Canadian Urological Association guideline: Management of ureteral calculi – Abridged version

Lee, Jason Y.; Andonian, Sero; Bhojani, Naeem; Bjazevic, Jennifer; Chew, Ben H.; De, Shubha; Elmansy, Hazem; Lantz-Powers, Andrea G.; Pace, Kenneth T.; Schuler, Trevor; Singal, Rajiv K.; Ordon, Michael

doi:10.5489/cuaj.7652

Cited by 7 publications

(3 citation statements)

References 157 publications

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“…Previous studies advocate for URS for larger ureteric stones due to its capability to directly access and fragment the stone. Our results, showing a trend in favor of URS for larger stones, align with this prevailing sentiment [15] .…”

Section: Discussionsupporting

confidence: 89%

To compare the efficiencies of shock waves extracorporeal lithotripsies (ESWL) versus ureterorenoscopy (URS) to remove proximate ureteric stones

Sarwar,

Farhan Khan,

Soomro

et al. 2023

J. Univ. Med. Dent. Coll.

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Introduction: - Urolithiasis is a widespread health problem. The objective of this research was to contrast the use of shock waves extracorporeals lithotripsies’ (ESWL) versus ureterorenoscopy (URS) for the proximal ureteric stones treatment. Ureteric stone is a common disease of urinary system in Pakistan. Despite ongoing success in endourological stone treatment, question about optimal management of proximal ureteric stone still remains debatable amongst urologist; therefore this study is being performed to find an appropriate and effective tool to treat ureteric stones. Objective: - For patients with large proximal ureteric gallstones, our goal was to compare the advantages of ureterorenoscopy with shock wave extracorporeal lithotripsy (ESWL) (10–15 mm). Settings: The Karachi-based Sindh Hospital of Urology & Transplantation's Urology Department. Duration: 6 months from 28-01-2022 to 28-07-2022 Design: Randomized control trial Subject and Methods: Sixty people were enrolled in the trial, all of whom had a single, radio-opaque stone in the proximal ureter detected by IVU. Thirty patients received ESWL and thirty received URS, both at random. After 3 weeks, x-ray KUB was used to monitor patients in both groups. A computerized pre-structured proforma was used for all data collection. Result: - The victims were 27.58 6.20 years old on aggregate.There were 38(63.3%) male and 22(36.7%) female. Efficacy of URS treatment was significantly high as compare to ESWL [93.33% vs. 60%; p 0.002]. Conclusion: - This research shows that the results support the hypothesis that URS is more effective for proximal ureteric stone clearance than ESWL.

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Section: Discussionsupporting

confidence: 89%

To compare the efficiencies of shock waves extracorporeal lithotripsies (ESWL) versus ureterorenoscopy (URS) to remove proximate ureteric stones

Sarwar,

Farhan Khan,

Soomro

et al. 2023

J. Univ. Med. Dent. Coll.

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“…However, the actual impact of tin prefiltration in ultra-low-dose photon-counting abdominal CT scans is still to be determined. A typical clinical application for unenhanced low-dose CT of the abdomen is for detection of urinary calculi [16][17][18]. In the case of urolithiasis, CT is considered superior to other imaging techniques such as Diagnostics 2023, 13, 603 2 of 10 ultrasound with sensitivity reported at 97% and specificity at 95% [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Potential of Unenhanced Ultra-Low-Dose Abdominal Photon-Counting CT with Tin Filtration: A Cadaveric Study

et al. 2023

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Objectives: This study investigated the feasibility and image quality of ultra-low-dose unenhanced abdominal CT using photon-counting detector technology and tin prefiltration. Materials and Methods: Employing a first-generation photon-counting CT scanner, eight cadaveric specimens were examined both with tin prefiltration (Sn 100 kVp) and polychromatic (120 kVp) scan protocols matched for radiation dose at three different levels: standard-dose (3 mGy), low-dose (1 mGy) and ultra-low-dose (0.5 mGy). Image quality was evaluated quantitatively by means of contrast-to-noise-ratios (CNR) with regions of interest placed in the renal cortex and subcutaneous fat. Additionally, three independent radiologists performed subjective evaluation of image quality. The intraclass correlation coefficient was calculated as a measure of interrater reliability. Results: Irrespective of scan mode, CNR in the renal cortex decreased with lower radiation dose. Despite similar mean energy of the applied x-ray spectrum, CNR was superior for Sn 100 kVp over 120 kVp at standard-dose (17.75 ± 3.51 vs. 14.13 ± 4.02), low-dose (13.99 ± 2.6 vs. 10.68 ± 2.17) and ultra-low-dose levels (8.88 ± 2.01 vs. 11.06 ± 1.74) (all p ≤ 0.05). Subjective image quality was highest for both standard-dose protocols (score 5; interquartile range 5–5). While no difference was ascertained between Sn 100 kVp and 120 kVp examinations at standard and low-dose levels, the subjective image quality of tin-filtered scans was superior to 120 kVp with ultra-low radiation dose (p < 0.05). An intraclass correlation coefficient of 0.844 (95% confidence interval 0.763–0.906; p < 0.001) indicated good interrater reliability. Conclusions: Photon-counting detector CT permits excellent image quality in unenhanced abdominal CT with very low radiation dose. Employment of tin prefiltration at 100 kVp instead of polychromatic imaging at 120 kVp increases the image quality even further in the ultra-low-dose range of 0.5 mGy.

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“…As the authors of this 2021 guideline illustrate, conservative management has been shown to be effective with small (<5 mm) stones; ureteroscopy and shockwave lithotripsy are both reasonable options for larger stones and stones that do not pass with conservative management. 1 Stone factors and patient factors can be used to determine which is the "best" treatment in a given situation, although the decision may ultimately depend on local resources.…”

mentioning

confidence: 99%

Both patient and stone factors determine “best” treatment for urolithiasis

Dushinski¹

2021

CUAJ

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Canadian Urological Association guideline: Management of ureteral calculi – Abridged version

Cited by 7 publications

References 157 publications

To compare the efficiencies of shock waves extracorporeal lithotripsies (ESWL) versus ureterorenoscopy (URS) to remove proximate ureteric stones

To compare the efficiencies of shock waves extracorporeal lithotripsies (ESWL) versus ureterorenoscopy (URS) to remove proximate ureteric stones

Potential of Unenhanced Ultra-Low-Dose Abdominal Photon-Counting CT with Tin Filtration: A Cadaveric Study

Both patient and stone factors determine “best” treatment for urolithiasis

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