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Kidney Stone Research

Guideline of guidelines for kidney and bladder stones

Guideline of guidelines for kidney and bladder stones

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by Arshad Ali
 both AUA and EAU guidelines offer a detailed, evidence-based framework to guide the urologists in the management of stone diseases. Although some discrepancies exist, particularly regarding the choice of surgical management in specific scenarios, there is generally a consensus between both the groups. However, the guidelines are not applicable to every clinical situation and need to be used in conjunction with the most recently published material and tailored to each individual patient.
Bladder stones Kidney Calculi Kidney Stone Types Kidney stones Lithotripsy Nephrolithotomy Percutaneous Nephrolithotomy (PCNL) stone treatment Treatment strategies Ureteroscopy Urolithiasis
Medical expulsive therapy

Medical expulsive therapy

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by Arshad Ali
The AUA/EAU guidelines suggest MET as a reasonable treatment choice in select patients. Previous studies have demonstrated a significant benefit in stone expulsion rates with the use of MET. A review of the data suggests greater success rates occur with the use of alpha antagonist compared to calcium channel blockers. The use of MET is not limited to just those patients attempting passage of calculi without other interventions; there is also an advantage to MET in those subjects treated with other modalities (i.e. SWL and ureteroscopy).
Even with multiple studies demonstrating the benefits of MET, it still is underutilized as a treatment modality. Education in the hospital setting appears to be beneficial in changing practice behaviors. MET may reduce medical costs and prevent unnecessary surgeries and the associated risks.
Expulsive Therapy How Kidney Stones Form Kidney stones Medical expulsive therapy Preventing Kidney Stones ureteral stones Urolithiasis
Comparison of imaging modalities for detection of residual fragments and prediction of stone related events following percutaneous nephrolitotomy

Comparison of imaging modalities for detection of residual fragments and prediction of stone related events following percutaneous nephrolitotomy

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by Arshad Ali
UHCT is the most sensitive diagnostic tool for detecting RFs after PNL. It has higher sensitivity regardless of stone size compared to KUB and US. Additionally UHCT has higher capability of predicting occurrence of stone related events.
Kidney stones PCNL Percutaneous Nephrolithotomy (PCNL) renal calculi Tomography Ultrasonography Urolithiasis X-Ray Computed
The ideal puncture approach for PCNL: Fluoroscopy, ultrasound or endoscopy?

The ideal puncture approach for PCNL: Fluoroscopy, ultrasound or endoscopy?

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by Arshad Ali
Each percutaneous renal guidance techniques has its advantages and disadvantages and no single technique is ideal in all circumstances. The two most commonly used modalities are ultrasonography and fluoroscopy. Color Doppler ultrasound, an addition to B-mode ultrasound guidance, can help avoid vascular injury, resulting in decreased intraoperative and postoperative hemorrhage. CT guidance is only used for access in complicated cases. MRI and robotic-assisted guidance are in their infancy and need more research. Endoscopic guide can improve the safety of renal access, but the cost, and experience of the operators need to be considered.
How Kidney Stones Form Kidney Calculi kidney stone Kidney Stone Types PCNL Percutaneous nephrolithotomy Percutaneous Nephrolithotomy (PCNL) percutaneous renal surgery Preventing Kidney Stones radiation Urolithiasis
Efficacy and safety of fURS in stones larger than 20 mm: is it still the threshold?

Efficacy and safety of fURS in stones larger than 20 mm: is it still the threshold?

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by Arshad Ali

Despite the relatively low stone-free rates in lower pole stones, our current results indicate that fURS can be an effective and safe treatment alternative to PNL in larger renal stones (>20 mm) located in the pelvis and in the upper part of the calyceal system of the involved kidney.

flexible ureteroscopy furs Kidney stones Retrograde intrarenal surgery Rirs Treatment Options ureteroscopes Ureteroscopy Urolithiasis
Endoscopic treatment of lower pole stones: is a disposable ureteroscope preferable? Results of a prospective case-control study

Endoscopic treatment of lower pole stones: is a disposable ureteroscope preferable? Results of a prospective case-control study

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by Arshad Ali
In this study, disposable flexible ureteroscopes have been validated as an option that is in the least equivalent to reusable ureteroscopes based on clinical results. The shorter surgical and fluoroscopy durations are possible advantages considering the high costs associated with time spent in the operating room and the need to reduce ionizing radiation.
disposable flexible ureteroscopes flexible ureteroscopy Kidney stones lower pole stone Renal stone Treatment Options ureteroscopes Urolithiasis
Factors affecting operative time during ureteroscopy and stone treatment and its effect on outcomes: retrospective results over 6.5 years

Factors affecting operative time during ureteroscopy and stone treatment and its effect on outcomes: retrospective results over 6.5 years

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by Arshad Ali
Patients with shorter operative times have a higher chance of being discharged home the same day without a post-operative stent. Higher operative times are associated with high-grade, especially infection-related, complications.
kidney stone Ureteroscopy Urolithiasis

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