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INTRODUCTION AND OBJECTIVES: Stone size is thought to be an important factor in the appropriate management of nephrolithiasis and counseling of patients. The typical quantification of stone size is based on a linear measurements on computed tomography (CT) imaging, but volumetric analysis has become more readily available and relevant in recent times. While discussions regarding the most accurate ways to analyze stone volume are currently ongoing, our study aims to further investigate the utility of volume measurement in the treatment of renal calculi.METHODS: A retrospective review of patients undergoing percutaneous nephrolithotomy (PCNL) between 2009 and 2013 was performed. Preoperative and postoperative helical CT images were used to measure stone size, location, and density; iPlan CMF software was used to reconstruct three-dimensional models from the aforementioned CT scans and calculate volume measurements. Logistic regression and correlational analysis was performed to evaluate the relationship between stone volume and linear measurements, and to identify predictors of postoperative percent-reduction in stone volume and stone-free rate.RESULTS: The analysis included a total of 175 patients undergoing first-look PCNL for solitary stones, regardless of size, shape, and location within the kidney; patients with ureteral stones were excluded. Stone volume was most correlated with linear measurements in the sagittal dimension (r ¼ 0.85, p < 0.05), but axial (r ¼ 0.82) and coronal (r ¼ 0.81) measurements were not far behind. Preoperative stone volume was positively correlated to postoperative stone volume (r ¼ 0.36, p < 0.05). There was no significant difference in postoperative stone volume reduction based on stone size, location, or density.CONCLUSIONS: In patients undergoing PCNL, volumetric stone measurement using three-dimensional reconstruction correlates positively with linear measurements and, therefore, does not significantly change or augment our understanding of a patient's stone burden.

The bulbar urethra is the most common site of stricture disease for which urethroplasty remains standard of care. A decrease in trauma as an etiology in the developed world and concerns regarding sexual dysfunction related to transection of the corpus spongiosum have placed a renewed emphasis on non-transecting urethroplasty techniques. Here, we present our surgical algorithm with emphasis on non-transecting techniques for bulbar urethral stricture disease and review the current state of literature comparing transecting to non-transecting approaches in order to provide guidance to practitioners on patient selection, counseling, and technique.

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Objectives: To evaluate which of previously reported monogenic genes are associated with increased bladder cancer risk, we reviewed published papers on associations of genes and bladder cancer risk and performed a confirmation study of these genes in a large population-based cohort. Subjects and methods:A systematic review of published papers prior to June 2022 was performed first to identify all genes where germline mutations were associated with bladder cancer risk. The associations of these candidate genes with bladder cancer risk were then tested among 1695 bladder cancer cases and 186 271 controls in the UK Biobank (UKB). The robust SKAT-O, a gene-based analysis that properly controls for type I error rates due to unbalanced case-control ratio, was used for association tests adjusting for age at recruitment, gender, smoking status, and genetic background.Results: The systematic review identified nine genes that were significantly associated with bladder cancer risk in at least one study (p < 0.05), including MUTYH, MSH2, MSH6, MLH1, ATM, BRCA2, ERCC5, TGFB1 and CHEK2. When pathogenic/ likely pathogenic mutations were aggregated within each gene, the association was confirmed for three genes in the UKB at p < 0.0056 (Bonferroni correction for nine tests), including CHEK2, ATM and BRCA2, all also known to be associated with hereditary breast cancer. Suggestive evidence of association was found for two other genes, including MLH1 (p = 0.006) and MSH2 (p = 0.007), both known to be associated with Lynch syndrome. Among these five genes, the bladder cancer risks range Abrar Mian and Jun Wei contributed equally to this work.