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Nephrolithiasis: Advances in Diagnosis, Treatment, and Prognosis
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Nephrolithiasis: Advances in Diagnosis, Treatment, and Prognosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (25 July 2022) | Viewed by 14692

Special Issue Editor

Prof. Dr. Olivier Traxer

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Guest Editor
Department of Urology AP-HP, Tenon Hospital, Sorbonne University, F-75020 Paris, France
Interests: endourology; minimally invasive surgery; surgical and medical management of Stone disease; conservative treatment of UTUC; lower and upper urinary tract diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nephrolithiasis is a condition that is growing in incidence worldwide. The development of kidney stones is multifactorial, leading to the deposits of minerals in the renal pelvis or calyces in a free or attached way to the renal papillae. Nonetheless, one of the leading causes of this increase is dietary habit modifications with an increased consumption of fat, sodium, animal proteins, and refined sugar and the decreased intake of fibers. 

Concerning diagnosis, patients usually present with typical renal colic. During evaluation, it is essential to have an X-ray of the patient before surgery, looking for anatomy abnormalities, and after surgery, for surveillance. Same as other surgical fields, the management of symptomatic kidney stones has evolved over the years. The arrival of minimal invasive treatments and of new technologies has focused on reducing the morbidity of the patient and bringing more efficient procedures. Those recent innovations include new single-use flexible endoscopes, the introduction of robots in endourology and, of course, new laser technologies. 

The aim of this Special Issue of the Journal of Clinical Medicine is to provide new insides about nephrolithiasis: advances in diagnosis, treatment, and prognosis.

Prof. Dr. Olivier Traxer
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • kidney stones
  • etiology
  • diagnosis
  • RIRS
  • lithotripsy
  • laser
  • robotics
  • outcomes
  • prognosis

Published Papers (6 papers)

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Research

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17 pages, 5283 KiB  
Article
The Effects of Scanning Speed and Standoff Distance of the Fiber on Dusting Efficiency during Short Pulse Holmium: YAG Laser Lithotripsy
by Junqin Chen, Daiwei Li, Wenjun Yu, Zhiteng Ma, Chenhang Li, Gaoming Xiang, Yuan Wu, Junjie Yao and Pei Zhong
J. Clin. Med. 2022, 11(17), 5048; https://doi.org/10.3390/jcm11175048 - 28 Aug 2022
Cited by 7 | Viewed by 1796
Abstract
To investigate the effects of fiber lateral scanning speed across the stone surface (vfiber) and fiber standoff distance (SD) on dusting efficiency during short pulse holmium (Ho): YAG laser lithotripsy (LL), pre-soaked BegoStone samples were treated in water using 0.2 [...] Read more.
To investigate the effects of fiber lateral scanning speed across the stone surface (vfiber) and fiber standoff distance (SD) on dusting efficiency during short pulse holmium (Ho): YAG laser lithotripsy (LL), pre-soaked BegoStone samples were treated in water using 0.2 J/20 Hz at SD of 0.10~0.50 mm with vfiber in the range of 0~10 mm/s. Bubble dynamics, pressure transients, and stone damage were analyzed. To differentiate photothermal ablation vs. cavitation damage, experiments were repeated in air, or in water with the fiber tip at 0.25 mm proximity from the ureteroscope end to mitigate cavitation damage. At SD = 0.10 mm, the maximum dusting efficiency was produced at vfiber = 3.5 mm/s, resulting in long (17.5 mm), shallow (0.15 mm), and narrow (0.4 mm) troughs. In contrast, at SD = 0.50 mm, the maximum efficiency was produced at vfiber = 0.5 mm/s, with much shorter (2.5 mm), yet deeper (0.35 mm) and wider (1.4 mm), troughs. With the ureteroscope end near the fiber tip, stone damage was significantly reduced in water compared to those produced without the ureteroscope. Under clinically relevant vfiber (1~3 mm/s), dusting at SD = 0.5 mm that promotes cavitation damage may leverage the higher frequency of the laser (e.g., 40 to 120 Hz) and, thus, significantly reduces the procedure time, compared to at SD = 0.1 mm that promotes photothermal ablation. Dusting efficiency during short pulse Ho: YAG LL may be substantially improved by utilizing an optimal combination of vfiber, SD, and frequency. Full article
(This article belongs to the Special Issue Nephrolithiasis: Advances in Diagnosis, Treatment, and Prognosis)
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Review

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17 pages, 1237 KiB  
Review
Is There Still a Place for Percutaneous Nephrolithotomy in Current Times?
by Elisa De Lorenzis, Stefano Paolo Zanetti, Luca Boeri and Emanuele Montanari
J. Clin. Med. 2022, 11(17), 5157; https://doi.org/10.3390/jcm11175157 - 31 Aug 2022
Cited by 9 | Viewed by 3117
Abstract
Background: Percutaneous nephrolithotomy (PCNL) and its miniaturized modifications are usually considered the standard surgical options for large (>20 mm) staghorn and infected stones. Moreover, PCNL is a viable alternative to retrograde intrarenal surgery (RIRS) for smaller stones (<20 mm) in the presence of [...] Read more.
Background: Percutaneous nephrolithotomy (PCNL) and its miniaturized modifications are usually considered the standard surgical options for large (>20 mm) staghorn and infected stones. Moreover, PCNL is a viable alternative to retrograde intrarenal surgery (RIRS) for smaller stones (<20 mm) in the presence of anatomical malformations or inaccessible lower pole stones. However, due to the advancements in laser and scope technology, RIRS is expanding its indications with the potential benefits of lower complications and a shorter hospital stay. Methods: A literature search using the PUBMED database from inception to June 2022 was performed to explore the current role of PCNL in endourology. The analysis involved a narrative synthesis. Results: PCNL confirmed its role in the treatment of large and complex stones; moreover, miniaturized PCNL has become more competitive, gaining space among classic indications of flexible ureteroscopy. Conclusions: considering all the evaluated subgroups, we can conclude that PCNL is an old fascinating procedure and is here to stay. Full article
(This article belongs to the Special Issue Nephrolithiasis: Advances in Diagnosis, Treatment, and Prognosis)
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11 pages, 348 KiB  
Review
Moses and Moses 2.0 for Laser Lithotripsy: Expectations vs. Reality
by Mariela Corrales, Alba Sierra and Olivier Traxer
J. Clin. Med. 2022, 11(16), 4828; https://doi.org/10.3390/jcm11164828 - 18 Aug 2022
Cited by 10 | Viewed by 2038
Abstract
Moses technology was born with the aim of controlling the Moses effect present in every single Ho:YAG laser lithotripsy. The capacity to divide the energy pulse into two sub-pulses gained popularity due to the fact that most of the energy would be delivered [...] Read more.
Moses technology was born with the aim of controlling the Moses effect present in every single Ho:YAG laser lithotripsy. The capacity to divide the energy pulse into two sub-pulses gained popularity due to the fact that most of the energy would be delivered in the second pulse. However, is this pulse modulation technique really better for endocorporeal laser lithoripsy? A review of the literature was performed and all relevant clinical trials of Moses 1.0 and 2.0, as well as the lab studies of Moses 2.0 carried out up to June 2022 were selected. The search came back with 11 clinical experiences (10 full-text clinical trials and one peer-reviewed abstract) with Moses 1.0 and Moses 2.0, and three laboratory studies (peer-reviewed abstracts) with Moses 2.0 only. The clinical experiences confirmed that the MT (1.0) has a shorter lasing time but lower laser efficacy, because it consumes more J/mm3 when compared with the LP Ho:YAG laser (35 W). This gain in lasing time did not provide enough savings for the medical center. Additionally, in most comparative studies of MT (1.0) vs. the regular mode of the HP Ho:YAG laser, the MT did not have a significant different lasing time, operative time or stone-free rate. Clinical trials with Moses 2.0 are lacking. From what has been published until now, the use of higher frequencies (up to 120 Hz) consumes more total energy and J/mm3 than Moses 1.0 for similar stone-free rates. Given the current evidence that we have, there are no high-quality studies that support the use of HP Ho:YAG lasers with MT over other lasers, such as LP Ho:YAG lasers or TFL lasers. Full article
(This article belongs to the Special Issue Nephrolithiasis: Advances in Diagnosis, Treatment, and Prognosis)
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23 pages, 343 KiB  
Review
Diet and Stone Disease in 2022
by Jessica C. Dai and Margaret S. Pearle
J. Clin. Med. 2022, 11(16), 4740; https://doi.org/10.3390/jcm11164740 - 13 Aug 2022
Cited by 6 | Viewed by 2378
Abstract
Diet plays a central role in the development and prevention of nephrolithiasis. Although pharmacologic treatment may be required for some patients who are resistant to dietary measures alone, dietary modification may be sufficient to modulate stone risk for many patients. While there is [...] Read more.
Diet plays a central role in the development and prevention of nephrolithiasis. Although pharmacologic treatment may be required for some patients who are resistant to dietary measures alone, dietary modification may be sufficient to modulate stone risk for many patients. While there is no single specialized diet for stone prevention, several dietary principles and recommendations for stone prevention are supported by practice guidelines, including adequate fluid intake, modest calcium intake, low dietary sodium, and limited animal protein. In this review, we summarized the evidence supporting these dietary recommendations and reviewed the current literature regarding specific dietary components and comprehensive diets for stone prevention. Full article
(This article belongs to the Special Issue Nephrolithiasis: Advances in Diagnosis, Treatment, and Prognosis)
8 pages, 368 KiB  
Review
Silicone vs. Polyurethane Stent: The Final Countdown
by Suresh Mathias and Oliver Wiseman
J. Clin. Med. 2022, 11(10), 2746; https://doi.org/10.3390/jcm11102746 - 12 May 2022
Cited by 1 | Viewed by 1967
Abstract
Ureteric stents are conventionally used in daily urological practice. There is ongoing debate on the superiority of different stent materials, particularly in terms of patient tolerance. We conducted a literature review to compare silicone stents and stents made of other materials from a [...] Read more.
Ureteric stents are conventionally used in daily urological practice. There is ongoing debate on the superiority of different stent materials, particularly in terms of patient tolerance. We conducted a literature review to compare silicone stents and stents made of other materials from a patient tolerability perspective. We conclude that silicone stents are better tolerated but further research is required. Full article
(This article belongs to the Special Issue Nephrolithiasis: Advances in Diagnosis, Treatment, and Prognosis)
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Other

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19 pages, 1081 KiB  
Systematic Review
New Generation Pulse Modulation in Holmium:YAG Lasers: A Systematic Review of the Literature and Meta-Analysis
by Antoni Sánchez-Puy, Alejandra Bravo-Balado, Pietro Diana, Michael Baboudjian, Alberto Piana, Irene Girón, Andrés K. Kanashiro, Oriol Angerri, Pablo Contreras, Brian H. Eisner, Josep Balañà, Francisco M. Sánchez-Martín, Félix Millán, Joan Palou and Esteban Emiliani
J. Clin. Med. 2022, 11(11), 3208; https://doi.org/10.3390/jcm11113208 - 04 Jun 2022
Cited by 9 | Viewed by 2267
Abstract
(1) Background: New pulse modulation (PM) technologies in Holmium:YAG lasers are available for urinary stone treatment, but little is known about them. We aim to systematically evaluate the published evidence in terms of their lithotripsy performance. (2) Methods: A systematic electronic search was [...] Read more.
(1) Background: New pulse modulation (PM) technologies in Holmium:YAG lasers are available for urinary stone treatment, but little is known about them. We aim to systematically evaluate the published evidence in terms of their lithotripsy performance. (2) Methods: A systematic electronic search was performed (MEDLINE, Scopus, and Cochrane databases). We included all relevant publications, including randomized controlled trials, non-randomized comparative and non-comparative studies, and in-vitro studies investigating Holmium:YAG lithotripsy performance employing any new PM. (3) Results: Initial search yielded 203 studies; 24 studies were included after selection: 15 in-vitro, 9 in-vivo. 10 In-vitro compared Moses with regular PM, 1 compared Quanta’s, 1 Dornier MedTech’s, 2 Moses with super Thulium Fiber Laser, and 1 compared Moses with Quanta PMs. Six out of seven comparative studies found a statistically significant difference in favor of new-generation PM technologies in terms of operative time and five out of six in fragmentation time; two studies evaluated retropulsion, both in favor of new-generation PM. There were no statistically significant differences regarding stone-free rate, lasing and operative time, and complications between Moses and regular PM when data were meta-analyzed. (4) Conclusions: Moses PM seems to have better lithotripsy performance than regular modes in in-vitro studies, but there are still some doubts about its in-vivo results. Little is known about the other PMs. Although some results favor Quanta PMs, further studies are needed. Full article
(This article belongs to the Special Issue Nephrolithiasis: Advances in Diagnosis, Treatment, and Prognosis)
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