Innovations in urolithiasis management

Abstract

Purpose of review This review provides a forecast about ongoing developments in the management of urolithiasis with a potential to challenge the current standard of care. We therefore emphasized innovative technology, which might be considered still experimental in the daily clinic or needs further clinical validation, but harbors the great potential to become a game changer for future stone management. Recent findings Especially in the endoscopic stone treatment, we observed a multitude of groundbreaking technical innovations, which changed our treatment algorithms over the last decades. Some of this technology already found its way into daily practice. Others like artificial intelligence, burst wave lithotripsy, smart laser systems or gene therapy may not be standardized yet, but have the potential to further revolutionize current practice. Besides those technical features, we included innovations in prevention and diagnostics, as well as patient expectations and patient satisfaction into the analysis. A proper metaphylaxis and patient communication seems to be essential for a long-lasting treatment success. Summary The combination of technical innovations, improved stone metaphylaxis and proper patient communication presents the cornerstone of future kidney stone management.

Risk factors for urinary infection after retrograde upper urinary lithotripsy

“…Urolithiasis is a common disease in the department of urology. The population prevalence is about 1% to 5%, and the recurrence rate after treatment is also very high [1] . The recurrence rate of urolithiasis in 10 years after surgery is about 50% [2] .…”

“…The population prevalence is about 1% to 5%, and the recurrence rate after treatment is also very high. [1] The recurrence rate of urolithiasis in 10 years after surgery is about 50%. [2] In recent years, various intracavitary techniques have made great progress, including retrograde upper urinary lithotripsy and percutaneous nephrolithotomy.…”

A kősebészet és a húgyúti endoszkópia hazai és nemzetközi kutatási irányzatai • National and International Research Trends in Stone Surgery and Urinary Tract Endoscopy

“…A húgycsövön keresztül végzett kőműtéteknél (URS) az évtizedek óta alkalma� zott úgynevezett szemirigid eszközök továbbfejlesztése elsősorban a vékonyabb külső átmérőre irányul (kisebb invazivitás) vastagabb munkacsatorna kialakí� tása mellett (Veser et al, 2021). Sajnos, a fentiek gyakran az eszközök fokozott sérülékenységével is járnak.…”

Dual-energy CT kidney stone characterization—can diagnostic accuracy be achieved at low radiation dose?

“…Dual-energy CT (DECT) offers an alternative to singleenergy CT due to its ability to differentiate uric acid from nonuric acid stones. This discrimination can guide therapeutic decision-making as uric acid stones can be treated pharmacologically by alkalization of the urine and stone recurrence can be influenced by metaphylaxis and secondary prevention [8,9]. Two meta-analyses have found high accuracy of DECT for stone characterization [10,11] with a mean pooled sensitivity of 82% and 95.5% and a specificity of 97% and 98.5%, respectively.…”