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Management of Kidney Stones: Current Scenario and Future Perspectives
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Management of Kidney Stones: Current Scenario and Future Perspectives

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 April 2024) | Viewed by 4817

Special Issue Editor

Prof. Dr. Bhaskar K. Somani

E-Mail Website
Guest Editor
University Hospital Southampton NHS Trust, University of Southampton, Southampton, UK
Interests: endourology; urinary tract infections; benign prostate disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are in the modern era of innovations, technological developments and minimisation in the field of urology. The management of kidney stone disease (KSD) has been revolutionised over these last two decades with the use of lasers, scopes and ancillary equipment. In addition, there has been more research on basic science related to stone disease with newer concepts around intrarenal temperature and pressure.

The role of minimally invasive surgical techniques with mini PCNL and endoscopic combined intrarenal surgery (ECIRS) has also evolved. Fragmentation devices have also become innovative. The management of ureteroscopy (URS) has now expanded to all patient groups too. There is an increasing emphasis on the role of suction in endourological procedures, while the quest for better intrarenal pressure and temperature monitoring continues. The use of thulium fiber laser (TFL), Moses technology and small disposable ureteroscopes all help in pushing the boundaries of ureteroscopy and percutaneous nephrolithotomy procedures. Endourological techniques have especially pushed the boundaries in the management of stones in special population groups such as pediatrics, stones in anomalous kidneys and in pregnancy.

New technological developments have also led to improvement in the quality of life (QoL), reduced hospital stay and a reduction in complication rates. The addition of artificial intelligence in endourology has also helped in improving outcomes with predictive models and outcome prediction.

This Special Issue will cover all issues related to current scenarios and future perspectives in the management of kidney stone disease.

Prof. Dr. Bhaskar K. Somani
Guest Editor

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Keywords

  • endourology
  • ureteroscopy
  • percutaneous nephrolithotomy (PCNL)
  • laser
  • technology and AI
  • shockwave lithotripsy
  • intrarenal temperature and pressure
  • social media

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Published Papers (4 papers)

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Research

11 pages, 2067 KiB  
Article
Comparative Approaches in Treating Double-J Stent Syndrome: Monotherapy or Combination Therapy?
by Cătălin Pricop, Carina Alexandra Bandac, Marius Ivanuță, Daniel Rădăvoi, Viorel Jinga and Dragoş Puia
J. Clin. Med. 2024, 13(14), 4278; https://doi.org/10.3390/jcm13144278 - 22 Jul 2024
Viewed by 999
Abstract
Introduction: The application of double-J ureteral stents in urology is widespread, but their use is often accompanied by complications and bothersome symptoms, affecting patients’ quality of life (QoL). While various medications have been tested for alleviating the symptoms associated with double-J stents, [...] Read more.
Introduction: The application of double-J ureteral stents in urology is widespread, but their use is often accompanied by complications and bothersome symptoms, affecting patients’ quality of life (QoL). While various medications have been tested for alleviating the symptoms associated with double-J stents, consensus on their effectiveness remains elusive. This study aims to investigate the effectiveness of tamsulosin, solifenacin, mirabegron, desloratadine, and combination therapy using a Romanian-adapted version of the Ureteral Stent Symptom Questionnaire (USSQ). Materials and Methods: A prospective, observational, randomised trial was conducted at the Urology and Renal Transplant Clinic of Dr. “C.I. Parhon” Clinical Hospital in Iasi between 1 January 2022 and 1 August 2023. Three hundred twenty seven patients who underwent their first double-J stent insertion were evaluated with the Romanian-adapted USSQ at baseline and 30 days post-insertion. Patients were randomly divided into six groups based on the prescribed medications: control, tamsulosin, mirabegron, solifenacin, desloratadine, and combination therapy. Results: The data suggest a significant reduction in symptoms in patients who received medication compared with the control group. Furthermore, the combined medication of solifenacin 10 mg and tamsulosin 0.4 mg was particularly effective in reducing pain with statistical significance compared to the control group (p = 0.001). The highest mean scores for urinary symptom severity were observed in the control group (12.37 ± 6.82), and the lowest was in the mirabegron group (9.94 ± 5.82). The individuals who received a daily dose of 50 mg of mirabegron saw the most notable influence on their job. Conclusions: While no single medication emerged as a “miracle drug” for managing symptoms related to double-J stent insertion, the combination therapy of solifenacin and tamsulosin is the most promising option for improving symptoms related to double-J stent insertion and QoL. Additional extensive research is required to validate these initial results. Full article
(This article belongs to the Special Issue Management of Kidney Stones: Current Scenario and Future Perspectives)
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12 pages, 609 KiB  
Article
Cardiovascular and Cerebrovascular Morbidity in Patients with Urolithiasis: An Epidemiological Approach Based on Hospitalization Burden Data from 1997 to 2021
by Javier Sáenz-Medina, Victoria Gómez Dos Santos, María Rodríguez-Monsalve, Alfonso Muriel-García, Manuel Durán-Poveda, Alfonso Gómez del Val, Javier Burgos Revilla and Dolores Prieto
J. Clin. Med. 2024, 13(12), 3564; https://doi.org/10.3390/jcm13123564 - 18 Jun 2024
Viewed by 892
Abstract
Background: Patients with kidney stones (KSFs) are known to have a heightened risk of coronary heart disease (CHD) or stroke. The objective of the present study was to describe the natural history of these complications through the longitudinal analysis of the hospitalizations due [...] Read more.
Background: Patients with kidney stones (KSFs) are known to have a heightened risk of coronary heart disease (CHD) or stroke. The objective of the present study was to describe the natural history of these complications through the longitudinal analysis of the hospitalizations due to kidney stones in Spain from 1997 to 2021. Methods: A retrospective longitudinal observational study was developed based on nationwide hospitalization data (minimum basic data base). Three different analyses were carried out. In the first step, the prevalence of coronary or cerebrovascular events in kidney stone hospitalizations was compared with the hospitalization burden of CHD or strokes related to the general population. In the second step, a survival analysis of the kidney stones–hospitalized patients using the Kaplan–Meier method was conducted. In the third step, a Cox regression was used to assess the influence of the classical comorbidities in the development of the lithiasic patients–cardiovascular disease. Results: Kidney stone-hospitalized patients exhibit a significantly higher risk of CHD (OR = 14.8 CI95%: 14.7–14.9) and stroke (OR = 6.7 CI95%: 6.6–6.8) compared to the general population across in all age groups, although they had less cardiovascular risk factors. A total of 9352 KSFs (1.5%) developed a coronary event within an average time of 78.8 months. A total of 2120 KSFs (0.33%) suffered a stroke in an average time of 71.1 months. Diabetes, hypertension, hyperlipidemia, and being overweight were identified as risk factors for developing CHD and stroke using a univariate and multivariate analysis. Conclusions: Our study confirms previous studies in which kidney stones must be considered as a risk factor for developing CHD or cerebrovascular disease. Preventive strategies should target patients with kidney stones and classical risk cardiovascular factors to mitigate modifiable conditions associated with cardiovascular diseases. Full article
(This article belongs to the Special Issue Management of Kidney Stones: Current Scenario and Future Perspectives)
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11 pages, 2883 KiB  
Article
Cystine Renal Calculi: New Aspects Related to Their Formation and Development
by Felix Grases, Francisca Tomàs Nadal, Francesca Julià Florit and Antonia Costa-Bauza
J. Clin. Med. 2024, 13(10), 2837; https://doi.org/10.3390/jcm13102837 - 11 May 2024
Cited by 1 | Viewed by 1051
Abstract
Background: Crystallization experiments of renal-calculi-forming compounds (calcium oxalate, calcium phosphates, uric acid) are normally performed by monitoring these processes during periods of time similar to the residence of urine inside the kidney. Nevertheless, cystine requires high supersaturation for its crystallization, and most [...] Read more.
Background: Crystallization experiments of renal-calculi-forming compounds (calcium oxalate, calcium phosphates, uric acid) are normally performed by monitoring these processes during periods of time similar to the residence of urine inside the kidney. Nevertheless, cystine requires high supersaturation for its crystallization, and most experiments last for longer periods. It must be considered that at high supersaturation, the inhibitors of crystalline development have poor effects. Methods: The induction time of crystallization (ti) of cystine in experimental conditions similar to those of the formation of cystine renal calculi and the effect of different cystine-binding thiol agents was determined through turbidimetric measurements. We also studied the macro- and microstructure of 30 cystine kidney stones through stereoscopic microscopy and scanning electron microscopy. Results: Under the studied conditions, the ti in absence of crystallization inhibitors was 15 min, and the presence of 9 mM of penicillamine, tiopronin, or N-acetylcysteine totally inhibited crystallization, as their effects relate to the formation of complexes with cystine, although N-acetylcysteine also delayed cystine crystalline development and modified cystine crystal morphology. Cystine stones have traditionally been classified as smooth and rough. The study of their structure shows that all of them begin their formation from a few crystals that generate a compact radial structure. Their subsequent growth, depending on the renal cavity where they are located, gives rise to the rough structure in the form of large blocks of cystine crystals or the smooth structure with small crystals. Conclusions: To prevent the development of cystine renal stones, the formation of small crystals must be avoided by reducing urinary cystine supersaturation, with N-acetylcysteine being the most effective among the studied cystine-binding thiol agents. Also, the removal of cystine crystals through increased water intake and physical activity can be a very important preventive measure. Full article
(This article belongs to the Special Issue Management of Kidney Stones: Current Scenario and Future Perspectives)
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11 pages, 1266 KiB  
Article
Monopolar Transurethral Enucleoresection of Prostate: Feasibility of Modified Nesbit’s Enucleoresection with Apical Release
by Nitesh Kumar and Bhaskar Somani
J. Clin. Med. 2024, 13(5), 1455; https://doi.org/10.3390/jcm13051455 - 2 Mar 2024
Viewed by 1462
Abstract
Background: Transurethral resection of the prostate (TURP) has been the standard surgical treatment for Benign Hyperplasia of the Prostate (BPH) for decades. Our objective was to evaluate the outcome of our new technique: Monopolar Transurethral Enucleoresection of the Prostate (TUERP) with apical [...] Read more.
Background: Transurethral resection of the prostate (TURP) has been the standard surgical treatment for Benign Hyperplasia of the Prostate (BPH) for decades. Our objective was to evaluate the outcome of our new technique: Monopolar Transurethral Enucleoresection of the Prostate (TUERP) with apical release (bring it all to centre). Methods: A prospective study of all cases undergoing TUERP at a tertiary centre from January 2020 to October 2022 was performed. Patient demographics, intraoperative variables and postoperative results along with follow-up data were collected. Data of all the cases who had completed a one-year follow-up post-surgery were included and analysed. Results: A total of 240 patients with complete data including a one-year follow-up were included. Mean prostatic volume was 55.3 ± 11.6 gm, and 28 (11.67%) cases were >100 gm. The mean operative time was 31.7 ± 7.6, and mean haemoglobin drop at 24 h was 0.73 ± 1.21 gm/dL. The overall complication rate was 16.67%, with only two (0.83%) Clavien–Dindo III complications (haematuria and clots needing evacuation) and the other complications being Clavien–Dindo I/II complications. Sustained improvement at 1 year of follow-up was noted: Qmax: 25.2 ± 5.6 mL/s, IPSS: 4.7 ± 2.5 and PVR: 22.5 ± 9.6 mL. Conclusions: Monopolar TUERP with a modified Nesbit’s enucleoresection with apical release can be considered a promising technique, which needs further studies to be validated with appropriate comparisons. Full article
(This article belongs to the Special Issue Management of Kidney Stones: Current Scenario and Future Perspectives)
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