Special Issue "Update of Urolithiasis and Treatment"

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Nephrology".

Deadline for manuscript submissions: 30 June 2023 | Viewed by 1128

Special Issue Editors

Dr. Dong Hyuk Kang
E-Mail Website
Guest Editor
Department of Urology, Inha University School of Medicine, Incheon 22212, Korea
Interests: urolithiasis; minimal invasive stone surgery; medical expulsive therapy; extracorporeal shockwave lithotripsy
Dr. Hae Do Jung
E-Mail Website
Guest Editor
Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
Interests: retrograde intrarenal surgery; minimal invasive percutaneous nephrolithotomy; laparoscopic/robotic stone surgery; pharmacological stone prevention

Special Issue Information

Dear Colleagues,

The incidence of urolithiasis is increasing globally, with approximately 10–15% of patients experiencing urolithiasis during their lifetime. Additionally, the recurrence rate is very high, reaching about 50% within the past 10 years. Urolithiasis presents a very clinically important disease that can lead to renal colic, hematuria, or UTIs and cause serious complications, such as renal dysfunction or sepsis.

The treatment of urolithiasis has advanced remarkably over the past few decades and is still improving. Research on metabolic tests or drug treatment aiming to reduce the incidence or recurrence rate of this disease has been actively conducted, and drug research for medical expulsive therapy has also progressed significantly. Surgery has progressed due to the development of endoscopic equipment such as the ureterorenoscope and nephroscope; lithotripters, including lasers; and essential surgical equipment, such as stone baskets, guidewire, and access sheaths. In addition, extracorporeal shock wave lithotripsy has been continuously advanced through the development of lithotripsy and research on appropriate indications and shock wave frequency and time.

This Special Issue aims to provide an updated overview of urolithiasis and its treatment; to this end, we are inviting researchers from all over the world to submit relevant papers to this issue.

Dr. Dong Hyuk Kang
Dr. Hae Do Jung
Guest Editors

Manuscript Submission Information

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Keywords

  • percutaneous nephrolithotomy
  • shockwave lithotripsy
  • treatment
  • ureteroscopy
  • urolithiasis

Published Papers (2 papers)

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Research

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Article
A New Parameter for Calcium Oxalate Stones: Impact of Linear Calculus Density on Non-Contrast Computed Tomography
Medicina 2023, 59(2), 267; https://doi.org/10.3390/medicina59020267 - 30 Jan 2023
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Abstract
Background and Objectives: Non-contrast computed tomography (NCCT) is widely used to evaluate urolithiasis. The NCCT attenuation, measured in Hounsfield units (HU), has been evaluated to predict stone characteristics. We propose a novel parameter, linear calculus density (LCD), and analyze variables from NCCT [...] Read more.
Background and Objectives: Non-contrast computed tomography (NCCT) is widely used to evaluate urolithiasis. The NCCT attenuation, measured in Hounsfield units (HU), has been evaluated to predict stone characteristics. We propose a novel parameter, linear calculus density (LCD), and analyze variables from NCCT imaging to predict calcium oxalate (CaOx) stones, which are common and challenging to fragment. Materials and Methods: We retrospectively reviewed the medical records of patients with urolithiasis between 2014 and 2017. Among those, 790 patients were included. Based on the NCCT pre-treatment, the maximal stone length (MSL), mean stone density (MSD), and stone heterogeneity index (SHI) were obtained. In addition, the variation coefficient of stone density (VCSD = SHI/MSD × 100) and linear calculus density (LCD = VCSD/MSL) were calculated. In accordance with the stone analysis, the patients were divided into two groups (CaOx and non-CaOx groups). The logistic regression model and receiver operating characteristic (ROC) curve were used for predictive modeling. Results: In the CaOx group, the SHI, VCSD, and LCD were more significant than in the non-CaOx group (all p < 0.001). SHI (OR 1.002, 95% CI 1.001–1.004, p < 0.001), VCSD (OR 1.028, 95% CI 1.016–1.041, p < 0.001), and LCD (OR 1.352, 95% CI 1.270–1.444, p < 0.001) were significant independent factors for CaOx stones in the logistic regression models. The areas under the ROC curve for predicting CaOx stones were 0.586 for SHI, 0.66 for VCSD, and 0.739 for LCD, with a cut-point of 2.25. Conclusions: LCD can be a useful new parameter to provide additional information to help discriminate CaOx stones before treatment. Full article
(This article belongs to the Special Issue Update of Urolithiasis and Treatment)
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Case Report
Percutaneous Nephrolithotomy Combined Antegrade Flexible Ureteroscope for Complete Staghorn Stones: A Case Report of a New Concept of Stone Surgery
Medicina 2023, 59(1), 35; https://doi.org/10.3390/medicina59010035 - 23 Dec 2022
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Abstract
Percutaneous nephrolithotomy (PCNL) is the treatment of choice for staghorn stones. However, residual stones in calyces remain a challenge due to the limited angle which makes the approach difficult. The new operative technique of endoscopic combined intrarenal surgery (ECIRS), which integrates the advantages [...] Read more.
Percutaneous nephrolithotomy (PCNL) is the treatment of choice for staghorn stones. However, residual stones in calyces remain a challenge due to the limited angle which makes the approach difficult. The new operative technique of endoscopic combined intrarenal surgery (ECIRS), which integrates the advantages of PCNL and retrograde intrarenal surgery (RIRS), was developed to overcome this difficulty. However, two experienced urologists are required to perform ECIRS, and the patient has to be placed in the Galdakao-modified supine Valdivia position or modified prone split-leg position which cannot be achieved in the elderly or patients with ankylosing arthritis, as it may cause harm due to abnormal traction of the joints. In addition, it is difficult for surgeons to create an ideal access tract to perform PCNL in this position. We report the case of a 72-year-old female patient with left staghorn stone. We performed RIRS first and then placed the patient in the decubitus position for PCNL with antegrade flexible ureteroscopy. This method allows patients to be placed in an easier position, with the use of flexible ureteroscopy through a nephroscope to find previously unreachable stones. Moreover, in addition to the more comfortable position both for surgeons and patients, this procedure can also deal with large complex renal stones as with ECIRS. We also created a brand-new definition for stone clearance rate, namely, stone reduction efficiency (SRE). There was a high stone reduction efficiency of 12.64 (mm2/min) in our patient, and no complications occurred. We suggest that this procedure is an ideal alternative treatment for a huge staghorn stone instead of PCNL or ECIRS. Full article
(This article belongs to the Special Issue Update of Urolithiasis and Treatment)
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