations and surgical procedures.
View Article and Find Full Text PDFWorld J Urol
February 2025
Purpose: To assess the 30-day stone-free rate and peri-operative outcomes of flexible ureteroscopy (FURS) with flexible and navigable suction ureteral access sheaths (FANS) in adults undergoing same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS).
Methods: Prospectively data of 115 adult patients with bilateral kidney stone disease undergoing SSB-RIRS across 14 global centers between July 2023 and March 2024 were analyzed. Patient demographics, stone characteristics and operative outcomes were recorded.
Objectives: To evaluate Urologists' perception regarding stone volume (SV) to assess the stone burden in current practice. Whilst SV might be considered as the most accurate measure of stone burden, international guidelines are to date based on maximum stone diameter (MSD).
Subjects And Methods: An on-line survey (four parts, 22 multiple choice questions) designed by international Endourology experts was submitted to the urological community between December 2023 and January 2024.
Objective: To assess the effect of upper urinary tract (UUT) urolithiasis on urology services in a region with a high prevalence of the condition, and analyze the trends in endourological procedures for treating UUT urolithiasis and the cost of treatments in 11 hospitals over the last 6 years.
Methods: Using the hospital surgery statistics database, data were gathered from the urology departments of 11 hospitals in Saudi Arabia. The analysis focused on the trends, distribution, and annual cost of endourological procedures for UUT urolithiasis from January 2017 to December 2022.
World J Urol
February 2025
Background: Retrograde intrarenal surgery (RIRS) is a preferred treatment for renal stones, yet challenges such as kidney movement due to respiration hinder surgical precision and outcomes. The introduction of flexible and navigable suction ureteral access sheaths (FANS) and novel techniques like gated respiration aim to improve stone-free rates (SFR) and reduce complications. This study evaluates the impact of gated respiration on perioperative outcomes in RIRS with FANS.
View Article and Find Full Text PDFUrology
May 2025
Objective: To study the long-term outcomes of the flexible and navigable suction ureteral access sheath (FANS) in flexible ureteroscopy (FURS). FANS has well-established efficiency and 30-day perioperative safety; however, its influence on pelvicalyceal and ureteric anatomy remains to be investigated.
Methods: This was a prospective study of patients with normal renal anatomy who underwent FURS with FANS for renal stones from April 2023 to August 2024 in 16 centers worldwide.
World J Urol
December 2024
Purpose: Use of suction in flexible ureteroscopy is increasing lately. The introduction of flexible and navigable suction access sheath (FANS) has shown improved stone free rate (SFR). However, its efficacy in lower pole stone (LPS) in terms of SFR and complications is yet to be studied.
View Article and Find Full Text PDFWe aim to evaluate stone-free rate (SFR) and complications after flexible ureteroscopy (F-URS) for kidney stones, using a flexible and navigable suction ureteral access sheath (FANS), comparing thulium fiber laser (TFL) and high-power holmium:yttrium-aluminum-garnet laser (HPHL). Data from adults who underwent F-URS in 15 centers were prospectively analyzed (August 2023-January 2024). Exclusion criteria were ureteral stones, concomitant bilateral procedures, and renal abnormalities.
View Article and Find Full Text PDFPurpose: To investigate the current thoughts and perspectives on kidney stone analysis amongst urologists and urology residents worldwide.
Methods: In October 2022 an online survey supported by the EULIS was circulated amongst urologists and urology residents worldwide. The survey was based on the current EAU guidelines regarding stone analysis and its role in urolithiasis management.
Introduction And Aim: Cystinuria represents a rare cause of urolithiasis, accounting for 1% of all cases. However, it poses unique challenges in diagnosis and management. This study aimed to examine the challenges of managing cystine stones from the perspective of cystinuria patients.
View Article and Find Full Text PDFInvestig Clin Urol
September 2024
Purpose: Traditionally, bilateral urolithiasis treatment involved staged interventions due to safety concerns. Recent studies have shown that same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS) is effective, with acceptable complication rates. However, there's no clear data on the optimum laser for the procedure.
View Article and Find Full Text PDFUrolithiasis
September 2024
The aim of this study was to construct the sixth in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis (IAU) that by providing a clinical framework for the management of pediatric patients with urolithiasis based on the best available published literature. All recommendations were summarized following a systematic review and assessment of literature in the PubMed database from January 1952 to December 2023. Each generated recommendation was graded using a modified GRADE methodology.
View Article and Find Full Text PDFSimple renal cysts are commonly acquired benign lesions of the kidney. Requiring management only when it causes pain, obstruction, or gross hematuria, endoscopic marsupialization of simple renal cysts is a new method for the management of renal cysts. Herein, we present a rare case of a 44-year-old female with a simple renal cyst that was managed for the first time in Saudi Arabia by endoscopic marsupialization and discuss its efficacy and outcome compared to other methods of management.
View Article and Find Full Text PDFEur Urol Focus
December 2024
Background And Objective: The aim of this study was to evaluate the stone-free status (SFS) rate and complications after flexible ureteroscopy (fURS) for treatment of renal stones using a flexible and navigable suction (FANS) ureteral access sheath.
Methods: Data for adults undergoing fURS in 25 centers worldwide were prospectively collected (August 2023 to January 2024). Exclusion criteria were abnormal renal anatomy and ureteral stones.
Purpose: To assess the incidence of the most common intra- and early postoperative complications following RIRS in a large series of patients with kidney stones.
Methods: We conducted a retrospective analysis of patients with kidney stones who underwent RIRS across 21 centers from January 2018 to August 2021, as part of the Global Multicenter Flexible Ureteroscopy Outcome (FLEXOR) Registry.
Results: Among 6669 patients undergoing RIRS, 4.
Background: The stone burden based management strategy reported in the guidelines published by different associations is well known for a long time. Staghorn calculi, representing the largest burden and most complex stones, is one of the most challenging cases to practicing urologists in clinical practice. The International Alliance of Urolithiasis (IAU) has released a series of guidelines on the management of urolithiasis.
View Article and Find Full Text PDFCurr Urol
March 2024
Background: Emphysematous pyelonephritis (EPN) is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality. We aimed to formulate a score that classifies the risk of mortality in patients with EPN at hospital admission.
Materials And Methods: Patients diagnosed with EPN between 2013 and 2020 were retrospectively included.
Objective: To compare same-sitting bilateral vs unilateral retrograde intrarenal surgery (RIRS) in elderly patients, focusing on postoperative complications and stone-free rates (SFR).
Methods: Data from 2 multicenter databases, FLEXible ureteroscopy Outcomes Registry (FLEXOR) (unilateral RIRS) and same sitting bilateral-retrograde intrarenal surgery (SSB-RIRS) (bilateral RIRS), were analyzed, considering only patients aged 70+ with preoperative computed tomography. Patients were categorized into Group 1 (bilateral RIRS) and Group 2 (unilateral RIRS).
Aims: The Saudi Urolithiasis Guidelines are a set of recommendations for diagnosing, evaluating, and treating urolithiasis in the Saudi population. These guidelines are based on the latest evidence and expert consensus to improve patient outcomes and optimize care delivery. They cover the various aspects of urolithiasis, including risk factors, diagnosis, medical and surgical treatments, and prevention strategies.
View Article and Find Full Text PDF