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Background: Mesenteric panniculitis is a rare condition and refers to benign and nonspecific inflammation of mesenteric fat. Objectives: This study aimed to evaluate the hypothesis of a greater prevalence of mesenteric panniculitis in patients with urolithiasis. Materials and methods: In this cross-sectional study, abdominopelvic CT scans of 500 patients were reviewed for the presence of urolithiasis and mesenteric panniculitis. The inclusion criteria were patients who were referred with acute abdominal pain and were suspected of having urolithiasis or other urinary conditions and who had undergone abdominopelvic CT scan. Subcutaneous fat thickness was measured, and pain intensity was recorded by patient evaluation. Results: Mesenteric panniculitis was found in 10 patients, all of whom (100%) had urinary stones (ureter or kidney or both), and none of them had previous surgeries or known malignancies. The prevalence of panniculitis was significantly greater in the group with urolithiasis. In the urolithiasis group, subcutaneous fat thickness was greater in patients with panniculitis, although the difference was not statistically significant. In the subgroup analysis, pain intensity was not significantly greater in patients with panniculitis. Conclusion: Mesenteric panniculitis is more prevalent among patients with urolithiasis, but it seems that it does not change the intensity of the pain. [ABSTRACT FROM AUTHOR]

Purpose: Stone extraction is an important treatment option when performing flexible ureteroscopic lithotripsy (f-URSL) for upper urinary stones. We used a f-URSL simulator model to investigate surgical factors affecting the efficacy of stone extraction with the one-surgeon basketing technique. Materials and Methods: This simulator-based study involved eight urologists and eight residents. These participants each performed two tasks, with Flexor (Cook Medical) and Navigator (Boston Scientific) ureteral access sheaths, with and without the M-arm (MC Medical) single-use basket holder, and with models representing both left and right kidneys. The two tasks were to touch each renal calix with the ureteroscope, and to extract stones. As outcomes, we recorded the number of times that the ureteroscope became stuck during insertion, the number of times a stone was dropped during removal, the number of times the basket forceps were opened and closed, and the time required to accomplish each task. Results: The ureteroscope became stuck significantly more often when Navigator was used compared with Flexor overall, and for both urologists and residents (all p

Extracorporeal shock wave lithotripsy (ESWL) is widely considered the primary approach for managing urinary tract stones. This study aimed to assess the predictive factors associated with non-contrast computed tomography (NCCT)-based parameters of upper urinary stones in relation to the outcomes of ESWL. A systematic search was conducted in PubMed, ScienceDirect, Web of Science, and Cochrane Library to identify all relevant studies published up to June 3, 2023. Several NCCT-based parameters to predict ESWL outcomes, comprised of mean stone density (MSD), skin-to-stone distance (SSD), and stone size, were extracted and analyzed using Review Manager software. Out of 979 publications screened, a total of 39 publications, involving 7869 patients, were enrolled in the analysis. The pooled estimate demonstrated significant differences between MSD, and stone size between successful and failure of stone fragmentation groups, in which lower values of these parameters are associated with successful ESWL outcomes. The results from the current study suggested that lower NCCT parameters, notably MSD, SSD, and stone size, are significantly associated with successful ESWL outcome. However, additional large-scale prospective studies are required to utilize these parameters effectively, and the optimal cutoff value should be determined. [ABSTRACT FROM AUTHOR]

Objective To evaluate the factors affecting urinary stone detection rate using virtual unenhanced(VUE)images obtained from triphasic dual-energy CT urography(DECTU)based on Logistic regression analysis. Methods For this study, 150 patients who had suspected urinary stone and underwent triphasic DECTU were included. The true unenhanced(TUE)images were reconstructed as 120 kVp-like images, and VUE images at the portal venous phase[VUE(VP)] and excretory phase[VUE(EP)] were obtained using iodine removal technique from portal venous and excretory phase DECTU images, respectively. Two readers independently evaluated the above three types of images, and recorded the number of urinary stones, their anatomical locations, and whether there was residual iodine on the VUE images. Stone size and CT number were recorded only on the TUE images. Stone size, CT number, anatomical location, and iodine contrast agent were included in univariate and multivariate Logistic regression analyses to evaluate the factors affecting urinary stone detection rate using VUE images. Thresholds for detecting urinary stones on VUE images were determined using receiver operating characteristics(ROC)analysis. Results We detected 304 stones on TUE images, while the detection rates were 92.4% and 71.4% when using VUE(VP)and VUE(EP)images, respectively. Stone size and CT number were important factors influencing urinary stone detection rate using VUE(VP)and VUE(EP)images(P<0.01). The area under curve(AUC)of using stone size and CT number for detecting stones using the VUE(VP)images was up to 0.96, and as threshold values, stones with size larger than 3.52 mm and CT number greater than 469 HU were found to have high accuracy. However, the AUC decreased to 0.88 when we combined stone size, CT number and anatomical location using the VUE(EP)images. In addition, different contrast agents did not affect the detection rate of stones on the VUE(EP)images(P=0.57). The stone detection rate in the kidney was significantly lower than those on the VUE(EP)images(P<0.001). Conclusion VUE(VP)images provide better stone detection. Stone size and CT number have significant impacts on the stone detection rate using VUE images. The lower stone detection rate in the kidney on the VUE(EP)images is related to the residual iodine. [ABSTRACT FROM AUTHOR]

Kidney stone disease has a multifactorial etiology, and evolving dietary habits necessitate continuous updates on the impact of dietary components on lithogenesis. The relationship between diseases influenced by lifestyle, such as obesity and diabetes, and kidney stone risk underscores the need for comprehensive lifestyle analysis. Effective management of kidney stones requires a multidisciplinary approach, involving collaboration among nutritionists, urologists, nephrologists, and other healthcare professionals to address the complex interactions between diet, lifestyle, and individual susceptibility. Personalized dietary therapy, based on each patient's unique biochemical and dietary profile, is essential and necessitates comprehensive nutritional assessments. Accurate dietary intake evaluation is best achieved through seven-day, real-time dietary records. Key factors influencing urinary risk include fluid intake, dietary protein, carbohydrates, oxalate, calcium, and sodium chloride. Personalized interventions, such as customized dietary changes based on gut microbiota, may improve stone prevention and recurrence. Current research suggests individualized guidance on alcohol intake and indicates that tea and coffee consumption might protect against urolithiasis. There is potential evidence linking tobacco use and secondhand smoke to increased kidney stone risk. The effects of vitamins and physical activity on kidney stone risk remain unresolved due to mixed evidence. For diseases influenced by lifestyle, conclusive evidence on targeted interventions for nephrolithiasis prevention is lacking, though preliminary research suggests potential benefits. Management strategies emphasize lifestyle modifications to reduce recurrence risks, support rapid recovery, and identify predisposing conditions, highlighting the importance of these changes despite inconclusive data. [ABSTRACT FROM AUTHOR]

Objective: Extracorporeal shockwave lithotripsy (SWL) currently plays an important role in the treatment of urinary tract lithiasis. The purpose of this article was to describe new concepts and procedural strategies that would improve results using SWL as a treatment for urolithiasis, thereby achieving better clinical practice. Methods: A systematic review process was carried in PubMed/PMC from January 2003 to March 2023. A narrative synthesis of the most important aspects has been made. Results: The important recommendations for the adequate selection of the candidate patient for treatment with SWL are summarized, as well as the new strategies for a better application of the technique. Aspects about intraoperative position, stone localization and monitoring, analgesic control, machine and energy settings, and measures aiming at reduced risk of complications are described. Conclusion: To achieve the therapeutic goal of efficient stone disintegration without increasing the risk of complications, it is necessary to make an adequate selection of patients and to pay special attention to several important factors in the application of treatment. Technological development in later generation devices will help to improve current SWL results.

Purpose: The present study aimed to investigate the effects of α-Klotho and oxidative stress markers on urinary stone disease (USD) and demonstrate their use as biochemical markers in USD. Methods: Among the 90 individuals included, 30 individuals were healthy controls (Group 1), 30 individuals presented with USD for the first time (Group 2), and 30 individuals demonstrated recurrent USD (Group 3). Serum levels of α-Klotho, vitamin D, malondialdehyde (MDA), total oxidant status, and total antioxidant status were determined using spectrophotometry analysis. Serum calcium and parathormone levels and 24-h urine calcium levels were measured via biochemical analysis. Results: No significant intergroup difference was noted in terms of age and sex. The groups had significant differences regarding α-Klotho, oxidative stress index (OSI), MDA, and 24-h urine calcium levels. α-Klotho was a determinant of 24-h urine calcium level and OSI. An increase of 1 pg/mL in α-Klotho level appeared to result in a decrease of 8.55 mg in 24-h urine calcium level and a decrease of 0.04 Arbitrary Unit in OSI. In patients experiencing USD for the first time, α-Klotho values were < 21.83 pg/mL and showed 66% sensitivity and 64% specificity. In individuals with recurrent stone formation, α-Klotho values below 19.41 pg/mL had 60% sensitivity and 77% specificity. Conclusions: The biochemical markers investigated herein, i.e., α-Klotho, OSI, and MDA, were involved in the pathogenesis of stone formation and can be used in day-to-day clinical practices of urology clinics to identify patients at risk for both first time and recurrent USD. [ABSTRACT FROM AUTHOR]

Urinary stone disease (USD) is a prevalent urological condition, ranking as one of the most common urinary tract disorders globally. Various risk factors influence the formation of kidney stones, and recent research indicates a rising prevalence of urolithiasis worldwide, particularly in developing countries. While the morbidity associated with urinary stones has decreased in recent years, long-term complications such as stone recurrence, kidney failure, and uremia continue to burden patients. Understanding the etiologies of urolithiasis, including the role of bacteria, is crucial as they can contribute to stone recurrence. The incidence of urinary tract infection (UTI) stones can be attributed to specific infectious risk factors, socio-demographic factors, and comorbid metabolic disorders. This review article explores the emerging evidence suggesting the involvement of bacteria in USD. It discusses the potential role of microorganisms in non-infection stones and highlights the association between UTIs and urolithiasis. Furthermore, it surveys the relationship between kidney stones and recurrent UTIs and the formation of bacterial biofilms in UTIs. Considering various risk factors, including biochemical stone analysis and the presence of bacteria, is essential for treating patients with infectious stones optimally. This review aims to provide an updated understanding of the association between bacteria and urinary stones in patients with urolithiasis, shedding light on the pathophysiology of urinary stone formation, urinary stone characteristics, and the urinary microbiome in urinary stones.

Nephrolithiasis is a prevalent issue around the globe, particularly in hot climates such as Saudi Arabia. This analysis's objectives were to investigate the characteristics of kidney stones in Eastern Saudi Arabia and to provide the following findings: urinary stone composition, gender and age distribution, seasonal variations in stone formation, coexisting diseases linked to stone development, and urinary stone incidence. With comparisons to European and American populations, the primary risk factors for nephrolithiasis in Asian populations are to be determined through this systematic review and meta-analysis. We synthesized data from 13 geographically different studies using a thorough literature search through PubMed, ScienceDirect, and ResearchGate following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses criteria. Potential targets for specialized public health programs were highlighted by the elucidation of differences in health-care-seeking behavior and disparities in health-care access. The results of this systematic analysis give doctors, researchers, and policymakers a thorough understanding of the condition of nephrolithiasis care in Saudi Arabia today. In addition, to maximize the care of nephrolithiasis in this particular group, this review identifies information gaps and highlights the necessity of context-specific guidelines and future research initiatives. All things considered, this systematic review addresses the unique possibilities and problems that exist within the Saudi Arabian health-care sector while also adding to the worldwide conversation on nephrolithiasis.

Urinary stones after urinary tract infections and prostate disorders are the third most common urinary tract diseases. In recent years various herbal medicines for preventing or treating renal stones have been marketed and may be helpful in prevention and treatment, but still effectiveness and safe drug therapy without surgical intervention is controversial. This study aimed to evaluate the effects of L. judaicus in the treatment of urinary stones. In order to form stone in an animal model, 1% Ethylene Glycol (EG) dissolved in drinking water was used. Forty rats were divided into eight groups. After 45 days of drug administration, to determine the effects of the drug on urinary and serum parameters, 24-hour urine and blood samples were obtained. Then animals were sacrificed and kidneys were sent to the pathology laboratory for histological examination. Results of our study showed that prescribing L. judaicus in the co-treatment group reduced serum BUN, elevated urinary citrate and urine pH, and reduced urinary parameters such as urine protein, calcium, oxalate, phosphorus, and creatinine, therefore L. judaicus is effective in inhibition of urinary stones formation. Histopathologic results showed a decline of urinary stones in L. judaicus groups in comparison with ethylene glycol group.

Objectives: The aim of this study is to analyze the compositions of urinary stones and investigate their distributions in different ages, genders, seasons, and clinical features of Northern Vietnamese patients. Methods: A total of 231 patients with urinary stones from Northern Vietnam were collected and analyzed composition from 1/2021-12/2022. For all patients, age, sex, stone location, stone side, urine pH, and hospitalized date (month) were collected. Results: Kidney stones are more frequently found in men than women with the male: female urinary stones ratio in this study being 1.96:1. The highest stone prevalence appeared between 60 and 69 years old. The most common stone composition was calcium oxalate, followed by calcium phosphate, uric acid, struvite, and cysteine. Mix stones of CaOx and CaP were more prevalent than pure stones. Males submitted more CaOx, CaP, and UA stones, whereas females were susceptible to infectious stones. Stones were more frequently found on the left side of the upper urinary tract (51.9%) than on the right side (27.3%) and lower urinary tract (7.8%). Cultural tendency leads to a smaller number of stones during the Lunar new year (February), and Ghost month (August). [ABSTRACT FROM AUTHOR]

Nephrolithiasis is a prevalent issue around the globe, particularly in hot climates such as Saudi Arabia. This analysis's objectives were to investigate the characteristics of kidney stones in Eastern Saudi Arabia and to provide the following findings: urinary stone composition, gender and age distribution, seasonal variations in stone formation, coexisting diseases linked to stone development, and urinary stone incidence. With comparisons to European and American populations, the primary risk factors for nephrolithiasis in Asian populations are to be determined through this systematic review and meta-analysis. We synthesized data from 13 geographically different studies using a thorough literature search through PubMed, ScienceDirect, and ResearchGate following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses criteria. Potential targets for specialized public health programs were highlighted by the elucidation of differences in health-care-seeking behavior and disparities in health-care access. The results of this systematic analysis give doctors, researchers, and policymakers a thorough understanding of the condition of nephrolithiasis care in Saudi Arabia today. In addition, to maximize the care of nephrolithiasis in this particular group, this review identifies information gaps and highlights the necessity of context-specific guidelines and future research initiatives. All things considered, this systematic review addresses the unique possibilities and problems that exist within the Saudi Arabian health-care sector while also adding to the worldwide conversation on nephrolithiasis. [ABSTRACT FROM AUTHOR]

Urinary stones after urinary tract infections and prostate disorders are the third most common urinary tract diseases. In recent years various herbal medicines for preventing or treating renal stones have been marketed and may be helpful in prevention and treatment, but still effectiveness and safe drug therapy without surgical intervention is controversial. This study aimed to evaluate the effects of L. judaicus in the treatment of urinary stones. In order to form stone in an animal model, 1% Ethylene Glycol (EG) dissolved in drinking water was used. Forty rats were divided into eight groups. After 45 days of drug administration, to determine the effects of the drug on urinary and serum parameters, 24-hour urine and blood samples were obtained. Then animals were sacrificed and kidneys were sent to the pathology laboratory for histological examination. Results of our study showed that prescribing L. judaicus in the co-treatment group reduced serum BUN, elevated urinary citrate and urine pH, and reduced urinary parameters such as urine protein, calcium, oxalate, phosphorus, and creatinine, therefore L. judaicus is effective in inhibition of urinary stones formation. Histopathologic results showed a decline of urinary stones in L. judaicus groups in comparison with ethylene glycol group. [ABSTRACT FROM AUTHOR]

To investigate the optimal scanning parameters of dual-energy computed tomography (DECT), which can accurately determine sensitivity (the detectability of urinary stones) and accuracy (the composition matching of urinary stones), and to apply them to clinical trials. Fifteen urinary stones were chemically analyzed, and their chemical compositions were considered a reference standard with which we compared the uric acid (UA) and non-UA compositions determined using DECT. The urinary stones were placed inside a bolus and scanned with a dual-source CT scanner under various selected dual-energy conditions (A to X) using various solid water phantom thicknesses. These datasets were analyzed using the Siemens syngo.via software tool (integrated into the CT system) for matching the sensitivity and accuracy assessments. This study showed that 80% of the highest sensitivity (detection of urinary stones) and 92% of the highest accuracy (composition matching of urinary stones) were achieved under condition A (a collimation beam width setting of 2 × 32 × 0.6 mm, an automatic exposure control setting of 80/sn140 peak kilovoltage, and a slice thickness of 0.5/0.5 mm) (P < 0.05). Application of the DECT energy parameters presented in the study will help identify the sensitivity and accuracy of UA and non-UA stone analysis, even in patients with small-sized urinary stones and in conditions difficult for analysis. [ABSTRACT FROM AUTHOR]

Kidney stone disease has a multifactorial etiology, and evolving dietary habits necessitate continuous updates on the impact of dietary components on lithogenesis. The relationship between diseases influenced by lifestyle, such as obesity and diabetes, and kidney stone risk underscores the need for comprehensive lifestyle analysis. Effective management of kidney stones requires a multidisciplinary approach, involving collaboration among nutritionists, urologists, nephrologists, and other healthcare professionals to address the complex interactions between diet, lifestyle, and individual susceptibility. Personalized dietary therapy, based on each patient’s unique biochemical and dietary profile, is essential and necessitates comprehensive nutritional assessments. Accurate dietary intake evaluation is best achieved through seven-day, real-time dietary records. Key factors influencing urinary risk include fluid intake, dietary protein, carbohydrates, oxalate, calcium, and sodium chloride. Personalized interventions, such as customized dietary changes based on gut microbiota, may improve stone prevention and recurrence. Current research suggests individualized guidance on alcohol intake and indicates that tea and coffee consumption might protect against urolithiasis. There is potential evidence linking tobacco use and secondhand smoke to increased kidney stone risk. The effects of vitamins and physical activity on kidney stone risk remain unresolved due to mixed evidence. For diseases influenced by lifestyle, conclusive evidence on targeted interventions for nephrolithiasis prevention is lacking, though preliminary research suggests potential benefits. Management strategies emphasize lifestyle modifications to reduce recurrence risks, support rapid recovery, and identify predisposing conditions, highlighting the importance of these changes despite inconclusive data.

Background: urinary stones are one of the most prevalent urological diseases worldwide. Aim: this study aimed to evaluate the effect of multimedia on dietary regimen for patients with urinary system stones. Design: A quasi experimental study. Setting: The study conducted at the Student Educational Hospital and Urology Department at Tanta Universal Teaching Hospital and both are affiliated to Tanta University Hospital. Subjects: A convenience sample of 60 adult conscious patients diagnosed with urolithiasis. Tools: Three tools were enrolled in the study for data collection: Tool (I) Socio-demographic and clinical data tool, Tool (II): Patients' knowledge assessment questionnaire, Tool (III): patients' perception assessment regarding using multimedia questionnaire. Results: there was a highly statistical significant difference in Patients' knowledge levels after application of multimedia through period of the study, pretest was (6.6%) which developed to (78.3%) posttest then become (80%) in follow up also the majority of the studied patients (81.7%) had satisfaction regarding using multimedia and only (18.3) didn't have satisfaction. Conclusion: the multimedia improved patients' knowledge and there was an increase in patients' satisfaction regarding using multimedia in health education. Recommendation: it was recommended that using multimedia and audio-visual materials in continuous health education regarding dietary regimen for urinary tract stone as it is important in improvement of patients' knowledge and nursing role. [ABSTRACT FROM AUTHOR]

Background and Objectives: Urinary tract stones have long been a common ailment afflicting the population, with a high incidence and a wide distribution across different age groups. Effectively preventing the occurrence of urinary tract stones is of paramount importance. The primary aim of this study is to investigate the correlations between individual characteristics, water consumption habits, dietary habits, exercise habits, and the occurrence of urinary tract stones in a Taiwanese population. Materials and Methods: This study is cross-sectional research conducted over one month in 2022. One hundred eligible urinary stone cases were recruited through physician screening at outpatient clinics, and an additional one hundred samples from surgical outpatients without urinary tract stones were included as the control group. A questionnaire survey was employed to gather information on demographic variables, dietary habits, water consumption, and exercise habits of the cases. Descriptive statistics, chi-square tests, and logistic regression were used to explore the impact of relevant factors on urinary stone formation. Results: The analysis results revealed that among the demographic variables, males exhibited a higher risk of contracting urinary tract stones than females, and the majority of cases fell within the 40- to 49-year-old age group. Unhealthy lifestyle habits such as smoking and betel nut chewing also demonstrated a higher susceptibility to urinary tract stones. A logistic regression analysis showed that individuals who engaged in physical activity more than three times per week and those with inadequate water intakes had a higher risk of developing urinary tract stones. Conclusions: There is a close relationship between lifestyle and urinary tract stones. It is recommended that individuals continue to hydrate adequately during exercise. [ABSTRACT FROM AUTHOR]

Flexible ureteroscopy (f-URS) is a minimally invasive surgical technique used for treating urinary tract stones. While general anesthesia (GA) is the standard method used, it comes with risks. Local anesthesia (LA) is a safer and more cost-effective alternative to GA, and its use in f-URS could potentially reduce patients' risks and increase accessibility to treatment. This study aims to investigate the feasibility, safety, and efficacy of using LA for f-URS in treating stones, as an initial experience in the diagnosis related group (DRG) era of China. Patients who met the inclusion and exclusion criteria and were continuously included in the study Between 2021 and 2023. We analyzed the stone free status, postoperative complication rate, hospitalization costs, and presented key points of the procedure performed under LA that we had summarized over the past two years. A study of 614 patients undergoing f-URS under LA for urinary stones in our hospital showed 83.4% stone-free rate with a mean operative time of 44.12 ± 16.63 minutes; 18 patients experienced fever postoperatively, and 12 had ureteral injuries. No severe complication was reported. The cost of LA was found to be only 1.7% of the DRG payment, which is around $40. The highest VAS scores were observed during the sheath insertion, with STAI scores decreasing during and after surgery. The study revealed that f-URS administered under LA was a well-tolerated, efficient, safe, and economical procedure. In the DRG era, this new anesthetic option for f-URS provides urologists with a more cost-effective alternative. [ABSTRACT FROM AUTHOR]

Objective To review the experience of metabolic evaluation of urinary stones in Peking Union Medical College Hospital, and summarize the ‘PUMCH model’ of metabolic evaluation. Methods With descriptive evaluation method, this study reviewed and analyzed 534 metabolic evaluation cases in the urology department of Peking Union Medical College Hospital from Jan. 2016 to Dec. 2021. The distribution differences of stone patients in gender, medical history, stone shape, stone composition, renal function, systemic metabolism and 24-hour urine metabolism were observed. Results This study found that males were more than females in terms of gender differences in stone patients; The average course of stone disease was about 10 years, and the first symptom was mainly renal colic; Calcium oxalate was the most common stone component; Kidney stone was more than urethral stone; Hyperlipidemia was the most common in patients with stones; The low concentration of urinary citrate was the most significant. Conclusions As a new method of stone diagnosis and treatment, the ‘PUMCH model’ of metabolic evaluation can comprehensively evaluate the patients' stone incidence and systemic metabolic abnormalities, which has a strong guiding role in stone treatment and prevention.

Abstract Background Absolute polycythemia can be primary or secondary. Erythropoietin-producing diseases (for example, hypoxia) are the major cause of secondary polycythemia. There are reports of polycythemia secondary to hydronephrosis. However, to our knowledge, there is no report on polycythemia secondary to hydronephrosis due to a urinary stone. Herein, we present a case of polycythemia with an elevated erythropoietin level in a patient with a urinary stone and unilateral hydronephrosis. Case presentation A 57-year-old Japanese man presented with polycythemia and an elevated erythropoietin level. Erythropoietin accumulation was not due to erythropoietin secretion by a tumor as no obvious lesions were detected on contrast-enhanced computed tomography. Abdominal ultrasonography revealed a stone in the left urinary tract and renal hydronephrosis, and 2 weeks later, the patient underwent transurethral ureterolithotripsy without complications. Blood tests 2 weeks after transurethral ureterolithotripsy showed that the erythropoietin level had declined. Hemoglobin concentration decreased from 20.8 mg/dL before and immediately after transurethral ureterolithotripsy to 15.8 mg/dL 3 months after transurethral ureterolithotripsy. This case was diagnosed as erythropoietin elevation due to unilateral hydronephrosis with a urinary stone, resulting in polycythemia. Conclusions Hydronephrosis is a common disease but is not often associated with polycythemia. Further studies are required to elucidate the mechanism and implications of elevated erythropoietin production in hydronephrosis.

In this research, we proposed a two-stage pipeline for segmenting urinary stones. The first stage U-Net generated the map localizing the urinary organs in full abdominal x-ray images. Then, this map was used for creating partitioned images input to the second stage U-Net to reduce class imbalance and was also used in stone-embedding augmentation to increase a number of training data. The U-Net model was trained with the combination of real stone-contained images and synthesized stone-embedded images to segment urinary stones on the partitioned input images. In addition, we proposed to use an inverse weighting method in the focal Tversky loss function in order to rebalance lesion size. The U-Net model using our proposed pipeline produced a 71.28% pixel-wise $F_{2}$ score and a 69.82% region-wise $F_{2}$ score, which were 2.88% and 7.63%, respectively, higher than those of a baseline method. Experimental results showed that the proposed method improved urinary stone segmentation results, especially for small stones and stones in uncommon locations.

Introduction: Urolithiasis is the third most common and painful disease in the globe, afflicting both men and women. The accumulation of a few minerals and crystalline elements in the renal calculi and urinary bladder are during the process of metabolism. The study's goals were to determine the frequency of risk variables for urinary stone patients. Methods: Across-sectional study had on urinary stone disease in Thanjavur and the surrounding areas. The study included 102 cases, 79 urinary stone patients, and 23 normal patients that all lived in the same area. Results: A total of 102 participants between the ages of 20 - 70 were studied. Thirty-eight percentages of urinary stone patients were over 60 years old. In this study, men accounted for 63 %. It was discovered that kidney stone patients were more prevalent in the age groups 41-70 (77%) and

Objective To review the experience of metabolic evaluation of urinary stones in Peking Union Medical College Hospital, and summarize the ‘PUMCH model’ of metabolic evaluation. Methods With descriptive evaluation method, this study reviewed and analyzed 534 metabolic evaluation cases in the urology department of Peking Union Medical College Hospital from Jan. 2016 to Dec. 2021. The distribution differences of stone patients in gender, medical history, stone shape, stone composition, renal function, systemic metabolism and 24-hour urine metabolism were observed. Results This study found that males were more than females in terms of gender differences in stone patients; The average course of stone disease was about 10 years, and the first symptom was mainly renal colic; Calcium oxalate was the most common stone component; Kidney stone was more than urethral stone; Hyperlipidemia was the most common in patients with stones; The low concentration of urinary citrate was the most significant. Conclusions As a new method of stone diagnosis and treatment, the ‘PUMCH model’ of metabolic evaluation can comprehensively evaluate the patients’ stone incidence and systemic metabolic abnormalities, which has a strong guiding role in stone treatment and prevention. [ABSTRACT FROM AUTHOR]

Background: Noncontrast CT (NCCT) relies on labor-intensive examinations of CT slices to identify urolithiasis in the urinary tract, and, despite the use of deep-learning algorithms, false positives remain. Materials and Methods: A total of 410 NCCT axial scans from patients undergoing surgical treatment for urolithiasis were used for model development. The deep learning model was customized to combine a urolithiasis segmentation with per-slice classification for screening. Prediction models of the axial, coronal, and sagittal views were trained, and an additive model with an intersection of the coronal and sagittal predictions added to the axial outcome was introduced. Automated quantification of clinical metrics was evaluated in three-dimensional models of urinary stones. Results: The axial model detected 88.92% of urinary stones and produced a dice similarity coefficient of 87.56% in the urolithiasis segmentation. For urolithiasis (>5 mm), the sensitivity of the axial model reached 95.10%. False positives were reduced to 0.34 per patient using an ensemble of individual models. The additive model improved the sensitivity to 90.97% by detecting more small urolithiasis (<5 mm). All clinical metrics of size, long-axis diameter, volume, mean stone density, stone heterogeneity index, and skin-to-stone distance showed a strong correlation of R2 > 0.964. Conclusions: The proposed system could reduce the burden on the physician for imaging diagnosis and help determine treatment strategies for urinary stones through automated quantification of clinical metrics with high accuracy and reproducibility. [ABSTRACT FROM AUTHOR]

Laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) studies on trace element concentration and their spatial distribution in CaC2O4-matrix urinary stones are important but powerfully rely on matrix-matched external calibration. In this work, CaC2O4 precipitate CaOx-1 which was doped with Mg, Cr, Mn, Fe, Co, Cu, Zn, and Sr was prepared by the homogeneous co-precipitation method. It had a homogeneous distribution of major (RSD of 0.46%) and trace elements (RSD of 1.83–6.92%) due to the negligible concentration difference compared with that prepared by the heterogeneous co-precipitation method. Based on this, an analytical method for quantitative determination of elemental concentration in CaC2O4-matrix samples was established using CaOx-1 as a calibration standard, and the accuracy of this method was assessed by calibrating the elemental concentration in another synthetic CaC2O4 precipitate CaOx-2 with relative deviation (Dr) from − 11.43% (Mn) to 9.76% (Mg). Finally, a methodology for quantitative imaging of Mg, Cr, Mn, Fe, Co, Cu, Zn, and Sr in urinary stones via LA-ICP-MS was developed. From the elemental distributional maps, an annular texture can be found for Mg, Cu, Zn, and Sr, which corresponds to the annular white and brown texture in the real urinary stone. A homogeneous distribution of Fe and low concentrations of Cr and Co were found throughout the stone, while Mn was highly concentrated in the margin of the stone. All these results demonstrate that quantitative distribution patterns of Mg, Cr, Mn, Fe, Co, Cu, Zn, and Sr can be obtained by LA-ICP-MS using CaOx-1 as a calibration standard, which can provide potential evidence for urological and other medical studies. [ABSTRACT FROM AUTHOR]

Background: Mutrashmari (urolithiasis), a pathological condition of the urinary system where aggregation of urinary crystalloids takes place anywhere in the urinary tract, i.e., from the kidney to urinary bladder showing male preponderance (male:female = 2:1) and now becoming medico-surgical as well as economical challenge for all health-care systems. Aims: The aim of this study is to evaluate the effect of Palasha Kshara (alkali) with Ashmarihara Kwatha (decoction) in the management of Mutrashmari (urolithiasis). Materials and method: Thirty-nine patients of Mutrashmari were selected and randomly allocated with a computerized randomized method into two groups. In trial group A (n = 20), capsule Palasha Kshara (Mridu), 500 mg three times a day after meal, and Ashmarihara Kwatha (decoction) (40 ml twice daily) were given orally after meals for 2 months. In placebo control group B (n = 19), placebo capsule (granulated wheat), was given in a dosage of 500 mg along with 3-4 l of water for 2 months. Results: Patients of Palasha Kshara and Ashmarihara Kwatha group showed better relief in chief complaints, i.e., pain and increased frequency of micturition as compared to the placebo group. Complete remission of symptoms of Mutrashmari was more in patients treated with Palasha Kshara with Ashmarihara decoction. Conclusion: Palasha Kshara with Ashmarihara Kwatha is found more effective than placebo in the management of Mutrashmari (urolithiasis). [ABSTRACT FROM AUTHOR]

Background: Absolute polycythemia can be primary or secondary. Erythropoietin-producing diseases (for example, hypoxia) are the major cause of secondary polycythemia. There are reports of polycythemia secondary to hydronephrosis. However, to our knowledge, there is no report on polycythemia secondary to hydronephrosis due to a urinary stone. Herein, we present a case of polycythemia with an elevated erythropoietin level in a patient with a urinary stone and unilateral hydronephrosis. Case presentation: A 57-year-old Japanese man presented with polycythemia and an elevated erythropoietin level. Erythropoietin accumulation was not due to erythropoietin secretion by a tumor as no obvious lesions were detected on contrast-enhanced computed tomography. Abdominal ultrasonography revealed a stone in the left urinary tract and renal hydronephrosis, and 2 weeks later, the patient underwent transurethral ureterolithotripsy without complications. Blood tests 2 weeks after transurethral ureterolithotripsy showed that the erythropoietin level had declined. Hemoglobin concentration decreased from 20.8 mg/dL before and immediately after transurethral ureterolithotripsy to 15.8 mg/dL 3 months after transurethral ureterolithotripsy. This case was diagnosed as erythropoietin elevation due to unilateral hydronephrosis with a urinary stone, resulting in polycythemia. Conclusions: Hydronephrosis is a common disease but is not often associated with polycythemia. Further studies are required to elucidate the mechanism and implications of elevated erythropoietin production in hydronephrosis. [ABSTRACT FROM AUTHOR]

Background: Urinary stone disease is very common, with an estimated prevalence among the general population of 2% to 3% and an estimated lifetime risk of 1 in 8 for white males and 5% to 6% for white females, with men forming stones three times as often as women. Aim of the Work: To compare the effectiveness of antispasmodics (hyoscine-N-butylbromide), a-blockers (tamsulosin), placebo as control (in the form of multivitamins), as preoperative medications for ureteral dilatation prior to semirigid ureteroscopic stone surgery. Patients and Methods: This prospective randomized control clinical study conducted on 90 patients admitted from Urology department, Faculty of Medicine, Ain Shams University hospitals in a period of 6 months starting from March 2022 till September 2022; they were randomized into 3 groups 30 patients per group: Group (A) received Tamsulosin 0.4 mg once daily for 7 days, Group (B) received Hyoscine-N-butylbromide 10 mg three times per day for 7 days, Group (C) received Placebo. Results: The operation time and the need of double J stent insertion significantly decrease with Tasmulosin or Hyoscine-N-butylbromide versus Placebo. Operative and postoperative complications significantly decrease while using Tamsulosin or Hyoscine-N-butylbromide versus Placebo. Conclusion: The administration of adjunctive alpha-blockers and/or antispasmodics prior to ureteroscopic management of lower ureteric stones seems to be associated with better advancing of the ureteroscope to access the stone, shorter procedure time, higher stone-free rate, lower incidence of intra- and postoperative complications and lesser need for postoperative analgesia. [ABSTRACT FROM AUTHOR]

Background: Urinary stones comprise both single and mixed compositions. Knowledge of the stone composition helps the urologists choose appropriate medical interventions for patients. The parameters from the spectral computerized tomography (CT) analysis have potential values for identification of the urinary stone compositions. Purpose: The present study aims to identify the compositions of urinary stones in vivo using parameters from spectral CT and machine learning, based on multilabel classification modeling. Methods: This retrospective study collected 252 urinary stone samples with single/mixed compositions (including carbapatite [CP], calcium oxalate monohydrate [COM], calcium oxalate dehydrate [COD], uric acid [UA], and struvite [STR]), which were confirmed by ex vivo infrared spectroscopy. Parameters were extracted from an energy spectrum analysis (ESA) of the spectral CT, including the effective atomic number (Zeff), Zeff histogram, CT values at a given x-ray energy level, and material densities. These ESA parameters were utilized for composition analysis via a multi-label classification fusion framework, where 250 multi-label models were built and the classification decisions from the top performance models were integrated by a multi-criterion weighted fusion (MCWF) approach in order to reach a consensus prediction. An example-based metric Accexam and label-based metric Acclabel were used for global and labelwise accuracy evaluations, respectively. The top-ranked parameters associated with discriminating the stone composition were also identified. Results: The multi-label classification fusion framework achieved an overall Accexam of 81.2%, with Acclabel of 86.7% (CP), 90.6% (COM), 80.6% (COD), 95.0% (UA), and 94.4% (STR) for each composition on the independent testing cohort 1, and Accexam of 76.4% with Acclabel of 80.5% (CP), 88.7% (COM), 74.9% (COD), 94.4% (UA), and 98.5% (STR) on the independent testing cohort 2. Conclusion: The parameters extracted from the ESA on spectral CT can be utilized to characterize single or mixed stone compositions via multi-label classification modeling. The generalization capability of the proposed methodology still requires further verification. [ABSTRACT FROM AUTHOR]

To analyze characteristics of urinary phospate stones using spectral CT (rapid kV switching dual-energy CT) in vivo. This study included 55 single-composition and 36 mixed-composition infection stones, which were derived from 38 patients (15 males and 23 females), with median age of 49 years old (range 10–71). The effective nuclear number (Zeff) peak, its high and low points, average Zeff value, water- and iodine-based values, and average CT values were detected. Post-surgical infrared spectroscopy results were compared with CT findings. In single-composition stones, 21 were of carbapatite, 20 of struvite, and 14 of brushite. These stones differed significantly in Zeff peak, its low and high points, average Zeff value, and iodine-based value. Three compositions had similar water-based and average CT values. The 36 mixed-composition stones all had two Zeff peaks, which included 23 of carbapatite, 25 of struvite, and 24 of brushite. When 95% confidence intervals of Zeff peaks in single-composition stones were as standard, this standard overlapped 82.6% of carbapatite, 88.0% of struvite, and 87.5% of brushite in mixed-composition stones. But many low and high points in three mixed-composition groups were outside the 95% confidence interval (overlap < 70%). The significance differences were not observed in water/iodine-based, average Zeff and average CT values. Zeff peaks in vivo spectral CT revealed some characteristics of various phospate stones. [ABSTRACT FROM AUTHOR]

We present a rare case of the clip migration after laparoscopic partial nephrectomy in which the clips were misdiagnosed as urinary stones. A 57-years-old female presented with right flank pain 3 months after the surgery. A computed tomography scan showed a 4 mm stone in the left upper ureter and hydronephrosis. Another 3 mm stone was also detected in the left upper calyx. Rigid ureteroscopy and flexible ureterorenoscopy revealed two LAPRA-TY clips, which were embedded in the upper ureter and calyx. The clips were fragmented by holmium laser lithotripsy and removed with stone basket. Pain and hydronephrosis are resolved at follow-up.

Background and Objectives: Urinary tract stones have long been a common ailment afflicting the population, with a high incidence and a wide distribution across different age groups. Effectively preventing the occurrence of urinary tract stones is of paramount importance. The primary aim of this study is to investigate the correlations between individual characteristics, water consumption habits, dietary habits, exercise habits, and the occurrence of urinary tract stones in a Taiwanese population. Materials and Methods: This study is cross-sectional research conducted over one month in 2022. One hundred eligible urinary stone cases were recruited through physician screening at outpatient clinics, and an additional one hundred samples from surgical outpatients without urinary tract stones were included as the control group. A questionnaire survey was employed to gather information on demographic variables, dietary habits, water consumption, and exercise habits of the cases. Descriptive statistics, chi-square tests, and logistic regression were used to explore the impact of relevant factors on urinary stone formation. Results: The analysis results revealed that among the demographic variables, males exhibited a higher risk of contracting urinary tract stones than females, and the majority of cases fell within the 40- to 49-year-old age group. Unhealthy lifestyle habits such as smoking and betel nut chewing also demonstrated a higher susceptibility to urinary tract stones. A logistic regression analysis showed that individuals who engaged in physical activity more than three times per week and those with inadequate water intakes had a higher risk of developing urinary tract stones. Conclusions: There is a close relationship between lifestyle and urinary tract stones. It is recommended that individuals continue to hydrate adequately during exercise.

IntroductionTo evaluate the clinical benefit of preoperative adrenergic α1-antagonist therapy in the management of upper urinary calculi.Materials and methodsPublications were searched for The Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE until 1 March 2022 that related to the adrenergic α1- antagonist intake as adjunctive therapy before retrograde surgery. Dichotomous data were reported with risk ratios (RR) with 95% confidence intervals (CIs) and the continuous data were reported with mean difference (MD) with 95% CIsResultsThere were nine studies with 867 patients included in this meta-analysis. Preoperative adrenergic α1- antagonists could significantly elevate the compared with the placebo. Higher successful access rate to the stone was found in patients who received preoperative adrenergic α1- antagonists than those who received the placebo (RR 1.24; 95% CI 1.17–1.33). Besides, the application of preoperative adrenergic α1- antagonists can also elevate 4th-week stone-free rate (RR 1.20; 95% CI 1.12–1.28), decrease postoperative analgesia (RR 0.30;95% CI 0.20–0.46) and result in a lower risk of overall complications (RR 0.38; 95% CI 0.24–0.61).ConclusionPreoperative adjunctive adrenergic α1- antagonist therapy is effective and safe in the management of retrograde surgery with a higher successful access rate and lower risk of severe complications.

The present investigation exposes the main results raised from an active collaboration started in 2018 with the San Pio Hospital (Benevento, Southern Italy), aiming at a detailed mineralogical investigation of urinary stones of patients from the Campania region. Forty-nine uroliths (both bladder and kidney stones) have been surgically collected from patients admitted between 2018 and 2020 at the Department of Urology of the San Pio Hospital and characterized for clinical purposes and environmental biomonitoring from a mineralogical point of view. Possible causes and environmental implications were inferred according to the morpho-constitutional classification of the uroliths carried out by means of a conventional analytical approach. The mineralogical frequency distribution of uroliths from the Campanian region can be discussed as a function of dietary, socio-demographic, and environmental risk factors. Whewellite [CaC2O4·H2O] and weddellite [CaC2O4·(2+x)H2O], along with anhydrous calcium oxalate, represent the main mineralogical phases forming the biominerals examined here. Worth to note is that the percentage of oxalates in the Campanian region (ca. 51%) is quite comparable to those of other Mediterranean areas. Frequent uricite [C5H4N4O3] (ca. 33%), mainly observed in bladder stones of older male patients, could be related to an incorrect lifestyle and dietary habits. Occurrence of lower percentages of phosphate (i.e., brushite [CaHPO4·2(H2O)] and carbonated apatite [Ca10(PO4CO3)6(OH)8]) and mixed stones (such as, for example, a mixture of ammonium urate [NH4C5H3N4O3] and calcium oxalates) indicates specific etiopathogenetic mechanisms, suggesting proper therapeutical approaches. [ABSTRACT FROM AUTHOR]

Background To develop risk scoring for the use of computed tomography (CT) imaging using the visual analog scale (VAS), physical examination, and laboratory findings of renal colic patients admitted to the emergency department (ED). Materials and Methods This is prospective observational study. Among the patients who presented to the ED with abdominal or flank pain, patients who were scheduled for CT imaging for urolithiasis were included in the study. The mean VAS pain scores, physical examination findings, laboratory parameters, and macroscopic and microscopic values in urinalysis were compared between the two groups with and without stones on CT. Results Of the 196 urolithiasis patients included in the study, 165 had ureteral stones, 76 had renal stones, and 45 had renal and ureteral stones. While the difference between the urine erythrocyte averages of the two groups was borderline significant (p = 0.04), there was a high difference between the urinary hemoglobin amounts (p < 0.001). In patients with urinary system stone disease, hydronephrosis, and ureteral dilatation, hemoglobin ++ and above were more significant (p < 0.001). For ureteral stones, pain intensity increased as the size increased (r = 0.34 p < 0.001). White blood cells > 10,000 10 3 /mL, and C-reactive protein (CRP) ≤ 5 mg/L were more significant in patients with acute renal colic. Conclusions Although we cannot develop a clinical scoring system for renal colic patients, the meaningful results we found for urinary stone disease can be used in a newly developed scoring system. It can be used in new scoring systems in the ED using a high VAS score, presence and amount of urine hemoglobin, CRP) ≤ 5 mg/L, and creatinine value. [ABSTRACT FROM AUTHOR]

Background/Aim: Urinary system stone disease creates a significant burden on the health system. Many treatment methods are available, including extracorporeal shock wave lithotripsy (ESWL), endourological procedures, and open and laparoscopic procedures. In recent years, in parallel with technological developments, endourological devices have become more usable in the renal system. For this reason, urologists are opting for endourological procedures more frequently. ESWL is the least invasive procedure for urinary system stone disease, and it has a higher success rate in pediatric patients than in adults. In this retrospective cohort study, we analyzed the data from the pediatric cases in which we used ESWL treatment in our clinic. We aimed to reveal the effectiveness of ESWL and the factors that will increase the success rate of this procedure in light of the current literature. Methods: The files of patients aged 16 years and under who underwent ESWL at the Urology Clinic of University of Health Sciences Sanliurfa Mehmet Akif Inan Training and Research Hospital between January 2010 and December 2021 were retrospectively reviewed. Age, gender, stone area, stone localization, number of sessions, energy and frequency used, complete stone-free status, and secondary intervention requirement were recorded. The absence of stone fragments or the presence of fragments smaller than 3 mm only in imaging after ESWL was considered a success. Results: This study included 433 pediatric patients. The mean age of the patients was calculated as 12.02 (4.67) (range: 1-16) years. The most important factors affecting the number of residual stones were stone localization (P = 0.045) and size (P < 0.001). When stone localization was compared according to patient age, the older patients were found to have a significantly higher rate of stones in the proximal ureter than in the lower calyx of the kidney (P = 0.045) and renal pelvis (P = 0.048). Conclusion: Although there are continual advances in other minimally invasive surgical methods today, ESWL is a treatment method that can be safely applied in pediatric patients. Stone size and stone localization are the two most important factors affecting its success rate. [ABSTRACT FROM AUTHOR]

Background and objective Urinary stones are a prevalent medical condition entailing significant health burdens and substantial financial ramifications. Its global prevalence is expected to rise notably, particularly in low-middle-income nations. Understanding the spectrum of diverse urinary stone types is crucial for effective management and prevention. This study aims to elucidate the demographic profiles, clinical types, and recurrence of urinary stone cases at a tertiary care hospital in Eastern India. Methods and materials The clinical data from the electronic medical record of 1,231 patients with urolithiasis who underwent surgery in a tertiary care center in eastern India from January 2015 to November 2022 were retrospectively analyzed. Patient data, including demographic information, clinical records, dietary habits, water intake, and stone recurrence history, were collected. A thorough statistical analysis was conducted to elucidate the associations between patient characteristics, urinary stone composition, and recurrence. Results Among the 1,231 participants, the majority of cases (343 (27.9%)) were in the 31-40 age group, with a higher prevalence in males (876 (71.2%)) than in females (355 (28.8%)). Flank pain or abdominal pain (593 (48.1%)) was the primary complaint, followed by nausea/vomiting (227 (18.5%)). Most stones (922 (74.9%)) were located in the kidney, and calcium oxalate was the predominant stone component (773 (62.8%)). The highest stone recurrence rates were in patients aged between 21-30 years (21 (36.8%)) and 31-40 years (16 (28.0%)). A low non-vegetarian diet and adequate hydration may reduce the likelihood of stone recurrences. Conclusion This study provides insights into the compositional analysis of urinary stones in the eastern Indian population, addressing the causes of their recurrence and management strategies, which are crucial for prevention and effective management. The findings indicate that the early middle-aged group exhibited the highest incidence of urinary stones. We also observed that strict adherence to a low animal protein, along with proper hydration and lifestyle changes, significantly reduced urinary stone recurrence., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ranchi Urology Centre's Institutional Ethics Committee issued approval (RUC IEC 04/23). The committee has reviewed the submitted proposal for stone analysis involving human participants and found no harm to the patients during the course of the study. Therefore, the study is approved in its current state. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kumar et al.)

Determine the epidemiological characteristics of urolithiasis in the South region of Tunisia and the impact of age and sex on stone composition. We conducted a retrospective study including patient records whose urinary lithiasis was analyzed within the biochemistry department of CHU Habib Bourguiba of Sfax (2011-2020). Stone analysis was performed using a stereomicroscope and infrared spectroscopy. A total of 1127 stones were analyzed. The sex ratio was 2,6. Renal Colic pain was the most common symptom (48,3%). The most frequent localization of the stones (84.6%) was the upper urinary tract. Whewellite was the most common component (64.1%). The study of stone component according to age showed a decrease in the frequency of weddellite (p = 0,024) and an increase in the frequency of uric acid stones with age (p < 0,001). Whewellite was more frequent in men (p = 0.022) and, notably in our series, uric acid was significantly more frequent in women (p < 0.001). The epidemiological profile of urolithiasis in south of Tunisia is similar to that observed in industrialized countries.

Abstrak. Batu kemih merupakan salah satu penyakit dengan tingkat prevalensi yang cukup tinggi di Indonesia. Pengetahuan komposisi pada kandungan batu kemih dapat membantu tenaga medis dalam melakukan justifikasi penanganan tindakan lanjut pada pasien dengan tepat.Tujuan penelitian iniadalah menentukan kandungan mineral yang terdapat pada batu kemih menggunakan metode analisa spektrum inframerah dan nilai hounsfield unit (HU) yang terdapat pada citra yang dihasilkan dari modality mCT-Scan. Hasil karakterisasi fourier transform infrared spectroscopy (FTIR) memperlihatkan kandungan mineral batu kemih terdiri dari batu kemih calcium oxlate monohydrate, uric acid, batu campuran calcium oxalate dengan phosphate dan batu campuran cystine dengan phosphate sedangkan hasil dari scanning mCT memperlihatkan adanya kandungan mineral batu kemih campuran seperti batu campuran calcium oxalate dan cystine, batu campuran calcium oxalate, struvite, dan cystine, dan batu campuran calciumoxalate dan uric acid.Dari hasil penelitian ini dapat disimpulkan bahwa kedua modaliti tersebut mampu memperlihatkan kandungan mineral batu kemih dengan baik. Hal ini terlihat adanya spektrum serapan karakteristik dari FTIR setiap sampel berbeda-beda dan dari hasil citra mCT-Scan memperlihatkan nilai HU yang bervariasi sehingga mengindikasikan kandungan mineral pada sampel batu kemih yang diamati juga memiliki jenis yang berbeda-beda. Abstract. Urinary stones are a disease with a high prevalence rate in Indonesia. Knowledge of the composition of the urinary stone is an essential part to determine suitable treatments for patients. The aim of this research is to determine the mineral contained in urinary stones using the infrared spectrum and the value of HU (hounsfield unit) from the image mCT-Scan. The results of FTIR characterization showed that the mineral content of urinary stones consisted of calcium oxlate monohydrate, uric acid, calcium oxalate and phosphate mixed stones and cystine-phosphate mixed stones. mCT-Scan results showed the mineral content of urinary stones such as calcium oxalate and cystine mixed stone, calcium oxalate, struvite, and cystine mixed stones, and calcium oxalate and uric acid mixed stones. This show that the two modalities are be able to determine the mineral content of urinary stones. It can be seen that the characteristic absorption spectrum of the FTIR for each sample is different and from the mCT-Scan image results, the HU value varies so that it indicates the mineral content of the observed urine stone sample are different.

The prevalence of renal stones has been increasing due to changes in lifestyle and behavioural habits, causing major economic and health burdens worldwide. This study aimed to determine the relationship between urolithiasis and behavioural habits and underlying diseases. This case–control study was performed on 161 patients with urinary stone disease and 254 healthy controls who were age‐ and sex‐matched with the case group. All participants were interviewed by the researcher using a questionnaire. Among different behavioural habits, consuming alcoholic drinks and smoking were reported more frequently in the renal stone formers compared to the controls (p = 0.007 and p = 0.004, respectively). However, the amount of water intake and level of physical activity were lower among the stone formers (p < 0.0001 and p = 0.009, respectively). Investigation of the two groups' past medical history revealed that the positive history of diseases such as diabetes mellitus (p < 0.0001), hypertension (p = 0.004), hyperlipidemia (p = 0.004) and urinary tract infections (p < 0.0001) was more common in the patients with urinary stones compared to the control group. In terms of medications, the use of antihypertensive drugs (p = 0.045), antidiabetic drugs (p = 0.12), analgesics (p = 0.04) and anti‐inflammatory drugs (p = 0.047) was significantly higher in the case group than in the control group. The study findings showed that some behavioural habits and specific underlying diseases were associated with urinary stones. In this regard, by careful assessment of personal health history and medical history, it is possible to identify at‐risk individuals and take measures to reduce their risk of developing the disease. [ABSTRACT FROM AUTHOR]

Background: Urinary stones usually start at a young age and tend to recur. Therefore, preventing stone occurrence and recurrence in young people is crucial. We aimed to investigate the association between subcutaneous adipose tissue, visceral adipose tissue, and stone episodes in young people. Methods: We retrospectively studied patients aged below 40 years with kidney or ureteral stones. Data on demographic and metabolic characteristics, urolithiasis history, subcutaneous fat area (SFA), and visceral fat area (VFA) were collected. We evaluated the association between SFA or VFA and the occurrence or recurrence of stone episodes using binary logistic regression and Poisson regression analyses. Results: In total, 120 patients were included. Abdominal obesity, overweight or obesity, dyslipidemia, metabolic syndrome, SFA, and VFA increased with the number of stone episodes (all p < 0.05). The increase in SFA was independently associated with episode occurrence (p = 0.015). Patients with an SFA > 97 cm2 had a higher risk of episode occurrence. SFA and VFA accumulation were independently associated with episode recurrence (all p < 0.05), and SFA had a stronger association than VFA did. Conclusions: In young people, SFA accumulation is an independent and early risk factor for the occurrence and recurrence of stone episodes. Subcutaneous fat could be a convenient and effective indicator to assess the risk of stone episodes before the development of metabolic disorders. [ABSTRACT FROM AUTHOR]

Abstract Background The Democratic Republic of Congo has been a country of intensive mining activities for centuries, but the data on the presence of heavy metals in stones are lacking. This study aimed to identify different heavy metals in urinary tract stones and to investigate their association with the main components of urinary stones. Methods Thirty-six stones from urolithiasis patients (n = 36) followed in 10 hospitals in the Democratic Republic of Congo between January 2016 and September 2019 were analyzed by Fourier transform infrared spectrophotometry. Further analysis using X-ray fluorescence was conducted at the Laboratory of Solids Physics. Results Eight heavy metals were detected in all the stones analyzed. The average (SD) number of heavy metals detected by stone was 5 (1.2). Iron and strontium were detected in all the stones analyzed. Other heavy metals detected included zinc, copper, bromine, rubidium, lead and nickel. Rubidium had the highest concentration in the stones regardless of the sampling site. There was no statistically significant association between the content of heavy metals at the center level and at the crown level of the stones. Rubidium had more affinity with phosphates and purines (p ˂ 0.001). Iron and strontium exhibited a high affinity with weddellite than with whewellite. Conclusion Iron and Strontium were present in all stones analyzed. The presence of heavy metals in stones analyzed might suggest environmental pollution rather than crystalline induction factors.

BackgroundUrinary stones usually start at a young age and tend to recur. Therefore, preventing stone occurrence and recurrence in young people is crucial. We aimed to investigate the association between subcutaneous adipose tissue, visceral adipose tissue, and stone episodes in young people.MethodsWe retrospectively studied patients aged below 40 years with kidney or ureteral stones. Data on demographic and metabolic characteristics, urolithiasis history, subcutaneous fat area (SFA), and visceral fat area (VFA) were collected. We evaluated the association between SFA or VFA and the occurrence or recurrence of stone episodes using binary logistic regression and Poisson regression analyses.ResultsIn total, 120 patients were included. Abdominal obesity, overweight or obesity, dyslipidemia, metabolic syndrome, SFA, and VFA increased with the number of stone episodes (all p < 0.05). The increase in SFA was independently associated with episode occurrence (p = 0.015). Patients with an SFA > 97 cm2 had a higher risk of episode occurrence. SFA and VFA accumulation were independently associated with episode recurrence (all p < 0.05), and SFA had a stronger association than VFA did.ConclusionsIn young people, SFA accumulation is an independent and early risk factor for the occurrence and recurrence of stone episodes. Subcutaneous fat could be a convenient and effective indicator to assess the risk of stone episodes before the development of metabolic disorders.

This study investigated the effect of the discontinuation of vitamin D supplementation on kidney stone formation in children under 2 years of age. This study involved a retrospective analysis of two patient groups. The first group comprised postoperative patients who were stone-free, while the second group consisted of asymptomatic patients with kidney stones. The patients who discontinued vitamin D supplementation and those who continued were compared in terms of stone formation and stone size progression. The data collected included patient characteristics, stone size measurements, and laboratory results. The findings showed that the discontinuation of vitamin D supplementation was not associated with kidney stone formation or the progression of stone size in either group. For patients who were stone-free on ultrasonography 1 month after the operation, according to the 12-month ultrasonography evaluation, in the group that discontinued vitamin D, 42 (78%) patients had no stones, 6 (11%) patients had stones larger than 3 mm, and 6 (11%) patients had microlithiasis. However, in the group that continued vitamin D, 49 (72%) patients were stone-free, 10 (15%) patients had stones larger than 3 mm, and 9 (13%) patients had microlithiasis. There was no difference between the groups in terms of stone status at 12 months (p = 0.76). For patients with asymptomatic kidney stones, the initial stone sizes were similar between the groups (p = 0.74). During the 6th month of ultrasound, the changes in stone size were 1.76 ± 1.81 mm and 1.79 ± 1.75 mm for the two groups, respectively (p = 0.9). During the 12-month ultrasound measurement, the changes in stone size were 1.98 ± 2.93 mm and 2.60 ± 2.48 mm for the two groups, respectively (p = 0.09). We believe that more research is needed to make definitive recommendations regarding vitamin D prophylaxis in infants with kidney stones. Although the first objective of our study is not conclusively proven with the current findings, we recommend continued vitamin D prophylaxis in infants with urolithiasis. Summary table Patient demographic characteristics and ultrasonography results at 12 months. Summary table (n) Stone-free After Surgery (122) Vitamin D Discontinuation Group (54) Vitamin D Group (68) Age (months mean ± SD) 13.19 ± 4.08 11.57 ± 4.59 Gender Boy 39 (72%) Girl 15 (28%) Boy 47 (69%) Girl 21 (31%) 12th month ultrasound imaging 42 (78%) Stone-free 6 (11%) Stone larger than 3 mm 6 (11%) microlithiasis 49 (72%) Stone-free 10 (15%) Stone larger than 3 mm 9 (13%) microlithiasis Asymptomatic Patients (228) Vitamin D Discontinuation Group (101) Vitamin D Group (127) Age (months mean ± SD) 11.89 ± 4.24 11.54 ± 4.52 Gender Boy 71 (70%) Girl 30 (30%) Boy 83 (65%) Girl 44 (35%) 12th month ultrasound imaging 1.98 ± 2.93 mm (stone size change) 2.60 ± 2.48 mm (stone size change) [ABSTRACT FROM AUTHOR]

Backgound: The composition of stones formed in the urinary tract plays an important role in their management over time. The most common imaging method for the non-invasive evaluation of urinary stones is radiography and computed tomography (CT). However, CT is not very sensitive, and cannot differentiate between all critical stone types. In this study, we propose the application, and evaluate the potential, of a multi-modal (or multi-contrast) X-ray imaging technique called speckle-based imaging (SBI) to differentiate between various types of urinary stones. Methods: Three different stone samples were extracted from animal and human urinary tracts and examined in a laboratory-based speckle tracking setup. The results were discussed based on an X-ray diffraction analysis and a comparison with X-ray microtomography and grating-based interferometry. Results: The stones were classified through compositional analysis by X-ray diffraction. The multi-contrast images obtained using the SBI method provided detailed information about the composition of various urinary stone types, and could differentiate between them. X-ray SBI could provide highly sensitive and high-resolution characterizations of different urinary stones in the radiography mode, comparable to those by grating interferometry. Conclusions: This investigation demonstrated the capability of the SBI technique for the non-invasive classification of urinary stones through radiography in a simple and cost-effective laboratory setting. This opens the possibility for further studies concerning full-field in vivo SBI for the clinical imaging of urinary stones. [ABSTRACT FROM AUTHOR]

The aim of this work was to compare the fragmentation efficiency of a novel, pulsed Thulium solid-state laser (p-Tm:YAG) to that of a chopped Thulium fibre laser (TFL) and a pulsed Holmium solid-state laser (Ho:YAG). During the fragmentation process, we used a silicone mould to fixate the hemispherical stone models under water in a jar filled with room-temperature water. Each laser device registered the total energy applied to the stone model to determine fragmentation efficiency. Our study examined laser settings with single pulse energies ranging from 0.6 to 6 J and pulse frequencies ranging from 5 to 15 Hz. Similar laser settings were applied to explicitly compare the fragmentation efficiency of all three devices. We experimented with additional laser settings to see which of the three devices would perform best. The fragmentation performance of the three laser devices differed statistically significantly (p < 0.05). The average total energy required to fragment the stone model was 345.96 J for Ho:YAG, 372.43 J for p-Tm:YAG and 483.90 J for TFL. To fragment the stone models, both Ho:YAG and p-Tm:YAG needed similar total energy (p = 0.97). TFL's fragmentation efficiency is significantly lower than that of Ho:YAG and p-Tm:YAG. Furthermore, we found the novel p-Tm:YAG's fragmentation efficiency to closely resemble that of Ho:YAG. The fragmentation efficiency is thought to be influenced by the pulse duration. TFL's shortest possible pulse duration was considerably longer than that of Ho:YAG and p-Tm:YAG, resulting in Ho:YAG and p-Tm:YAG exhibiting better fragmenting efficiency. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The study aimed to compare the outcomes of patients undergoing ureterorenoscopy (URS) after failed shock-wave lithotripsy (SWL) (Salvage URS) with those undergoing URS without any history of SWL (Primary URS). MATERIALS AND METHODS: PubMed, Embase, and CENTRAL databases were searched up to 10th January 2021 for studies comparing outcomes of salvage URS vs. primary URS. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for procedure success and complications. Operating time was summarized using mean difference (MD). RESULTS: Seven retrospective studies were included. Meta-analysis indicated no statistically significant difference in the success rates of URS between the salvage URS and primary URS groups (OR: 0.83 95% CI: 0.65, 1.06 I2=0% p=0.13). On subgroup analysis, the success rate was significantly reduced in the salvage URS group for renal stones (OR: 0.55 95% CI: 0.34, 0.91 I2=0% p=0.02) but with no difference for ureter stones OR: 0.90 95% CI: 0.67, 1.21 I2=0% p=0.49). Pooled analysis demonstrated a tendency of longer operating time in the salvage URS group as compared to the primary URS group, albeit with a statistically non-significant difference (MD: 8.91 95% CI: -0.56, 18.38 I2=98% p=0.07). Meta-analysis indicated significantly increased complications in the salvage URS group as compared to the primary URS group (OR: 1.83 95% CI: 1.34, 2.49 I2=0% p=0.0001). CONCLUSIONS: Evidence from retrospective studies suggests that patients undergoing salvage URS for renal stones have significantly lower success rates which is not the case for ureteral stones. There is a non-significant tendency of increased operating times for salvage URS. Complication rates are significantly higher for salvage URS as compared to primary URS. Future studies with propensity-score matching are required to strengthen current conclusions. [ABSTRACT FROM AUTHOR]