Natural History, Complications and Re-Intervention Rates of Asymptomatic Residual Stone Fragments after Ureteroscopy: a Report from the EDGE Research Consortium

Chew, Ben H.; Brotherhood, Hilary; Sur, Roger L.; Wang, An Qi; Knudsen, Bodo E.; Yong, Courtney; Marien, Tracy; Miller, Nicole L.; Krambeck, Amy E.; Charchenko, Cameron M.; Humphreys, Mitchell R.

doi:10.1016/j.juro.2015.11.009

Cited by 141 publications

(73 citation statements)

References 12 publications

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“…However, when used in the broad field and looked at carefully, the re-intervention rate for residual fragments after URS was about 40%. This is similar to that of ESWL 51, 52 . Potentially, these differences in the success rates of URS are because of different techniques (e.g.…”

Section: Managing Urolithiasissupporting

confidence: 87%

Recent advances in understanding and managing urolithiasis

Strohmaier

2016

F1000Res

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During the last few years, there has been relevant progress in both understanding and managing urolithiasis. Our knowledge of stone formation has changed; although the importance of urine biochemistry was questioned by several investigators years ago, the decisive role of cellular processes (induced by oxidative stress) and the renal papilla has only recently been generally accepted as the most important step in stone formation. For calcium oxalate urolithiasis, the formation of papillary calcifications plays a key role and is of prognostic relevance. Further research has to concentrate on these aspects of preventing urolithiasis. Stone prevention (metaphylaxis) is a major issue when considering the burden it places on healthcare systems. An effective metaphylaxis could lower the cost of stone therapy significantly. For uric acid urolithiasis, so far there is only preliminary information available showing that papillary plaques are not as important as they are in calcium oxalate urolithiasis. Concerning stone management, endourology has improved stone therapy significantly during the last few years. Morbidity decreased and success (stone-free) rates increased. Therefore, the indications for extracorporeal shockwave lithotripsy (ESWL) narrowed. ESWL, however, still has its place in stone therapy. There is not one single treatment modality that is equally effective for all situations. It is important to observe the differential indications for different stones depending on size, localization, and composition.

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Section: Managing Urolithiasissupporting

confidence: 87%

Recent advances in understanding and managing urolithiasis

Strohmaier

2016

F1000Res

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“…Sometimes, it is not possible to extract all renal stone fragments resulting in residual stone fragments. 6,7 Therefore, development of a new laser technology minimizing stone retropulsion and thus improving effeciency of stone fragmentation and stone-free rates is needed. Lumenis recently developed a new laser technology called "Moses technology" which has improved stone fragmentation capacity by increased energy transmission in water and reduced stone retropulsion in in vitro and animal studies.…”

Section: Introductionmentioning

confidence: 99%

Moses technology in a stone simulator

Ibrahim

Badaan

Elhilali

et al. 2017

CUAJ

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“…It also raises the question of the true cost effectiveness of the procedure, whereby less aggressive treatments may reduce the cost of scope repairs at the expense of secondary interventions for the patient with residual fragments. 16 We suspect that the combination of our technique along with the training nature of our hospital likely plays a considerable role in our repair rate.…”

Section: Discussionmentioning

confidence: 99%

“…This technique has been suggested to be more efficacious in terms of stone-free rate and reduced likelihood of secondary stone events. 16 However, it is also more time consuming and requires more aggressive manipulation of the fURS including increased torqueing to inspect anatomically unfavorable calyces, multiple passes of lasers and baskets through the working channel, and repeated passage of the scope through the sheath. This could explain some difference in our repair rates compared to prior studies where alternative techniques such as dusting or less aggressive attempts at complete stone removal may have been implemented.…”

Section: Discussionmentioning

confidence: 99%