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Recent Advances in Clinical Management of Urolithiasis
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Recent Advances in Clinical Management of Urolithiasis

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 (10 August 2023) | Viewed by 6624

Special Issue Editor

Dr. Takaaki Inoue

E-Mail Website
Guest Editor
1. Department of Urology, Hara Genitourinary Hospital, 5-7-17 Kitanagasadori, Chuo-ku, Kobe City 650-0012, Japan
2. Department of Urology, Kobe University, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe City 650-0017, Japan
Interests: urinary stone; urology; kidney stones; laser lithotripsy; shockwave lithotripsy; ureteroscopy; endoscopic stone
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

With the advancements of endoluminal technologies and techniques, the management of upper urinary tract stones has dramatically changed. We now have various tools available that can help patients, such as high-power Holmium lasers, Thulium fiber lasers, single flexible ureteroscopy (fURS), percutaneous miniature instruments, and irrigation methods, and a robotic retrograde approach has now also been developed. All these innovations can help to minimize the invasiveness of interventions for both patients and medical personnel, but for such instruments and machines to be used widely in the field, it is necessary to have a forum where practitioners can share in-depth knowledge and experience of these tools’ use. Therefore, this Special Issue aims to highlight the most recent outcomes of clinical studies and scientific research on the following topics:

  • How to use reusable fURS or single fURS;
  • How to use high-power Ho laser or Thulium fiber laser lithotripsy in upper urinary tract stones;
  • The benefits of different irrigation methods, such as gravity, hand-pump, pressure-bag, or automated irrigation pump;
  • How robotic retrograde intrarenal surgery works;
  • Current management of 2–3 cm kidney stones or staghorn stones;
  • Current opinions regarding how to manage 5–10 mm lower pole kidney stones;
  • How to manage ureteral stones;
  • Patient-entered QOL for stone treatment;
  • Surgeon ergonomics during endourological surgery.

Dr. Takaaki Inoue
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

  • ureteroscopy
  • retrograde intrarenal surgery
  • laser lithotripsy
  • robotic ureteroscopy
  • percutaneous nephrolithotomy
  • endoscopic combined intrarenal surgery

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Published Papers (3 papers)

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Research

18 pages, 4229 KiB  
Article
A Prospective Study of Renal Blood Flow during Retrograde Intrarenal Surgery
by Krzysztof Balawender
J. Clin. Med. 2023, 12(8), 3030; https://doi.org/10.3390/jcm12083030 - 21 Apr 2023
Cited by 1 | Viewed by 1680
Abstract
(I) Introduction: The use of Doppler ultrasound allows us to indirectly assess the effect of increased intrarenal pressure on renal blood flow during retrograde intrarenal surgery (RIRS). On the basis of vascular flow spectra from selected blood vessels in the kidney, it is [...] Read more.
(I) Introduction: The use of Doppler ultrasound allows us to indirectly assess the effect of increased intrarenal pressure on renal blood flow during retrograde intrarenal surgery (RIRS). On the basis of vascular flow spectra from selected blood vessels in the kidney, it is possible to determine Doppler parameters that reflect the renal perfusion status, which indirectly shows the degree of vasoconstriction and reflects the resistance of kidney tissue. (II) Materials and methods: A total of 56 patients were included in the study. The study assessed the changes of three Doppler parameters of intrarenal blood flow: resistive index-RI, pulsatility index-PI, and acceleration time-AT in the ipsilateral and contralateral kidneys during RIRS. The effects of mean stone volume, energy used, and pre-stenting were examined as predictors and calculated at two time intervals. (III) Results: The mean value of RI and PI was significantly higher in the ipsilateral kidney than in the contralateral kidney just after RIRS. The mean value of the acceleration time was not significantly different before and after RIRS. The values of all three parameters 24 h after the procedure were comparable to their values immediately after the RIRS. The size of the stone exposed to laser lithotripsy, the value of the energy used, and pre-stenting are not factors that significantly influence Doppler parameters during RIRS. (IV) Conclusions: The significant increase in RI and PI after RIRS in the ipsilateral kidney suggests a vasoconstriction of the interlobar arteries generated by increased intrarenal pressure during the procedure. Full article
(This article belongs to the Special Issue Recent Advances in Clinical Management of Urolithiasis)
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13 pages, 1597 KiB  
Article
A Newly Developed Hematuria Grading System May Predict the Status of Stone-Free and Acute Pyelonephritis of Minimally Invasive Renal Stone Surgery
by Gyeong Hun Kim, Gyoohwan Jung, Jungyo Suh, Juhyun Park and Sung Yong Cho
J. Clin. Med. 2023, 12(8), 2820; https://doi.org/10.3390/jcm12082820 - 12 Apr 2023
Cited by 2 | Viewed by 2214
Abstract
Objectives: The aim of this study was to evaluate the level of hematuria and the presence of clots during retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mPCNL) to predict surgical outcomes. Materials and Methods: The data of patients who underwent RIRS and [...] Read more.
Objectives: The aim of this study was to evaluate the level of hematuria and the presence of clots during retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mPCNL) to predict surgical outcomes. Materials and Methods: The data of patients who underwent RIRS and mPCNL were analyzed separately. A hematuria grading (HG) system was classified into five grades based on the presence of blood clots and any visible stones according to the irrigation settings. Inter-observer reliability of the grading system was assessed using intra-class correlation and Spearman’s rho. Results: The HG system showed high agreement among examiners, with high intra-class reliability and a strong correlation between RIRS and mPCNL groups. The stone density of the Houns-field unit was the most important factor in determining the hematuria across the development and validation groups of RIRS and mPCNL patients. Multivariate logistic regression analysis showed that the HG system was a significant predictor for remnant stones in the PCNL group and the probability of acute pyelonephritis or sepsis in the RIRS group. The high hematuria group showed lower basketing difficulty with the basket with a blue marker instrument than with others. Conclusions: The new HG system shows excellent inter-observer reliability and a correlation with a gradual increase in stone density and surgical difficulty. Full article
(This article belongs to the Special Issue Recent Advances in Clinical Management of Urolithiasis)
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9 pages, 707 KiB  
Article
Single-Session Impact of High-Power Laser with Moses Technology for Lower Pole Stones in Retrograde Intrarenal Surgery: Retrospective Study
by Takaaki Inoue, Shuzo Hamamoto, Shinsuke Okada, Fukashi Yamamichi, Masaichiro Fujita, Koki Tominaga, Yasumasa Tobe and Masato Fujisawa
J. Clin. Med. 2023, 12(1), 301; https://doi.org/10.3390/jcm12010301 - 30 Dec 2022
Cited by 5 | Viewed by 1725
Abstract
Background: 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). Methods: Herein, 305 patients with lower pole stones who underwent RIRS using a high-power [...] Read more.
Background: 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). Methods: 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. Results: A total of 173 (56.7%) and 229 (75.1%) patients achieved a SF status on postoperative day one and at one month, respectively. Operation time in the SF group was shorter than that in the non-SF group (51.0 vs. 74.5 min). There were no significant differences in postoperative complications between the SF and non-SF groups. Significantly predictive risk factors in postoperative SF included total stone volume (odds ratio (OR), 1.056; 95% CI, 1.015–1.099; p = 0.007), IPA (OR, 0.970; 95% CI, 0.956–0.993; p = 0.009), and IW (OR, 0.295; 95% CI, 0.121–0.718; p = 0.007). The cut-off values of stone volume, IPA, and IW were 515.2 mm3, 46.8°, and 7.75 mm, respectively. Conclusions: A high-power holmium laser with MT in lower pole stones is a valuable option for positive outcomes and patient’s safety. Larger stone volume, acute IPA, and narrow IW were negative predictors related to postoperative SF status. Full article
(This article belongs to the Special Issue Recent Advances in Clinical Management of Urolithiasis)
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