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Kidney Stones: Updates on Diagnosis and Treatment
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Kidney Stones: Updates on Diagnosis and Treatment

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

Deadline for manuscript submissions: 20 December 2024 | Viewed by 2692

Special Issue Editor

Dr. Razvan Multescu

E-Mail Website
Guest Editor
Department of Urology, “St. John” Emergency Clinical Hospital, 042122 Bucharest, Romania
Interests: kidney stones; urolithiasis; flexible ureteroscopy; percutaneous nephrolithotomy; metaphylaxis; laser; lithotripsy

Special Issue Information

Dear Colleagues,

Urolithiasis is one of the most frequent urologic pathologies across the globe, and its incidence is increasing due to diet habits and the general life style. However, risk factors are much better understood nowadays, allowing urologists to identify these risks more efficiently, improving the metaphylaxis of urolithiasis. Kidney stones may be therapeutically sanctioned using multiple methods. The immense majority of the cases may be treated nowadays using minimally invasive techniques. Technological progress has significantly impacted these methods, especially the flexible ureteroscopic approach for treating kidney stones, as the efficacy and safety of the procedures have been improved, and these procedures are becoming more affordable. In the last few years we have witnessed the development of multiple models of single-use endoscopes as well as new accessory instruments such as suction access sheaths.

Dr. Razvan Multescu
Guest Editor

Manuscript Submission Information

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Keywords

  • kidney stones
  • urolithiasis
  • flexible ureteroscopy
  • percutaneous nephrolithotomy
  • metaphylaxis
  • laser
  • lithotripsy

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Published Papers (2 papers)

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Research

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10 pages, 442 KiB  
Article
Urinary Tract Infection Predictors in Patients Undergoing Retrograde IntraRenal Surgery for Renal Stones: Does the Instrument Make the Difference?
by Francesco Prata, Loris Cacciatore, Annamaria Salerno, Francesco Tedesco, Alberto Ragusa, Salvatore Basile, Andrea Iannuzzi, Antonio Testa, Gianluigi Raso, Giuseppe D’Addurno, Marco Fantozzi, Marco Ricci, Antonio Minore, Angelo Civitella, Roberto Mario Scarpa and Rocco Papalia
J. Clin. Med. 2024, 13(10), 2758; https://doi.org/10.3390/jcm13102758 - 8 May 2024
Cited by 1 | Viewed by 887
Abstract
Background: Retrograde intrarenal surgery (RIRS) using flexible ureterorenoscopes is a cornerstone approach for renal stone removal, yet it carries a significant risk of postoperative urinary tract infection (UTI). With the emergence of single-use ureterorenoscopes, there is growing interest in their potential to mitigate [...] Read more.
Background: Retrograde intrarenal surgery (RIRS) using flexible ureterorenoscopes is a cornerstone approach for renal stone removal, yet it carries a significant risk of postoperative urinary tract infection (UTI). With the emergence of single-use ureterorenoscopes, there is growing interest in their potential to mitigate this risk. This study aimed to compare the postoperative infection rates between single-use and multi-use ureterorenoscopes in RIRS procedures and to identify predictors of postoperative UTI. Methods: Data were collected from 112 consecutive patients who underwent RIRS for renal stones between March 2022 and September 2023. Peri-operative variables including age, gender, body mass index (BMI), stone size, stone location, type of ureterorenoscope, Hounsfield Units (HU), pre-operative hydronephrosis, laboratory analysis, and operative time were evaluated. Univariate and multivariate logistic regression analyses were performed to assess the predictors of postoperative UTI. Results: Of the cohort, 77 surgeries (68.7%) utilized multi-use ureterorenoscopes, while 35 (31.3%) utilized single-use devices. Stone diameter, number of stones, type of ureterorenoscope, and operative time were significant predictors of postoperative UTI in the univariate analysis. Multivariable logistic regression showed that operative time (OR, 1.3; 95% CI, 0.55–0.99; p = 0.03) and type of ureterorenoscope (multi-use vs. single-use) (OR, 1.14; 95% CI, 1.08–1.2; p < 0.001) were independent predictors of postoperative UTI. Conclusions: In conclusion, this study highlights that multi-use ureterorenoscopes and prolonged operative time are associated with an increased risk of postoperative UTI in RIRS procedures. Careful pre-operative evaluation and meticulous patient selection are essential to minimize the occurrence of postoperative UTIs and optimize patient outcomes in RIRS for renal stones. Full article
(This article belongs to the Special Issue Kidney Stones: Updates on Diagnosis and Treatment)
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Review

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9 pages, 734 KiB  
Review
Retrograde Intrarenal Surgery for Lithiasis Using Suctioning Devices: A Shift in Paradigm?
by Petrisor Geavlete, Razvan Multescu, Cristian Mares, Bogdan Buzescu, Valentin Iordache and Bogdan Geavlete
J. Clin. Med. 2024, 13(9), 2493; https://doi.org/10.3390/jcm13092493 - 24 Apr 2024
Cited by 1 | Viewed by 1441
Abstract
New suction endoscopes, ureteral access sheaths (UAS) and catheters aim to improve the efficacy of flexible ureteroscopy and optimize its safety. Suction UAS with non-flexible tips have shown promising results, especially in maintaining low intrarenal pressure, but also in removing small debris and [...] Read more.
New suction endoscopes, ureteral access sheaths (UAS) and catheters aim to improve the efficacy of flexible ureteroscopy and optimize its safety. Suction UAS with non-flexible tips have shown promising results, especially in maintaining low intrarenal pressure, but also in removing small debris and reducing the “snow globe” effect. In addition, suctioning UAS with a flexible tip offers the advantage of being able to be navigated through the pyelocaliceal system to where the laser lithotripsy is performed. It can also remove small stone fragments when the flexible ureteroscope is retracted, using the Venturi effect. Direct in-scope suction (DISS) involves aspirating dust and small stone debris through the working channel of a flexible ureteroscope, thus regulating intrarenal pressure and improving visibility. Steerable aspiration catheters are other devices designed to increase stone clearance of the pyelocaliceal system. They are inserted under fluoroscopic guidance into every calyx after retraction of the flexible ureteroscope, alternating irrigation and aspiration to remove dust and small gravels. Combining flexible-tip suction UAS and the DISS technique may offer some advantages worth evaluating. The advantage of using these instruments to achieve a low intrarenal pressure was demonstrated. The true practical impact on the long-term stone-free status is a matter requiring further studies. Full article
(This article belongs to the Special Issue Kidney Stones: Updates on Diagnosis and Treatment)
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