The Need for Better Decision Tools in Managing Stone Disease

Matlaga, Brian R.

doi:10.1016/j.juro.2012.06.060

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…A standard Galerkin finite element method is applied to semidiscretize the weak form of Equation 4. This leads to the semidiscrete equations…”

Section: A Finite Element Csd Solvermentioning

confidence: 99%

“…In many countries including the United States, SWL is the most often used treatment for kidney stone patients . Despite the extensive use, however, SWL is to some extent still a “black box” to the treating urologist: The in‐depth mechanisms of stone fragmentation and tissue injury are still unclear; and there is no rational approach to predict the outcome of an SWL treatment . Statistical studies have shown that SWL has a relatively low success rate ( ∼ 50 % stone free rate) and a high retreatment rate (3.6 procedures per patient).…”

Section: Introductionmentioning

confidence: 99%

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Multiphase fluid‐solid coupled analysis of shock‐bubble‐stone interaction in shockwave lithotripsy

Wang

2017

Numer Methods Biomed Eng

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A novel multiphase fluid-solid-coupled computational framework is applied to investigate the interaction of a kidney stone immersed in liquid with a lithotripsy shock wave (LSW) and a gas bubble near the stone. The main objective is to elucidate the effects of a bubble in the shock path to the elastic and fracture behaviors of the stone. The computational framework couples a finite volume 2-phase computational fluid dynamics solver with a finite element computational solid dynamics solver. The surface of the stone is represented as a dynamic embedded boundary in the computational fluid dynamics solver. The evolution of the bubble surface is captured by solving the level set equation. The interface conditions at the surfaces of the stone and the bubble are enforced through the construction and solution of local fluid-solid and 2-fluid Riemann problems. This computational framework is first verified for 3 example problems including a 1D multimaterial Riemann problem, a 3D shock-stone interaction problem, and a 3D shock-bubble interaction problem. Next, a series of shock-bubble-stone-coupled simulations are presented. This study suggests that the dynamic response of a bubble to LSW varies dramatically depending on its initial size. Bubbles with an initial radius smaller than a threshold collapse within 1 μs after the passage of LSW, whereas larger bubbles do not. For a typical LSW generated by an electrohydraulic lithotripter (p = 35.0MPa, p =- 10.1MPa), this threshold is approximately 0.12mm. Moreover, this study suggests that a noncollapsing bubble imposes a negative effect on stone fracture as it shields part of the LSW from the stone. On the other hand, a collapsing bubble may promote fracture on the proximal surface of the stone, yet hinder fracture from stone interior.

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“…A standard Galerkin finite element method is applied to semidiscretize the weak form of Equation 4. This leads to the semidiscrete equations…”

Section: A Finite Element Csd Solvermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multiphase fluid‐solid coupled analysis of shock‐bubble‐stone interaction in shockwave lithotripsy

Wang

2017

Numer Methods Biomed Eng

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“…10 Limitations of past studies include small sample size, inadequate ascertainment of potential predictors, and referral-based study populations (stone clinics). Previous studies combined symptomatic stone episodes with radiographic detection or growth of asymptomatic stones, but the latter is not a clinical event.…”

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confidence: 99%

The ROKS Nomogram for Predicting a Second Symptomatic Stone Episode

Rule¹,

Lieske²,

Li³

et al. 2014

Journal of the American Society of Nephrology

217

161

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Most patients with first-time kidney stones undergo limited evaluations, and few receive preventive therapy. A prediction tool for the risk of a second kidney stone episode is needed to optimize treatment strategies. We identified adult first-time symptomatic stone formers residing in Olmsted County, Minnesota, from 1984 to 2003 and manually reviewed their linked comprehensive medical records through the Rochester Epidemiology Project. Clinical characteristics in the medical record before or up to 90 days after the first stone episode were evaluated as predictors for symptomatic recurrence. A nomogram was developed from a multivariable model based on these characteristics. There were 2239 first-time adult kidney stone formers with evidence of a passed, obstructing, or infected stone causing pain or gross hematuria. Symptomatic recurrence occurred in 707 of these stone formers through 2012 (recurrence rates at 2, 5, 10, and 15 years were 11%, 20%, 31%, and 39%, respectively). A parsimonious model had the following risk factors for recurrence: younger age, male sex, white race, family history of stones, prior asymptomatic stone on imaging, prior suspected stone episode, gross hematuria, nonobstructing (asymptomatic) stone on imaging, symptomatic renal pelvic or lower-pole stone on imaging, no ureterovesicular junction stone on imaging, and uric acid stone composition. Ten-year recurrence rates varied from 12% to 56% between the first and fifth quintiles of nomogram score. The Recurrence of Kidney Stone nomogram identifies kidney stone formers at greatest risk for a second symptomatic episode. Such individuals may benefit from medical intervention and be good candidates for prevention trials.

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“…23,24 If the patients at risk can be predicted among those who have had stone disease at least once, we can get a chance to recommend metabolic evaluation and preventive treatment to forestall new stone formation. 25 Unfortunately, almost 95% of clinicians are not aware of nomograms prepared for this purpose. 21 While there are simple applicable scoring methods that can be used to predict stone recurrence, they are not sufficient.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of modified stone recurrence predictive score in predicting recurrence of urinary stone disease

Beşer,

Yuvanç,

Yılmaz

2023

JOCS

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Aims: The present study is intended to define the scoring system consisting of questions to be answered by the patients in an outpatient clinic setting in order to predict recurrence of urinary system stone disease. Methods: Two hundred patients who were admitted for urinary system stone treatment in our clinic between 2016 and 2017 were included in the study. A Modified Stone Recurrence Predictive Score (MSRPS) comprising 23 questions under 14 headings including risk factors such as age, gender, smoking and alcohol consumption, family history of stone, number of stones, additional diseases and medications, presence of urinary tract infection, dietary characteristics, stress factors, occupation, and obesity was created. Three-year follow-up data of all patients were recorded. Results: The mean MSRPS was 18.4±6.2 (6-35). We noted that the high Modified Stone Recurrence Predictive Score correlated significantly with the incidence of recurrent stone formation (p<0.001 r2: 0.923). When the cutoff value was considered as 18, the sensitivity was 89.4% and the specificity was 93.1% in predicting recurrent stones. Recurrent stone formation was observed within 3 years in all patients with an MSRPS value of 26 and above. Conclusion: Thanks to this scoring system developed by expanding the scope of similar studies conducted in previous years, the possibility of recurrence of urinary stone disease is predicted using a questionnaire that can be filled easily, and it would be an appropriate choice regarding both patient health and cost-effectiveness in terms of directing patients to metabolic analyses or recommending preventive measures.

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The Need for Better Decision Tools in Managing Stone Disease

Cited by 4 publications

References 11 publications

Multiphase fluid‐solid coupled analysis of shock‐bubble‐stone interaction in shockwave lithotripsy

Multiphase fluid‐solid coupled analysis of shock‐bubble‐stone interaction in shockwave lithotripsy

The ROKS Nomogram for Predicting a Second Symptomatic Stone Episode

The effectiveness of modified stone recurrence predictive score in predicting recurrence of urinary stone disease

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