When should bepridil concomitant with catheter ablation for persistent atrial fibrillation be discontinued? The importance of left atrial reverse remodeling.

Bepridil are often administered after catheter ablation (CA) in patients with persistent atrial fibrillation (AF); however, it is unclear for how long it should be continued. We administered hybrid therapy consisting of CA and bepridil to 130 patients with persistent AF and left atrial (LA) enlargement (volume index > 48 ml/m). After 2 months of hybrid therapy, bepridil discontinuation was attempted.

Role and Efficacy of Percutaneous 4.5-Fr Semi-Rigid Ureteroscope While Creating Through-And-Through Guidewire Passage During Minimally Invasive Endoscopic Combined Intrarenal Surgery in the Supine Position; Retrospective Study at a Single Institution.

Objective: This study was performed to evaluate the efficacy of using a percutaneous 4.5-Fr semi-rigid ureteroscope (4.5-rURS) and preoperative clinical factors in the performance of the through-and-through guidewire technique (T&TGW) under the guidance of retrograde flexible ureteroscope (fURS)-assisted fluoroscopy during minimally invasive endoscopic combined intrarenal surgery (mini-ECIRS).

Ureteral stent biomaterial encrustation after endoscopic lithotripsy: a randomized, single-blind study.

This study evaluated the adherence of bacteria, calcium, and magnesium to three different ureteral stents after endoscopic surgery for urinary calculi. We randomly assigned 61 patients requiring the insertion of ureteral stents after urinary calculi treatment into three groups: Percuflex with a coating composition of Hydroplus (n = 21); Tria with a coating composition of Percushied (n = 22); and InLay Optima, which had a proprietary pHreeCoat coating (n = 18). All stents were removed and evaluated 1 month after treatment.

Efficacy of mini-endoscopic combined intrarenal surgery for pediatric kidney calculi: a single center retrospective study.

Management of large pediatric kidney calculi (PKC) is challenging. This study aimed to evaluate the efficacy and safety of miniature endoscopic combined intrarenal surgery (mini-ECIRS) for PKC. We retrospectively analyzed mini-ECIRS in 16 pediatric patients undergoing kidney stone treatment between November 2014 and October 2023 to determine its safety, efficacy, and associated outcomes.

Japanese survey of perioperative complications and ureteral stricture after ureteroscopy with laser lithotripsy for upper urinary tract stones in multicenter collaborative study.

Objectives: This study aimed to investigate perioperative complications and the details of postoperative ureteral stricture after ureteroscopy with laser lithotripsy (URS-L) for upper urinary tract stones in Japan.

Methods: Patient data on intra- and postoperative complications after ureteroscopy using URS-L were retrospectively collected from multiple centers in Japan between April 2017 and March 2020 with the cooperation of the Japanese Society of Endourology and Robotics. Data included the number of patients undergoing URS-L, number and type of intra- and postoperative complications, and detailed characteristics of postoperative ureteral stricture.

Quality of life after urinary stone surgery based on Japanese Wisconsin Stone Quality of Life questionnaire: multicenter analysis from SMART study group.

We aimed to evaluate the impact of surgical treatment for urinary stones on perioperative health-related quality of life (HRQOL) using the Japanese Wisconsin Stone Quality of Life questionnaire (J-WISQOL), an HRQOL measure designed for patients with urinary stones. This study prospectively enrolled 123 patients with urinary stones who visited three academic hospitals for stone treatment. The participants completed the J-WISQOL within 4 weeks before and after the urinary stone treatment.

Application of ultrasound imaging in the treatment of urinary tract stones.

Urinary tract stones are a common clinical condition that affect millions of individuals worldwide. The management of these stones has evolved significantly over the past 70 years, and ultrasound imaging has emerged as a valuable tool for diagnosis, treatment planning, and follow-up. This review aims to provide an overview of the application of ultrasound imaging in the treatment of urinary tract stones, highlighting its advantages, limitations, and current advancements in the field.

The Atrial Natriuretic Peptide-to-brain Natriuretic Peptide Ratio Predicts Left Atrial Reverse Remodeling after Rhythm Control Therapy in Patients with Persistent Atrial Fibrillation.

Objective The association between natriuretic peptide levels in atrial fibrillation (AF) patients with advanced left atrial (LA) remodeling and reverse remodeling after rhythm control therapy has not been clarified. The present study assessed the role of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) measurements to predict LA reverse remodeling after catheter ablation (CA) in persistent AF patients with LA enlargement. Methods This study included 88 persistent AF patients with LA enlargement (volume index >48 mL/m) who underwent CA.

Single-Session Impact of High-Power Laser with Moses Technology for Lower Pole Stones in Retrograde Intrarenal Surgery: Retrospective Study.

This study aimed to evaluate the efficacy of a high-power holmium laser with Moses technology (MT) for the treatment of lower pole stones during retrograde intrarenal surgery (RIRS). Herein, 305 patients with lower pole stones who underwent RIRS using a high-power holmium laser with MT were retrospectively classified into the stone-free (SF) and non-SF groups. We measured the stone burden, stone volume, stone hardness, pre- or post-operative stent placement, infundibulopelvic angle (IPA), infundibular width (IW), infundibular length (IL), and calyceal pelvic height in terms of pelvicalyceal anatomy using retrograde pyelograms and evaluated the predictive factors of postoperative SF.

Pelvicalyceal anatomy on the accessibility of reusable flexible ureteroscopy to lower pole calyx during retrograde intrarenal surgery.

Objective: This study aimed to evaluate the pelvicalyceal anatomy on accessibility of reusable flexible ureteroscopy (fURS) to the lower pole calyx during retrograde intrarenal surgery (RIRS).

Methods: Here, 854 patients with ureteral or kidney stones with access to a renal collecting system using reusable fURS were classified into either the accessible group, in whom the deepest lower pole calyces could be touched; and the inaccessible group, in whom the deepest lower calyces could not be touched. We measured the infundibulopelvic angle (IPA), infundibular width (IW), infundibular length (IL), and calyceal pelvic height (CPH) using retrograde pyelograms and performed intergroup comparisons.

Primary impact of simultaneous use of double devices through one-working channel when performing flexible ureteroscope with ureteral access sheath for single ureteral stone: In bench and retrospective clinical study.

Objectives: This study aimed to compare the simultaneous use of two devices versus a single device through a single working channel in flexible ureteroscopy using a ureteral access sheath for single ureteral stones.

Methods: In a bench study, the time to (i) set laser fiber, (ii) exchange laser fiber and nitinol basket through working channel, and (iii) pull out the device from working channel were measured 10 times in each step. In a clinical study, 156 patients who underwent flexible ureteroscopy with a ureteral access sheath for a ureteral stone in middle and upper ureter between April 2019 and November 2021 were assessed.

Microbial differences between active and remission peri-implantitis.

Peri-implantitis has a polymicrobial etiology and is a major cause of dental implant loss. Various clinical protocols for its prevention and treatment have been proposed; however, some cases show a rapid progression with non-resolving clinical symptoms. To clear a means of differentiating between such cases, the implants with peri-implantitis in this study were categorized as the active group and the remission group and that two kinds of samples were obtained from the same subjects (n = 20).

Evaluating Predictive Factor of Systemic Inflammatory Response Syndrome and Postoperative Pain in Patients Without Ureteral Stent Placement After Ureteral Access Sheath Use in Flexible Ureteroscopy for Stone Management.

This retrospective cohort study aimed to evaluate the safety of stentless flexible ureteroscopy (fURS) using a ureteral access sheath (UAS) for stone management. A total of 270 ureteral stentless postoperative patients were analyzed. Stentless indication was characterized by having no ureteral wall or mucosa injury with only slight erosion, <1 hour operative time, and no endoscopic stone fragments with or without stone dust.

Comparison of the safety and efficacy between the prone split-leg and Galdakao-modified supine Valdivia positions during endoscopic combined intrarenal surgery: A multi-institutional analysis.

Objectives: To evaluate the safety and efficacy of the prone split-leg and the Galdakao-modified supine Valdivia positions during endoscopic combined intrarenal surgery.

Methods: A multi-institutional, retrospective cohort study was conducted between January 2014 and December 2018. The stone-free and complication rates were compared between the prone split-leg and the Galdakao-modified supine Valdivia positions.

Validation of the Japanese Version of The Wisconsin Stone Quality of Life Questionnaire: Results from SMART Study Group.

The Wisconsin Stone Quality of Life questionnaire (WISQOL) is a health-related quality of life (HRQOL) measure designed for patients with urinary stones. It has been translated and used in several languages. This study aimed to validate the Japanese version of the WISQOL (J-WISQOL).

One- versus two-surgeon active stone retrieval procedures for flexible ureteroscopy: An off-site simulator comparative study.

Objectives: To evaluate the efficacy of the one-surgeon basketing technique compared to the conventional two-surgeon method for flexible ureteroscopy.

Methods: Seven urologists (three trained and four less-trained surgeons) extracted three renal stones using each technique with an off-site simulator. We analyzed the task completion time, the number of times the basket forceps were opened and closed, and unexpected events during stone-catching, for both techniques.

Retrograde intrarenal surgery: Past, present, and future.

With the recent technological advancements in endourology, retrograde intrarenal surgery has become a more popular procedure for treatment of urolithiasis. Furthermore, since the introduction of new laser systems and advanced flexible ureteroscopy with miniaturized ureteroscopes, the treatment indications for retrograde intrarenal surgery have expanded to include not only larger renal stones of >2 cm but also upper urinary tract urothelial carcinoma, ureteral stricture, and idiopathic renal hematuria. Clinicians must keep up with these trends and make good use of these technologies in the rapidly changing field of endourology.

Bone turnover markers to assess jawbone quality prior to dental implant treatment: a case-control study.

Background: Bone quality is as important as bone mineral density in terms of bone strength. Bone turnover markers (BTMs) are clinical indicators of bone quality. In implant dentistry, bone quality is considered equivalent to bone density on radiographic assessments.

Prospective evaluation and classification of endoscopic findings for ureteral calculi.

Difficulty in performing ureteroscopic lithotripsy (URSL) depends on endoscopic findings surrounding calculi. In this multicentre prospective cohort study of 185 patients with a single ureteral stone who underwent ureteroscopic lithotripsy registered in the SMART study between January 2014 and February 2017, we established a classification of endoscopic findings and analysed risk factors for ureteral changes. We evaluated endoscopic findings (oedema, polyps, ureteral mucosa-stone adherence, and distal ureteric tightness) based on the SMART classification.

Change in irrigation flow through a flexible ureteroscope with various devices in the working channel: Comparison between an automatic irrigation pump and gravity-based irrigation.

Objectives: To evaluate the change in the irrigation flow with various instruments in the working channel of a flexible ureteroscope by two automatic irrigation pumps and gravity-based irrigation in an ex vivo setting.

Methods: We used two automatic irrigation pumps: the Endoflow II and the UROMAT Endoscopic Automatic System for Irrigation and gravity-based irrigation. A flexible ureteroscope was connected to an irrigation tube with a working channel.

A Novel Flexible Ureteroscope with Omnidirectional Bending Tip Using Joystick-Type Control Unit (URF-Y0016): Initial Validation Study in Bench Models.

The conventional flexible ureteroscope has limited access into the lower calix and often causes biomechanical stress to surgeons. Recently, a novel flexible ureteroscope with an omnidirectional bending tip with a joystick-type control unit (URF-Y0016; Olympus, Japan) was developed. We verified the operability and ergonomics of the URF-Y0016 compared with that of the conventional flexible ureteroscope (URF-P6) in bench models.