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Objective: To assess the effect of 2 over-the-counter alkalizing agents on 24 hour urinary parameters. Materials and Methods: Ten healthy volunteers without a history of kidney stones were recruited to complete a baseline 24 hour urinalysis with a 4 day diet inventory. Participants then maintained the same diet on either LithoLyte (20 mEq 2 times per day) or KSPtabs (1 tablet 2 times per day) and submitted another 24 hour urinalysis. The process was repeated with the other supplement. Urinary alkali parameters were compared to baseline, and side effects were elicited with a questionnaire. Results: LithoLyte intake resulted in a non-significant increase in citrate (597-758 mg/day, P =.058, an increase in urine pH (6.46-6.66, P =.028), and a decrease in urine ammonium (41-36 mmol/day, P =.005) compared to baseline. KSPtabs resulted in an increase in citrate (597-797 mg/day, P =.037) and urine pH (6.46-6.86, P =.037), with a non-significant decrease in ammonium (41-34 mmol/day, P =.059). No significant differences were seen comparing urinary analytes between LithoLyte and KSPtabs. With Litholyte, no side effects, mild, moderate, and severe side effects were seen in 50%, 40%, 10%, and 0%, respectively. With KSPtabs, rates were 60%, 20%, 10%, and 10%, respectively. Conclusion: In healthy participants without a history of kidney stones, LithoLyte and KSPtabs are effective over-the-counter alkali supplements, with a similar side effect profile to prescription potassium citrate.

Flexible ureteroscopes are essential devices, and reusable models require meticulous cleaning and sterilization between procedures. Reprocessing is complex, time-consuming, and difficult due to the instrument's small size, fragility, and internal channel. The Food and Drug Administration recently raised concerns about the effectiveness of ureteroscope reprocessing. Due to inadequate reprocessing and maintenance, contaminated and damaged ureteroscopes pose risks to patient safety. This review describes ureteroscope reprocessing methods and summarizes evidence on reprocessing effectiveness and documented outcomes associated with the use of damaged or inadequately cleaned and sterilized ureteroscopes.