Duration of Follow-up and Timing of Discharge from Imaging Follow-up, in Adult Patients with Urolithiasis After Surgical or Medical Intervention: A Systematic Review and Meta-analysis from the European Association of Urology Guideline Panel on Urolithiasis

Tzelves, Lazaros; Geraghty, Robert; Lombardo, Riccardo; Davis, Niall F.; Petřík, Aleš; Neisius, Andreas; Gambaro, Giovanni; Türk, Christian; Thomas, Kay; Somani, Bhaskar; Skolarikos, Andreas

doi:10.1016/j.euf.2022.06.016

Cited by 26 publications

(11 citation statements)

References 83 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reintervention rates in this study were 8.8% for the stone-free group, 23.5% for the group with RFs ≤ 4 mm and 45.7% for RFs > 4 mm. A recent systematic review and meta-analysis showed reintervention rates of 17% at 20 months in a pooled analysis including 1274 patients with RFs ≤ 4 mm and reintervention rates of 47% in a pooled analysis of 367 patients at 20 months [ 17 ]. This corresponds with our findings.…”

Section: Discussionmentioning

confidence: 99%

The significance of clinically insignificant residual fragments after percutaneous nephrolithotomy: an analysis into the relevance of complete stone clearance

Kingma,

Doppen,

Bus

et al. 2024

World J Urol

View full text Add to dashboard Cite

Purpose After treatment for kidney stones, residual fragments with a diameter of ≤ 4 mm are traditionally referred to as ‘clinically insignificant residual fragments’. We hypothesize that patients with these fragments are at an increased risk for stone-related morbidity, such as complaints, hydronephrosis, and stone regrowth, when compared to stone-free patients. This study aimed to investigate the relevance of complete stone clearance in surgical treatment of urolithiasis. Methods We conducted a single-center retrospective cohort study. Patients who underwent percutaneous nephrolithotomy between 2015 and 2020 were included if a CT-scan was available within 6 months after the procedure, and the follow-up duration was at least 1 year. The stone-free status at the end of the first stone episode during the study period was categorized as fully stone-free, not stone-free with small residual fragments (≤ 4 mm) and not stone-free with large residual fragments (> 4 mm). Follow-up data were collected, including stone-related events and re-intervention rates. Results A total of 103 subjects were included with a median follow-up of 21.4 months. Stone-related events occurred in 10 (29.4%) of the fully stone-free subjects, 20 (58.8%) of the subjects with small residual fragments and 25 (71.4%) of the subjects with large residual fragments. The stone-related event-free survival per subgroup resulted in a significantly different survival distribution in a log rank test (p = 0.008). Conclusion A complete stone-free status seems to be of fundamental importance for decreasing stone-related morbidity. Further developments and research should focus on optimizing the full clearance of stone material during PCNL.

show abstract

Section: Discussionmentioning

confidence: 99%

The significance of clinically insignificant residual fragments after percutaneous nephrolithotomy: an analysis into the relevance of complete stone clearance

Kingma,

Doppen,

Bus

et al. 2024

World J Urol

View full text Add to dashboard Cite

show abstract

“…75 Catastrophic events in Hiroshima and Nagasaki have made clear how harmful ionizing radiation is for human tissues; yet according to a recent survey education is lacking and protective equipment is not used ideally among endourologists. 76 Patients are exposed to radiation during diagnosis, management and follow-up of urolithiasis, [77][78][79] while surgeons are also prone to its mutagenic effects due to long-term, low-dose exposure. 80 Although not a technological innovation per se, the establishment and adoption of radiation-free protocols for URS and PCNL can drastically reduce radiation exposure and associated risks.…”

Section: Miniaturization Of Pcnl Sheaths -Innovations In Pcnl Lithotr...mentioning

confidence: 99%

Innovations in Kidney Stone Removal

Tzelves¹,

Geraghty²,

Hughes³

et al. 2023

RRU

Self Cite

View full text Add to dashboard Cite

Urolithiasis is a common clinical condition, and surgical treatment is performed with different minimally invasive procedures, such as ureteroscopy, shockwave lithotripsy and percutaneous nephrolithotomy. Although the transition from open surgery to endourological procedures to treat this condition has been a paradigm shift, ongoing technological advancements have permitted further improvement of clinical outcomes with the development of modern equipment. Such innovations in kidney stone removal are new lasers, modern ureteroscopes, development of applications and training systems utilizing three-dimensional models, artificial intelligence and virtual reality, implementation of robotic systems, sheaths connected to vacuum devices and new types of lithotripters. Innovations in kidney stone removal have led to an exciting new era of endourological options for patients and clinicians alike.

show abstract

“…After treatment for urinary stones, patients without residual stones should be monitored for no less than 2 years in the case of radio-opaque stones and no less than 3 years in the case of radiolucent stones. A 5-year follow-up window allows for a greater margin of safety that can be evaluated on the basis of cost-effectiveness (58,59). In patients with residual stones no greater than 4mm, disease progression and need for intervention are reported in less than 40%.…”

Section: Follow Upmentioning

confidence: 99%

The role of the general practictioner in the management of urinary calculi

Prezioso,

Piccinocchi,

Abate

et al. 2023

Arch Ital Urol Androl

View full text Add to dashboard Cite

Background: The prevalence of kidney stones tends to increase worldwide due to dietary and climate changes. Disease management involves a high consumption of healthcare system resources which can be reduced with primary prevention measures and prophylaxis of recurrences. In this field, collaboration between general practitioners (GPs) and hospitals is crucial. Methods: a panel composed of general practitioners and academic and hospital clinicians expert in the treatment of urinary stones met with the aim of identifying the activities that require the participation of the GP in the management process of the kidney stone patient. Results: Collaboration between GP and hospital was found crucial in the treatment of renal colic and its infectious complications, expulsive treatment of ureteral stones, chemolysis of uric acid stones, long-term follow-up after active treatment of urinary stones, prevention of recurrence and primary prevention in the general population. Conclusions: The role of the GP is crucial in the management and prevention of urinary stones. Community hospitals which are normally led by GPs in liaison with consultants and other health professional can have a role in assisting multidisciplinary working as extended primary care.

show abstract

Duration of Follow-up and Timing of Discharge from Imaging Follow-up, in Adult Patients with Urolithiasis After Surgical or Medical Intervention: A Systematic Review and Meta-analysis from the European Association of Urology Guideline Panel on Urolithiasis

Cited by 26 publications

References 83 publications

The significance of clinically insignificant residual fragments after percutaneous nephrolithotomy: an analysis into the relevance of complete stone clearance

The significance of clinically insignificant residual fragments after percutaneous nephrolithotomy: an analysis into the relevance of complete stone clearance

Innovations in Kidney Stone Removal

The role of the general practictioner in the management of urinary calculi

Contact Info

Product

Resources

About