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Berger I, Medairos R, Margolin E, Antonelli J, Lipkin ME, Scales CD, Kaye DR. Work absence and productivity loss of patients undergoing a trial of spontaneous passage for ureteral stones. Urolithiasis 2024; 52:111. [PMID: 39105811 DOI: 10.1007/s00240-024-01608-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 07/20/2024] [Indexed: 08/07/2024]
Abstract
Patients with ureteral stones are often managed with a spontaneous trial of passage. While cost effective, the current literature has not examined the effects of a trial of passage on patients' work productivity. In this study, we aim to characterize work absence and productivity losses in a cohort of patients undergoing a trial of passage for ureteral stones. Actively employed patients aged 18 to 64 and discharged from Duke emergency departments without surgical intervention for ureteral stones ≤ 10 mm were contacted by phone four weeks after their presentation. Participants completed the Institute for Medical Technology Assessment Productivity Cost Questionnaire which assesses three domains: absenteeism - missed work; presenteeism -productivity when returning to work; and unpaid work - assistance with household work. Linear regression associated demographic and stone factors with productivity losses.109 patients completed the survey. In total, 67% of patients missed work, 46% had decreased productivity when returning to work, and 55% required assistance with unpaid work. 59% of patients with stones ≤ 5 mm missed work versus 84% with stones > 5 mm (p = 0.009). African American race (coefficient 23.68, 95% confidence interval 2.24-45.11, p = 0.031), first-time stone formers (coefficient 20.28, 95% confidence interval 2.50-38.07, p = 0.026), and patients with stones > 5 mm (coefficient 25.34, 95% CI 5.25-45.44, p = 0.014) were associated with increased productivity losses. The majority of patients miss work while undergoing a trial of passage and many have decreased productivity when returning to work. This information may help counsel patients in emergency departments, especially first-time stone formers, and prevent return visits.
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Affiliation(s)
- Ian Berger
- Department of Urology, Duke University Medical Center DUMC, 3704 Duke South Yellow Zone Room 1079, 27710, Durham, NC, USA.
| | - Robert Medairos
- Department of Urology, Duke University Medical Center DUMC, 3704 Duke South Yellow Zone Room 1079, 27710, Durham, NC, USA
| | - Ezra Margolin
- Department of Urology, Duke University Medical Center DUMC, 3704 Duke South Yellow Zone Room 1079, 27710, Durham, NC, USA
| | - Jodi Antonelli
- Department of Urology, Duke University Medical Center DUMC, 3704 Duke South Yellow Zone Room 1079, 27710, Durham, NC, USA
| | - Michael E Lipkin
- Department of Urology, Duke University Medical Center DUMC, 3704 Duke South Yellow Zone Room 1079, 27710, Durham, NC, USA
| | - Charles D Scales
- Department of Urology, Duke Clinical Research Institute, Duke University Medical Center, Duke University National Clinician Scholars Program, Duke University School of Medicine, Durham, NC, USA
| | - Deborah R Kaye
- Department of Urology, Duke Clinical Research Institute, Duke Cancer Institute, Margolis Center for Health Policy, Duke University Medical Center, Duke University School of Medicine, Duke University School of Medicine, Duke University, Durham, NC, USA
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Shee K, Liu AW, Chan C, Yang H, Sui W, Desai M, Ho S, Chi T, Stoller ML. A Novel Machine-Learning Algorithm to Predict Stone Recurrence with 24-Hour Urine Data. J Endourol 2024; 38:809-816. [PMID: 39121452 DOI: 10.1089/end.2023.0457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2024] Open
Abstract
Objectives: The absence of predictive markers for kidney stone recurrence poses a challenge for the clinical management of stone disease. The unpredictability of stone events is also a significant limitation for clinical trials, where many patients must be enrolled to obtain sufficient stone events for analysis. In this study, we sought to use machine learning methods to identify a novel algorithm to predict stone recurrence. Subjects/Patients and Methods: Patients enrolled in the Registry for Stones of the Kidney and Ureter (ReSKU), a registry of nephrolithiasis patients collected between 2015-2020, with at least one prospectively collected 24-hour urine test (Litholink 24-hour urine test; Labcorp) were included in the training set. A validation set was obtained from chart review of stone patients not enrolled in ReSKU with 24-hour urine data. Stone events were defined as either an office visit where a patient reports symptomatic passage of stones or a surgical procedure for stone removal. Seven prediction classification methods were evaluated. Predictive analyses and receiver operator characteristics (ROC) curve generation were performed in R. Results: A training set of 423 kidney stone patients with stone event data and 24-hour urine samples were trained using the prediction classification methods. The highest performing prediction model was a Logistic Regression with ElasticNet machine learning model (area under curve [AUC] = 0.65). Restricting analysis to high confidence predictions significantly improved model accuracy (AUC = 0.82). The prediction model was validated on a validation set of 172 stone patients with stone event data and 24-hour urine samples. Prediction accuracy in the validation set demonstrated moderate discriminative ability (AUC = 0.64). Repeat modeling was performed with four of the highest scoring features, and ROC analyses demonstrated minimal loss in accuracy (AUC = 0.63). Conclusion: Machine-learning models based on 24-hour urine data can predict stone recurrences with a moderate degree of accuracy.
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Affiliation(s)
- Kevin Shee
- Department of Urology, UCSF, San Francisco, California, USA
| | - Andrew W Liu
- Department of Urology, UCSF, San Francisco, California, USA
| | - Carter Chan
- Department of Urology, UCSF, San Francisco, California, USA
| | - Heiko Yang
- Department of Urology, UCSF, San Francisco, California, USA
| | - Wilson Sui
- Department of Urology, UCSF, San Francisco, California, USA
| | - Manoj Desai
- Department of Urology, UCSF, San Francisco, California, USA
| | - Sunita Ho
- Department of Urology, UCSF, San Francisco, California, USA
| | - Thomas Chi
- Department of Urology, UCSF, San Francisco, California, USA
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Assad A, Raizenne BL, El Yamani MEM, Saud A, Bechis SK, Sur RL, Nakada SY, Streeper NM, Sivalingam S, Pais VM, Chew BH, Bird VG, Andonian S, Penniston KL, Bhojani N. The impact of kidney stone disease on quality of life in high-risk stone formers. BJU Int 2024; 133:570-578. [PMID: 38332669 DOI: 10.1111/bju.16294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To assess the impact of kidney stone disease (KSD) and its treatment on the health-related quality of life (HRQOL) of high-risk stone formers with hyperparathyroidism, renal tubular acidosis, malabsorptive disease, and medullary sponge kidney. PATIENTS AND METHODS The Wisconsin Stone Quality of Life questionnaire was used to evaluate HRQOL in 3301 patients with a history of KSD from 16 institutions in North America between 2014 and 2020. Baseline characteristics and medical history were collected from patients, while active KSD was confirmed through radiological imaging. The high-risk group was compared to the remaining patients (control group) using the Wilcoxon rank-sum test. RESULTS Of 1499 patients with active KSD included in the study, the high-risk group included 120 patients. The high-risk group had significantly lower HRQOL scores compared to the control group (P < 0.01). In the multivariable analyses, medullary sponge kidney disease and renal tubular acidosis were independent predictors of poorer HRQOL, while alkali therapy was an independent predictor of better HRQOL (all P < 0.01). CONCLUSIONS Among patients with active KSD, high-risk stone formers had impaired HRQOL with medullary sponge kidney disease and renal tubular acidosis being independent predictors of poorer HRQOL. Clinicians should seek to identify these patients earlier as they would benefit from prompt treatment and prevention.
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Affiliation(s)
- Anis Assad
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Brendan L Raizenne
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | | | - Almousa Saud
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Seth K Bechis
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Roger L Sur
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Stephen Y Nakada
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Necole M Streeper
- Department of Urology, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Sri Sivalingam
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Vernon M Pais
- Urology Section, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vincent G Bird
- Department of Urology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Sero Andonian
- Division of Urology, McGill University Health Center, Montreal, Quebec, Canada
| | - Kristina L Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Naeem Bhojani
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
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Siener R, Stein J, Ritter M. [Prevention of recurrence of urolithiasis]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:387-395. [PMID: 38466398 DOI: 10.1007/s00120-024-02312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
Urolithiasis is one of the most frequent urological diseases. Identifying the causes of stone formation forms the basis for successful prevention of recurrence. Metabolic diagnostics and measures for prevention of recurrence are based on the assignment of the patient to a low-risk or high-risk group. Analysis of the urinary calculi is an essential prerequisite for identifying patients at risk. The general recommendations on diet and lifestyle are considered to be the basis of treatment. Depending on the type of stone and the individual biochemical risk profile of a patient, these general measures should be supplemented by targeted medical nutrition therapy and pharmacological treatment. Mixed stones can pose a challenge for the treatment and prevention of recurrence. A personalized treatment decision that takes the various components of mixed stones into account could further improve the prevention of recurrence of urolithiasis.
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Affiliation(s)
- Roswitha Siener
- Universitäres Steinzentrum, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - Johannes Stein
- Universitäres Steinzentrum, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Manuel Ritter
- Universitäres Steinzentrum, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
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Vo AK, Somani BK, Ulvik Ø, Beisland C, Seitz C, Juliebø-Jones P. Measuring quality of life in patients with kidney stone disease: is it the future in endourology? Curr Opin Urol 2024; 34:91-97. [PMID: 37889517 DOI: 10.1097/mou.0000000000001138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
PURPOSE OF REVIEW Kidney stone disease is recognized to negatively impact quality of life. This pertains to acute episodes, surgical interventions and even during asymptomatic periods. Over time there has been increased attention towards assessing this subjective parameter, including as a determinant of treatment success. Our aim was to evaluate the current status and emerging trends in this field. RECENT FINDINGS Patient groups most affected appear to be recurrent stone formers, cystine stone formers, women, younger populations, non-Caucasians and low-income populations. Several stone specific patient reported outcome measures are now available of which, WISQol has been implemented the most in clinical research studies. More invasive interventions such as percutaneous nephrolithotomy impede quality of life to greater extent than alternatives such as shockwave lithotripsy. SUMMARY There are certain patient groups who are more vulnerable to the negative impact of kidney stone disease on their quality of life. Urologists can improve patient care by recognizing these particular populations as well as by implemented patient reported outcome measures in their routine clinical practice and when performing research.
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Affiliation(s)
- Anh Khoi Vo
- Department of Urology, Haukeland University Hospital, Bergen, Norway
| | | | - Øyvind Ulvik
- Department of Urology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Christian Beisland
- Department of Urology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Christian Seitz
- Department of Urology, Medical University of Vienna, Austria
| | - Patrick Juliebø-Jones
- Department of Urology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Caglar U, Erbin A, Ucpinar B, Ayranci A, Sarilar O, Yanaral F, Baykal M, Ozgor F, Akbulut F. Failed insertion of ureteral access sheath during flexible ureterorenoscopy: a randomized controlled trial comparing second session flexible ureterorenoscopy or same session mini percutaneous nephrolithotomy. Int Urol Nephrol 2024; 56:433-439. [PMID: 37807032 DOI: 10.1007/s11255-023-03820-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE To compare different treatment approaches in patients with failed ureteral access sheath placement during first flexible ureterorenoscopy (f-URS) session. METHODS Patients with kidney stones measuring 1-2 cm, presented to our urology clinic between September 2020 and September 2021, were included in the study for evaluation. The study was designed prospectively (Clinical-Trials number NCT05911945). Patients were randomized into two groups, in case of a failed ureteral access sheath placement during the first f-URS session. In group 1, JJ stent was placed for dilation and second session of f-URS was planned. In group 2, mini percutaneous nephrolithotomy (mPNL) was performed in the same session. RESULTS Twenty-four patients were included in each group. Pre-operative demographic data and stone characteristics of the patients in each group were comparable. Operation time, fluoroscopy time, and hospital stay were significantly higher in the mini-PNL group. When SF-36 values were compared, physical function, pain, role limitation, and general health value scores were improved in both groups after treatment. The improvement in physical function and pain parameters was statistically significant in the mPNL group. In patients with failed ureteral access sheath placement, placing a JJ stent for dilation and postponing f-URS for 4-6 weeks provides the advantages of low hospitalization time for each admission, shorter fluoroscopy and operation time. CONCLUSIONS Performing mPNL in the same session, results in better improvements in SF-36 parameters such as pain and physical function compared to f-URS. The success and complication rates of the two procedures were comparable.
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Affiliation(s)
- Ufuk Caglar
- Department of Urology, Haseki Training and Research Hospital, Ugur Mumcu Mahallesi, Belediye Sokak, No:7, Sultangazi, Istanbul, Turkey.
| | - Akif Erbin
- Department of Urology, Haseki Training and Research Hospital, Ugur Mumcu Mahallesi, Belediye Sokak, No:7, Sultangazi, Istanbul, Turkey
| | - Burak Ucpinar
- Department of Urology, Haseki Training and Research Hospital, Ugur Mumcu Mahallesi, Belediye Sokak, No:7, Sultangazi, Istanbul, Turkey
| | - Ali Ayranci
- Department of Urology, Haseki Training and Research Hospital, Ugur Mumcu Mahallesi, Belediye Sokak, No:7, Sultangazi, Istanbul, Turkey
| | - Omer Sarilar
- Department of Urology, Haseki Training and Research Hospital, Ugur Mumcu Mahallesi, Belediye Sokak, No:7, Sultangazi, Istanbul, Turkey
| | - Fatih Yanaral
- Department of Urology, Haseki Training and Research Hospital, Ugur Mumcu Mahallesi, Belediye Sokak, No:7, Sultangazi, Istanbul, Turkey
| | - Murat Baykal
- Department of Urology, Haseki Training and Research Hospital, Ugur Mumcu Mahallesi, Belediye Sokak, No:7, Sultangazi, Istanbul, Turkey
| | - Faruk Ozgor
- Department of Urology, Haseki Training and Research Hospital, Ugur Mumcu Mahallesi, Belediye Sokak, No:7, Sultangazi, Istanbul, Turkey
| | - Fatih Akbulut
- Department of Urology, Haseki Training and Research Hospital, Ugur Mumcu Mahallesi, Belediye Sokak, No:7, Sultangazi, Istanbul, Turkey
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Almeras C, Raynal G, Meria P. 2022 recommendations of the AFU Lithiasis Committee: Objectives, results, residual stones and fragments. Prog Urol 2023; 33:893-900. [PMID: 37918990 DOI: 10.1016/j.purol.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 11/04/2023]
Abstract
The main objectives of interventional stone treatment are stone removal, symptom elimination, and kidney function preservation. After treatment of kidney stones (extracorporeal shock wave lithotripsy [ESWL], or endoscopy), fragments may remain in the kidney, either deliberately left in place or due to treatment failure (i.e. residual stone [RS], resistant to ESWL, left or inaccessible by endoscopy), or due to failure to eliminate the obtained fragments (i.e. residual fragments [RF]). Their management may differ. The most commonly used definition of RF in the literature is based on a size cut-off (≤4mm) and on three criteria: spontaneous clearance rate, secondary intervention rate, and disease progression rate. RF may be spontaneously eliminated (42%), persist and increase in size (32%), or become complicated and require a secondary urological procedure (36%). Like for the initial treatment, it is important to consider the stone composition for the treatment decision-making concerning RS/RF. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendation (CPR) method and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis) (EAU, 2022) and their adaptability to the French context.
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Affiliation(s)
- C Almeras
- UroSud, clinique La Croix du Sud, Quint-Fonsegrives, France.
| | - G Raynal
- GRC lithiase, Sorbonne université, AP-HP, Paris, France
| | - P Meria
- Service d'urologie, hôpital Saint-Louis, AP-HP, centre université Paris Cité, Paris, France
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Siener R, Pitzer MS, Speller J, Hesse A. Risk Profile of Patients with Brushite Stone Disease and the Impact of Diet. Nutrients 2023; 15:4092. [PMID: 37764875 PMCID: PMC10534559 DOI: 10.3390/nu15184092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
This study examined the profile of patients and the impact of diet on the risk of brushite stone formation under controlled, standardized conditions. Sixty-five patients with brushite nephrolithiasis were enrolled in the study. Metabolic, dietary, and 24 h urinary parameters were collected under the habitual, self-selected diet of the patients and the balanced mixed, standardized diet. The [13C2]oxalate absorption, ammonium chloride, and calcium loading tests were conducted. All patients had at least one abnormality on the usual diet, with hypercalciuria (84.6%), increased urine pH (61.5%), and hyperphosphaturia (43.1%) being the most common. Absorptive hypercalciuria was present in 32.1% and hyperabsorption of oxalate in 41.2%, while distal renal tubular acidosis (dRTA) was noted in 50% of brushite stone formers. The relative supersaturation of brushite did not differ between patients with and without dRTA. Among all recent brushite-containing calculi, 61.5% were mixed with calcium oxalate and/or carbonate apatite. The relative supersaturation of brushite, apatite, and calcium oxalate decreased significantly under the balanced diet, mainly due to the significant decline in urinary calcium, phosphate, and oxalate excretion. Dietary intervention was shown to be effective and should be an integral part of the treatment of brushite stone disease. Further research on the role of dRTA in brushite stone formation is needed.
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Affiliation(s)
- Roswitha Siener
- University Stone Center, Department of Urology, University Hospital Bonn, 53127 Bonn, Germany
| | - Maria Sofie Pitzer
- University Stone Center, Department of Urology, University Hospital Bonn, 53127 Bonn, Germany
| | - Jan Speller
- Department of Medical Biometry, Informatics and Epidemiology, Medical Faculty, University of Bonn, 53127 Bonn, Germany
| | - Albrecht Hesse
- University Stone Center, Department of Urology, University Hospital Bonn, 53127 Bonn, Germany
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Zeng G, Zhong W, Chaussy CG, Tiselius HG, Xu C, Turney B, Turk C, Tailly GG, Preminger GM, Akpinar H, Petrik A, Bernardo N, Wiseman O, Farahat Y, Budia A, Jones DK, Beltran Suarez E, De Marco F, Mazzon G, Lv J, Natchagande G, Guven S, Ibrahim TAA, Xu H, Xie L, Ye Z, Sarica K. International Alliance of Urolithiasis Guideline on Shockwave Lithotripsy. Eur Urol Focus 2023; 9:513-523. [PMID: 36435718 DOI: 10.1016/j.euf.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/04/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022]
Abstract
Different international associations have proposed their own guidelines on urolithiasis. However, the focus is primarily on an overview of the principles of urolithiasis management rather than step-by-step technical details for the procedure. The International Alliance of Urolithiasis (IAU) is releasing a series of guidelines on the management of urolithiasis. The current guideline on shockwave lithotripsy (SWL) is the third in the IAU guidelines series and provides a clinical framework for urologists and technicians performing SWL. A total of 49 recommendations are summarized and graded, covering the following aspects: indications and contraindications; preoperative patient evaluation; preoperative medication; prestenting; intraoperative analgesia or anesthesia; intraoperative position; stone localization and monitoring; machine and energy settings; intraoperative lithotripsy strategies; auxiliary therapy following SWL; evaluation of stone clearance; complications; and quality of life. The recommendations, tips, and tricks regarding SWL procedures summarized here provide important and necessary guidance for urologists along with technicians performing SWL. PATIENT SUMMARY: For kidney and urinary stones of less than 20 mm in size, shockwave lithotripsy (SWL) is an approach in which the stone is treated with shockwaves applied to the skin, without the need for surgery. Our recommendations on technical aspects of the procedure provide guidance for urologists and technicians performing SWL.
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Affiliation(s)
- Guohua Zeng
- Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China.
| | - Wen Zhong
- Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Christian G Chaussy
- University of Munich, Munich, Germany; University of Regensburg, Regensburg, Germany
| | - Hans Göran Tiselius
- Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Changbao Xu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ben Turney
- Department of Urology, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Christian Turk
- Department of Urology, Hospital of the Sisters of Charity, Vienna, Austria
| | | | - Glenn M Preminger
- Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Haluk Akpinar
- Department of Urology, Florence Nightingale Hospitals Group, Istanbul, Turkey
| | - Ales Petrik
- Department of Urology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Norberto Bernardo
- Department of Urology, Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
| | - Oliver Wiseman
- Department of Urology, Cambridge University Hospitals, Cambridge, UK
| | - Yasser Farahat
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Alberto Budia
- Department of Urology, La Fe Polytechnic University Hospital, Valencia, Spain
| | - David K Jones
- Department of Pharmacology, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Edgar Beltran Suarez
- Department of Urology, Specialty Hospital La Raza, National Medical Center of the Mexican Institute of Social Security, Mexico City, Mexico
| | - Ferdinando De Marco
- Urology Division, Istituto Neurotraumatologico Italiano-Grottaferrata, Rome, Italy
| | - Giorgio Mazzon
- Department of Urology, San Bassiano Hospital, Vicenza, Italy
| | - Jianlin Lv
- Department of Urology, Jiangning Hospital, Nanjing Medical University, Nanjing, China
| | | | - Selcuk Guven
- Urology Department, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | | | - Hanfeng Xu
- Department of Urology, First Affiliated Hospital of University of South China, Henyang, China
| | - Lei Xie
- Department of Urology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Zhangqun Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kemal Sarica
- Department of Urology, Biruni University Medical School, Istanbul, Turkey.
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Shojaei-Zarghani S, Safarpour AR, Askari H, Jahromi HK, Abbasi E, Fattahi MR. Metabolic Syndrome and Nephrolithiasis; A Cross Sectional Population-based Study on the Baseline Data of the PERSIAN Kavar Cohort Study. Urology 2023; 173:61-67. [PMID: 36435345 DOI: 10.1016/j.urology.2022.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/19/2022] [Accepted: 11/06/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the relationship between metabolic syndrome and its components with nephrolithiasis. METHODS In current study, 4,901 individuals from the PERSIAN (Prospective Epidemiological Research Studies in IrAN) Kavar cohort study were included. Metabolic syndrome was defined according to the ATP III criteria (2005 revision). The nephrolithiasis was assessed using a structured questionnaire, and ultrasound findings were reviewed in subjects who reported positive history of nephrolithiasis. We applied logistic regression to estimate the odds ratio (OR) and 95% confidence interval (CI). RESULTS The prevalence of nephrolithiasis and metabolic syndrome was 28.5% and 40.91%, respectively. Almost 31% of the patients with metabolic syndrome had a history of nephrolithiasis. Multivariable logistic regression analysis revealed a positive association between metabolic syndrome and nephrolithiasis (OR= 1.30, 95% CI: 1.14-1.49, P<.001) after adjustment age, sex, ethnicity, physical activity, smoking status, and alcohol intake. Furthermore, the relation was higher for elders aged 50 years or more (P for interaction= .016) and Turk Nomad participants (P for interaction= 0.044) than the others. There was also a positive independent association between hypertension (OR=1.29, 95% CI: 1.12-1.48, P<.001) and hypertriglyceridemia (OR= 1.15, 95% CI: 1.01-1.31, P=.033) with nephrolithiasis. CONCLUSION In this large sample study, we demonstrate a weak positive association between metabolic syndrome, hypertension, and hypertriglyceridemia with nephrolithiasis.
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Affiliation(s)
- Sara Shojaei-Zarghani
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hassan Askari
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Kargar Jahromi
- Research center for non-Communicable Disease, Jahrom University of Medical Sciences, Jahrom, Iran; Zoonoses research center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Elham Abbasi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Lu IC, Yang CC, Huang CH, Chen SY, Lin CW, Lin CH, Chuang HY. The Risk Factors for Radiolucent Nephrolithiasis among Workers in High-Temperature Workplaces in the Steel Industry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15720. [PMID: 36497793 PMCID: PMC9738220 DOI: 10.3390/ijerph192315720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Workers in high-temperature workplaces with inadequate water supply may exhibit symptoms of chronic dehydration and have increased risk of nephrolithiasis. The aim of this study was to investigate the risk of radiolucent stone formation among workers in a high-temperature workplace and the related risk factors associated with the condition. We collected data from 1681 workers in a steel factory in Southern Taiwan who underwent regular health examinations. Radiolucent stones were defined as positive findings on ultrasound with negative radiographic images. The prevalences of nephrolithiasis and radiolucent stones in this study were 12.0% and 5.1%, respectively. Heat exposure and age were two major risk factors influencing the probability of radiolucent stones. We combined the age and heat exposure into four groups (over and under 35 years of age with and without heat exposure) in a logistic regression. For workers younger than 35 years, the odds ratio of radiolucent stones was 2.695 (95% confidence interval: 1.201-6.049) in workers with heat exposure compared to workers without. Our investigation further demonstrated that heat exposure was a main risk factor for radiolucent stone formation. In conclusion, our identification of heat exposure as an independent factor for radiolucent stone development in steel workers highlights the need for attention to be paid to those working in similar environments.
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Affiliation(s)
- I-Cheng Lu
- Department of Occupational Medicine, E-Da Hospital, I-Shou University, Kaohsiung City 824, Taiwan
| | - Chen-Cheng Yang
- Department of Occupational Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City 812, Taiwan
| | - Chi-Hsien Huang
- Department of Family Medicine, E-Da Hospital, I-Shou University, Kaohsiung City 824, Taiwan
| | - Szu-Ying Chen
- Department of Occupational Medicine, E-Da Hospital, I-Shou University, Kaohsiung City 824, Taiwan
| | - Chi-Wei Lin
- Department of Family Medicine, E-Da Hospital, I-Shou University, Kaohsiung City 824, Taiwan
| | - Chia-Hsiang Lin
- Department of Urology Medicine, E-Da Hospital, I-Shou University, Kaohsiung City 824, Taiwan
| | - Hung-Yi Chuang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, and Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
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12
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Thompson WR, Tolofari SK, Starmer B, Broome J, Garrod H, Agarwal K, Wong K, Panayi Z, Hughes K, Iskander M, Javed S, Kelly P, Lazarowicz H, Calvert RC. Patient-reported outcome measures (PROMs) in stone surgery: A multi-centre study of patient experience of flexible ureteroscopy (fURS) versus extracorporeal shockwave lithotripsy (SWL). JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221135692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives: To compare patient-reported outcome measures (PROMs) for patients with symptomatic renal stone disease treated by flexible ureterorenoscopy (fURS) and shockwave lithotripsy (SWL) Introduction: Historically, surgical outcomes are measured by surgeon-specific outcomes such as ‘stone-free rates’. More recently, there is increasing emphasis on PROMs to ascertain a patient’s perspective of their own surgical outcome. Despite this, the literature in reference to renal stone-specific PROMs following stone treatment remains limited. Methods: Data were collected in a prospective multi-centre study. Patients undergoing fURS or SWL were asked to complete the validated Cambridge Renal Stone Patient Reported Outcome Measure ( CReSP) on the day of initial treatment and at weeks 1, 6 and 12 post-operatively. Results: Data were collected for 119 patients. Three were excluded as stone metric and demographic details were incomplete. Sixty underwent SWL and 56 underwent fURS. Median stone size was 7.52 mm. There were no significant differences in baseline PROM scores between the treatment groups. At 1 week, the PROM scores were significantly higher in the fURS group compared to SWL (27.40 ± 0.85sd versus 22.51 ± 1.07sd; p < 0.05). However, at 6 and 12 weeks, the PROM scores were significantly lower in the fURS group (18.51 ± 2.27sd versus 23.67 ± 1.30sd; p < 0.05) and (17.01 ± 2.29sd versus 22.49 ± 1.49sd; p < 0.05), respectively. By week 12, overall scores for anxiety and social factors were more favourable in the fURS cohort. Conclusion: Our study suggests that fURS is associated with a short-lived increase in morbidity in comparison with SWL, which may be due to ureteric stenting in the majority of patients post-operatively. However, fURS patients appear to report significantly better PROM scores in the longer term. This appears to be associated with more favourable anxiety and social factor scoring over the treatment period. Level of evidence: Not applicable.
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Affiliation(s)
- William R Thompson
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | | | - Ben Starmer
- Department of Urology, Mid Cheshire Hospitals NHS Foundation Trust, UK
| | - James Broome
- Department of Urology, St Helens and Knowsley Teaching Hospitals NHS Trust, UK
| | - Huw Garrod
- Department of Urology, Wrexham Maelor Hospital, UK
| | | | - Kee Wong
- Department of Urology, Arrowe Park Hospital, UK
| | - Zoe Panayi
- Department of Urology, Arrowe Park Hospital, UK
| | - Kaylie Hughes
- Department of Urology, St Helens and Knowsley Teaching Hospitals NHS Trust, UK
| | - Morkos Iskander
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | - Saqib Javed
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | - Pat Kelly
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | - Henry Lazarowicz
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
| | - Rob C Calvert
- Department of Urology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Royal Liverpool University Hospital, UK
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Johnston SS, Chen BPH, Rai P, Grange P, Dwarakanathan HR, Amos T, Johnson BH, Ghosh SK, Buchholz N. Incremental Healthcare Cost Implications of Retreatment Following Ureteroscopy or Percutaneous Nephrolithotomy for Upper Urinary Tract Stones: A Population-Based Study of Commercially-Insured US Adults. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2022; 15:371-384. [DOI: 10.2147/mder.s384823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/28/2022] [Indexed: 11/10/2022] Open
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14
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Sperling CD, Chelluri R, Dobbs RW, Talwar R, Lin G, Stambakio H, Ziemba JB. Longitudinal Changes in Quality of Life after Ureteroscopy for Nephrolithiasis. Urology 2022; 170:60-65. [DOI: 10.1016/j.urology.2022.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 07/26/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022]
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15
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Raizenne B, Deyirmendjian C, Bechis SK, Sur RL, Nakada SY, Antonelli JA, Streeper N, Sivalingam S, Viprakasit D, Averch TD, Landman J, Chi T, Pais VM, Chew BH, Bird V, Andonian S, Canvasser NE, Harper JD, Penniston KL, Bhojani N. The duration of stone disease and the impact of a stone event on patients' quality of life. J Endourol 2022; 36:1371-1376. [PMID: 35722905 DOI: 10.1089/end.2021.0897] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION With a 5-year stone recurrence rate of 30-50%, kidney stone formers are subject to significant morbidity which negatively impacts their Health Related Quality of Life (HRQOL). We sought to determine the impact of age of kidney stone onset, duration of stone disease, and kidney stone event (surgery or stone passage) on patients' individual HRQOL by querying the validated and prospectively collected Wisconsin Stone Quality of Life (WISQOL) database. MATERIALS AND METHODS Cross-sectional data were obtained from a total of 2,438 kidney stone formers from 14 institutions in North America who completed the WISQOL questionnaire from 2014 to 2019. The 28-question survey has a 1-5 point scale for each item (total score range 0-140). Multivariable linear regression models assessed the impact of age of kidney stone onset, duration of stone disease and time since most recent surgery or stone passage on HRQOL. RESULTS Of 2,438 patients, older age at kidney stone onset and longer duration of disease were both independent predictors of better WISQOL (β=0.33 points/year; CI 0.17-0.49; p<0.001 and β=0.50 points/year; CI 0.32-0.68; p<0.001, respectively). Of 1,376 patients with surgery between 2010-2019, increased time since most recent surgery was an independent predictor of better WISQOL scores (β = 2.28 points/year; CI: 1.47-3.10; p=<0.001). Of 1,027 patients with spontaneous stone passage between 2010-2019, increased time since most recent stone passage was an independent predictor of better WISQOL scores (β = 1.59 points/year; CI: 0.59-2.59; p=<0.05). CONCLUSION Our study demonstrates that older age of onset, longer duration of disease, increase time from most recent surgery or stone passage were independent predictors of better HRQOL in kidney stone formers. Results of future studies that focus on optimizing stone related modifiable risk factors to decrease the amount of recurrent stone episodes and thus the need for recurrent surgeries will be essential.
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Affiliation(s)
- Brendan Raizenne
- Centre hospitalier de l'Université de Montréal, Division of Urology, 900 rue saint-denis, Montréal, Quebec, Canada, H2X 0A9;
| | - Claudia Deyirmendjian
- Université de Montréal, 5622, Medicine, 2900 Boulevard Edouard-Montpetit, Montreal, Montreal, Quebec, Canada, H3T 1J4;
| | - Seth K Bechis
- University of California San Diego Health System, 21814, Urology, San Diego, California, United States;
| | - Roger L Sur
- UC San Diego, 8784, Urology, Department of Urology, 200 Arbor Drive #8897, San Diego, California, United States, 92130.,UC San Diego, 8784, Roger Sur, Department of Urology, 200 Arbor Drive #8897, San Diego, California, United States, 92130;
| | | | - Jodi A Antonelli
- UT Southwestern Medical Center, Urology, 5323 Harry Hines Blvd J8.106, Dallas, Texas, United States, 75390-9110;
| | - Nicole Streeper
- The Pennsylvania State University College of Medicine, 12310, Division of Urology, Hershey, Pennsylvania, United States;
| | - Sri Sivalingam
- University of Wisconsin, Urology, 3108 Bluff Street, apt 5, Madison, Wisconsin, United States, 53705;
| | - Davis Viprakasit
- UNC, Urology, 2114 POB, Campus Box 7235, Chapel Hill, North Carolina, United States, 27599;
| | - Timothy D Averch
- Palmetto Health USC Medical Group, Dept. of Surgery; Division of Urology, 2 Richmond Medical Park Drive - Ste 306, Columbia, South Carolina, United States, 29203.,CELL: 412-956-5226;
| | - Jaime Landman
- University of California Irvine, Urology, 333 City Blvd West, Orange, California, United States, 92868;
| | - Thomas Chi
- University of California San Francisco, Urology, 400 Parnassus Ave, 6th floor Urology Clinics A638, San Francisco, California, United States, 94143;
| | - Vernon M Pais
- Dartmouth Hitchcock Medical Center, Urology, Lebanon, New Hampshire, United States;
| | - Ben H Chew
- University of British Columbia, Urologic Sciences, Level 6, 2775 Laurel st., Level 6 - 2775 Laurel St, Vancouver, British Columbia, Canada, V5Z 1M9.,University of British Columbia, 8166, Urologic Sciences, 2775 Laurel St, Level 6, Vancouver, British Columbia, Canada, V5Z 1M9;
| | - Vincent Bird
- University of Florida, Urology, 1600 SW Archer Road, Box 100247, Gainesville, Florida, United States, 32610;
| | - Sero Andonian
- McGill University Health Centre, 54473, Division of Urology, Montreal, Quebec, Canada;
| | - Noah E Canvasser
- University of California Davis Health System, 70083, Urologic Surgery, 4860 Y Street, Suite 3500, Sacramento, California, United States, 95817.,United States;
| | | | - Kristina L Penniston
- University of Wisconsin School of Medicine and Public Health, Urology, 1685 Highland Avenue, 3258 MFCB, Madison, Wisconsin, United States, 53705-2281;
| | - Naeem Bhojani
- Centre Hospitalier de L'Universite de Montreal, 25443, Urology, 900 St. Denis street, Pavillon R, R08.474, Montreal, Quebec, Canada, H2X 0A9;
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Lee JY, Andonian S, Bhojani N, Bjazevic J, Chew BH, De S, Elmansy H, Lantz-Powers AG, Pace KT, Schuler TD, Singal RK, Wang P, Ordon M. Canadian Urological Association guideline: Management of ureteral calculi - Abridged version. Can Urol Assoc J 2021; 15:383-393. [PMID: 34847343 PMCID: PMC8631858 DOI: 10.5489/cuaj.7652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jason Y. Lee
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Sero Andonian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Naeem Bhojani
- Department of Urology, Université de Montréal, Montreal, QC, Canada
| | - Jennifer Bjazevic
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Ben H. Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Shubha De
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Hazem Elmansy
- Urology, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | | | - Kenneth T. Pace
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Trevor D. Schuler
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Rajiv K. Singal
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Peter Wang
- London Health Sciences Centre, Western University, London, ON, Canada
| | - Michael Ordon
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
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Innes GD, Teichman JMH, Scheuermeyer FX, McRae AD, Grafstein E, Andruchow J, Cheng L, Law MR. Does early intervention improve outcomes for patients with acute ureteral colic? CAN J EMERG MED 2021; 23:679-686. [PMID: 34491558 DOI: 10.1007/s43678-020-00016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/26/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Early surgical intervention is increasingly employed for patients with ureteral colic, but guidelines and current practice are variable. We compared 60-day outcomes for matched patients undergoing early intervention vs. spontaneous passage. METHODS This multicentre propensity-matched cohort analysis used administrative data and chart review to study all eligible emergency department (ED) patients with confirmed 2.0-9.9 mm ureteral stones. Those having planned stone intervention within 5 days comprised the intervention cohort. Controls attempting spontaneous passage were matched to intervention patients based on age, sex, stone width, stone location, hydronephrosis, ED site, ambulance arrival and acuity level. The primary outcome was treatment failure, defined as rescue intervention or hospitalization within 60 days, using a time to event analysis. Secondary outcome was ED revisit rate. RESULTS Among 1154 matched patients, early intervention did not reduce the risk of treatment failure (adjusted hazard ratio 0.94; P = 0.61). By 60 days, 21.8% of patients in both groups experienced the composite primary outcome (difference 0.0%; 95% confidence interval - 4.8 to 4.8%). Intervention patients required more hospitalizations (20.1% vs. 12.8%; difference 7.3%; 95% CI 3.0-11.5%) and ED revisits (36.1% vs. 25.5%; difference 10.6%; 95% CI 5.3-15.9%), but (insignificantly) fewer rescue interventions (18.9% vs. 21.3%; difference - 2.4%; 95% CI - 7.0 to 2.2%). CONCLUSIONS In matched patients with 2.0-9.9 mm ureteral stones, early intervention was associated with similar rates of treatment failure but greater patient morbidity, evidenced by hospitalizations and emergency revisits. Physicians should adopt a selective approach to interventional referral and consider that spontaneous passage probably provides better outcomes for many low-risk patients.
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Affiliation(s)
- Grant D Innes
- Department of Emergency Medicine and Department of Community Health Sciences, University of Calgary, Room C231, Foothills Medical Centre, 1403, 29 Street NW, Calgary, AB, T2N 2T9, Canada.
| | - Joel M H Teichman
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Frank X Scheuermeyer
- Department of Emergency Medicine and Center for Healthcare Evaluation and Outcome Sciences, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Andrew D McRae
- Department of Emergency Medicine and Department of Community Health Sciences, University of Calgary, Room C231, Foothills Medical Centre, 1403, 29 Street NW, Calgary, AB, T2N 2T9, Canada
| | - Eric Grafstein
- Department of Emergency Medicine and Center for Healthcare Evaluation and Outcome Sciences, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - James Andruchow
- Department of Emergency Medicine and Department of Community Health Sciences, University of Calgary, Room C231, Foothills Medical Centre, 1403, 29 Street NW, Calgary, AB, T2N 2T9, Canada
| | - Lucy Cheng
- Centre for Health Services and Policy Research, School for Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Michael R Law
- Centre for Health Services and Policy Research, School for Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Mazzon G, Choong S, Pavan N, Zeng G, Wu W, Durutovic O, Pirozzi M, Zhong J, Bada M, Celia A. Introducing Trifecta for percutaneous nephrolithotomies: a proposal for standard reporting outcomes after treatment for renal stones. Minerva Urol Nephrol 2021; 74:351-359. [PMID: 33769014 DOI: 10.23736/s2724-6051.21.04046-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In literature, the reports of outcomes after percutaneous nephrolithotomies are rather heterogeneous. This may influence studies comparison, it may also render difficult to evaluate surgical adequacy, peri-operative morbidity and patient's quality of life between studies. For this reason, we propose to introduce PNL-Trifecta as composite measure to standardize data reporting outcomes after percutaneous nephrolithotomies. METHODS We performed a prospective multicentric study on consecutive patients undergone PNL to treat renal stones between 2018 and 2020. Successful PNL-trifecta was considered achieved when procedures obtained the three following results: no residual fragments > 2mm at unenhanced CT scan at 3 months post-op, no complications (defined as Clavien-Dindo Score 0) and operation carried out without placing a nephrostomy tube (tubeless or totally tubeless). We compared results of standard versus mini-PNL and between stones of different complexity (evaluated with Guy's Stone Score and S.T.O.N.E. nephrolithometry Score). Univariate analysis was utilized to identify other factors influencing achievement of PNL-Trifecta. RESULTS 245 patients fulfilled inclusion/exclusion criteria and have been enrolled in the study (median age: 56, IQR 48-57). The overall PNL-Trifecta achievement rate was 22.85% (28.66% in the mini-PNL group and 13.68% in the standard-PNL group, p=0.010). The stone free rate, CD 0 rate and tubeless/totally tubeless rate in the mini-PNL group were 60.66%, 89.33% and 51.33% respectively. In the standard-PNL group they were 44.21%, 40.00% and 15.78% respectively. At the univariate analysis, differences between Guy's Stone Score groups in achieving PNL-Trifecta were significant (p=0.001). Also, the level of upper puncture (p=0.010) and utilization of device with active suction (p=0.002) showed statistically significant differences. Furthermore, the length of stay in the patient's group achieving Trifecta was 2.28 versus a mean length of stay of 4.64 days in the group of patients not achieving Trifecta (p=0.046). CONCLUSIONS We present Trifecta for PNLs as a potential tool to evaluate quality of percutaneous nephrolithotomies and to provide an instrument for an adequate standard data reporting. It can represent a valid way to assess and monitor surgeon's learning curves. It will require further external validation and studies to evaluate its correlation with mid- and long-term results and patient's health related quality of life outcomes.
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Affiliation(s)
- Giorgio Mazzon
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy -
| | - Simon Choong
- Institute of Urology, University College Hospital of London, London, UK
| | - Nicola Pavan
- Department of Urology, University of Trieste, Trieste, Italy
| | - Guohua Zeng
- Department of Urology, minimally invasive Centre, the first affiliated hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenqi Wu
- Department of Urology, minimally invasive Centre, the first affiliated hospital of Guangzhou Medical University, Guangzhou, China
| | - Otas Durutovic
- Department of Urology, University of Belgrade, Belgrade, Serbia
| | - Marco Pirozzi
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy
| | - Jiehui Zhong
- Department of Urology, minimally invasive Centre, the first affiliated hospital of Guangzhou Medical University, Guangzhou, China
| | - Maida Bada
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy
| | - Antonio Celia
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy
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Comparing extracorporeal shock wave lithotripsy and ureteroscopy laser lithotripsy for treatment of urinary stones smaller than 2 cm: a cost-utility analysis in the Spanish clinical setting. World J Urol 2021; 39:3593-3598. [PMID: 33616709 DOI: 10.1007/s00345-021-03620-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/30/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To analyze the efficiency and cost-utility profile of ureteroscopy versus shock wave lithotripsy for treatment of reno-ureteral stones smaller than 2 cm. METHODS Patients treated for urinary stones smaller than 2 cm were included in this study (n = 750) and divided into two groups based on technique of treatment. To assess the cost-utility profile a sample of 48 patients (50% of each group) was evaluated. Quality of life survey (Euroqol 5QD-3L) before-after treatment was applied, Markov model was designed to calculate quality of life in each status of the patients (stone or stone-free with and without double-J stent) and to estimate the incremental cost-utility. Monte carlo simulation was conducted for a probabilistic sensitivity analysis. Chi-square was used for comparing qualitative variables and T student's for continuous variables. RESULTS Shock wave lithotripsy group had 408 (54.4%) and ureteroscopy group had 342 (45.6%) patients. Of them, 56.3% were treated for renal stones and 43.7% for ureteral stones. Ureteroscopy produced slightly higher overall quality of patients' life, but produced a significant higher overall cost per quality-adjusted life year (QALY) than shock wave lithotripsy, exceeding the cost-utility threshold (20,000€/QALY). Sensitivity analysis confirmed results in 93.65% of cases. Difference was maintained in subgroup analysis (ureteral vs renal stones). CONCLUSIONS Results suggest that in our clinical setting shock wave lithotripsy has better cost-utility profile than ureteroscopy for treatment of reno-ureteral stones less than 2 cm, but excluding waiting times, in ideal clinical setting, ureteroscopy would have better cost-utility profile than shock wave lithotripsy.
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20
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Yuan Y, Zhong R, Lai H, Huang Z, Zeng Y, Wu S, Zhong L. The effectiveness and safety of Sun tip-flexible ureterorenoscope for the management of kidney stones: A protocol for systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2021; 100:e23964. [PMID: 33429757 PMCID: PMC7793437 DOI: 10.1097/md.0000000000023964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Kidney stone is one of the urinary system diseases with a high incidence. In this study, we will evaluate the effectiveness and safety of Sun tip-flexible ureterorenoscope treating patients with kidney stone. METHODS AND ANALYSIS English and Chinese literature about Sun tip-flexible ureterorenoscope treatment for kidney stones published before October 31, 2020 will be systematic searched in PubMed, Embase, Web of Science, Cochrane Library, Open Grey, Clinicaltrials.gov, Chinese Clinical Trial Registry, WANFANG, VIP Chinese Science and Technology Journal Database, CNKI, Chinese biomedical document service system (SinoMed). Only randomized controlled trials (RCTs) of patients with kidney stones will be included. Literature screening, data extraction, and the assessment of risk of bias will be independently conducted by 2 reviewers, and the 3rd reviewer will be consulted if any different opinions existed. Systematic review and meta-analysis will be produced by RevMan 5.3 and Stata 14.0. This protocol reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. RESULTS The current study is a protocol for systematic review and meta-analysis without results, and data analysis will be carried out after the protocol. We will share our findings in the fourth quarter of 2021. CONCLUSION This study will provide recommendations for the effectiveness and safety of Sun tip-flexible ureterorenoscope for patients with kidney stones (KS), which may help to guide clinician. ETHICS AND DISSEMINATION Ethical approval is not required as the review is a secondary study based on published literature. The results of the study will be published in peer-reviewed publications and disseminated electronically or in print. PROTOCOL REGISTRATION NUMBER INPLASY2020110099.
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Affiliation(s)
- Yuecai Yuan
- Zhongshan Hospital Affiliated to Guangzhou TCM University, Zhongshan, Guangdong Province
| | - Rui Zhong
- The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China
| | - Haibiao Lai
- Zhongshan Hospital Affiliated to Guangzhou TCM University, Zhongshan, Guangdong Province
| | - Zhifeng Huang
- Zhongshan Hospital Affiliated to Guangzhou TCM University, Zhongshan, Guangdong Province
| | - Ye Zeng
- Zhongshan Hospital Affiliated to Guangzhou TCM University, Zhongshan, Guangdong Province
| | - Song Wu
- Zhongshan Hospital Affiliated to Guangzhou TCM University, Zhongshan, Guangdong Province
| | - Liang Zhong
- Zhongshan Hospital Affiliated to Guangzhou TCM University, Zhongshan, Guangdong Province
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Tapiero S, Limfuco L, Bechis SK, Sur RL, Penniston KL, Nakada SY, Antonelli JA, Streeper NM, Sivalingam S, Viprakasit DP, Averch TD, Okhunov Z, Patel RM, Chi T, Pais VM, Chew BH, Bird VG, Andonian S, Bhojani N, Canvasser NE, Landman J. The impact of the number of lifetime stone events on quality of life: results from the North American Stone Quality of Life Consortium. Urolithiasis 2021; 49:321-326. [PMID: 33409555 DOI: 10.1007/s00240-020-01238-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/17/2020] [Indexed: 11/28/2022]
Abstract
To evaluate the impact of chronic stone recurrence on an individual's quality of life using the validated Wisconsin Stone Quality of Life (WISQOL) questionnaire. We collected cross-sectional data on patients with kidney stones from 14 institutions in North America. A stone event was defined as renal colic, stone-related procedure or emergency department visit. The regression analyses using general linear models and pairwise comparison determined the impact of the number of stone events on quality of life. The median number of stone events among the 2205 patients who completed the questionnaire was 3 (IQR 1-6). The mean total score was 107.4 ± 28.7 (max 140 points). The number of lifetime stone events was an independent predictor of lower quality of life (p < 0.001), specifically, score declined significantly beyond five events. Compared with patients who experienced a single stone event, there was a 0.4, 2.5, and 6.9 point decline in the adjusted mean WISQOL score after 2-5, 6-10, or > 10 events, respectively. The cumulative number of lifetime stone events was associated with a lower quality of life when more than five stone events were occurred. These findings underscore the importance of efforts to determine the underlying metabolic etiology of urolithiasis in the recurrent stone former, and the institution of a regimen to place their stone disease in remission.
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Affiliation(s)
- Shlomi Tapiero
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA.
| | - Luke Limfuco
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA
| | - Seth K Bechis
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Roger L Sur
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Kristina L Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Stephen Y Nakada
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jodi A Antonelli
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Necole M Streeper
- Division of Urology, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Sri Sivalingam
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Davis P Viprakasit
- Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Timothy D Averch
- Department of Urology, Palmetto Health USC Medical Group, Columbia, SC, USA
| | - Zhamshid Okhunov
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA
| | - Roshan M Patel
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA
| | - Thomas Chi
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Vernon M Pais
- Urology Section, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Vincent G Bird
- Department of Urology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Sero Andonian
- Division of Urology, McGill University Health Center, Montreal, QC, Canada
| | - Naeem Bhojani
- Division of Urology, University of Montreal, Montreal, QC, Canada
| | - Noah E Canvasser
- Department of Urology, University of California Davis, Sacramento, CA, USA
| | - Jaime Landman
- Department of Urology, University of California Irvine, 333 City Blvd W, Suite 2100, Orange, CA, 92868, USA
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22
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Nguyen DD, Luo JW, Lu XH, Bechis SK, Sur RL, Nakada SY, Antonelli JA, Streeper NM, Sivalingam S, Viprakasit DP, Averch TD, Landman J, Chi T, Pais VM, Chew BH, Bird VG, Andonian S, Canvasser NE, Harper JD, Penniston KL, Bhojani N. Estimating the health-related quality of life of kidney stone patients: initial results from the Wisconsin Stone Quality of Life Machine-Learning Algorithm (WISQOL-MLA). BJU Int 2020; 128:88-94. [PMID: 33205549 DOI: 10.1111/bju.15300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/06/2020] [Accepted: 11/13/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To build the Wisconsin Stone Quality of Life Machine-Learning Algorithm (WISQOL-MLA) to predict urolithiasis patients' health-related quality of life (HRQoL) based on demographic, symptomatic and clinical data collected for the validation of the Wisconsin Stone Quality-of-Life (WISQOL) questionnaire, an HRQoL measurement tool designed specifically for patients with kidney stones. MATERIAL AND METHODS We used data from 3206 stone patients from 16 centres. We used gradient-boosting and deep-learning models to predict HRQoL scores. We also stratified HRQoL scores by quintile. The dataset was split using a standard 70%/10%/20% training/validation/testing ratio. Regression performance was evaluated using Pearson's correlation. Classification was evaluated with an area under the receiver-operating characteristic curve (AUROC). RESULTS Gradient boosting obtained a test correlation of 0.62. Deep learning obtained a correlation of 0.59. Multivariate regression achieved a correlation of 0.44. Quintile stratification of all patients in the WISQOL dataset obtained an average test AUROC of 0.70 for the five classes. The model performed best in identifying the lowest (0.79) and highest quintiles (0.83) of HRQoL. Feature importance analysis showed that the model weighs in clinically relevant factors to estimate HRQoL, such as symptomatic status, body mass index and age. CONCLUSIONS Harnessing the power of the WISQOL questionnaire, our initial results indicate that the WISQOL-MLA can adequately predict a stone patient's HRQoL from readily available clinical information. The algorithm adequately relies on relevant clinical factors to make its HRQoL predictions. Future improvements to the model are needed for direct clinical applications.
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Affiliation(s)
- David-Dan Nguyen
- Faculty of Medicine, McGill University, Montreal, QC, Canada.,Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jack W Luo
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Xing Han Lu
- School of Computer Science, McGill University, Montreal, QC, Canada
| | - Seth K Bechis
- University of California San Diego School of Medicine, San Diego, CA, USA
| | - Roger L Sur
- University of California San Diego School of Medicine, San Diego, CA, USA
| | - Stephen Y Nakada
- Department of Urology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Jodi A Antonelli
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Sri Sivalingam
- Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA
| | | | | | - Jaime Landman
- University of California Irvine School of Medicine, Orange, CA, USA
| | - Thomas Chi
- University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Vernon M Pais
- Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Vincent G Bird
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Sero Andonian
- McGill University Health Center, Montreal, QC, Canada
| | - Noah E Canvasser
- University of California Davis School of Medicine, Sacramento, CA, USA
| | | | - Kristina L Penniston
- Department of Urology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Naeem Bhojani
- Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC, Canada
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Is Stone-free Status After Surgical Intervention for Kidney Stones Associated With Better Health-related Quality of Life? - A Multicenter Study From the North American Stone Quality of Life Consortium. Urology 2020; 148:77-82. [PMID: 33290774 DOI: 10.1016/j.urology.2020.09.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the health-related quality of life (HRQOL) of patients with residual fragments after surgical intervention for kidney stones to patients that are stone-free using the disease-specific Wisconsin stone quality of life (WISQOL) questionnaire. Kidney stones contribute to impaired HRQOL, which is increasingly recognized as an important healthcare outcome measurement. MATERIALS AND METHODS With institutional review board approval, 313 adult patients who underwent surgical intervention for kidney stones at 4 sites completed a WISQOL questionnaire. We retrospectively collected surgical data including presence of residual fragments on post-operative imaging. We calculated standardized WISQOL total and domain scores (0-100), which included items related to social functioning (D1), emotional functioning (D2), stone-related impact (D3), and vitality (D4). Scores were compared between patients with residual fragments to those who were stone-free after surgical intervention. RESULTS Demographics did not differ between groups, overall mean age 54.6 ± 13.5 and 55.4% female. There was no significant difference in total WISQOL score for patients with residual fragments (n = 124) compared to patients that were stone-free (n = 189), 110.5 ± 27.8 vs 115.4 ± 23.6 respectively, (P = .12). Interestingly, patients with residual fragments who underwent secondary surgery were found to have significantly lower total WISQOL score (88.4 ± 30.1 vs 116.6 ± 25.0, P <.0001). CONCLUSION Stone-free status after surgical intervention is not associated with better HRQOL when compared with patients whose surgeries left residual fragments. Indeed, further surgical intervention on residual fragments to achieve stone-free status may actually result in worse HRQOL.
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Lundeen C, Lim JRZ, Scotland KB, Ardekani RS, Penniston KL, Streeper NM, Chi T, Landman J, Viprakasit DP, Chew BH. What is the relationship of stress to patients' kidney stone-related quality of life? Can Urol Assoc J 2020; 15:E256-E260. [PMID: 33119497 DOI: 10.5489/cuaj.6652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Health-related quality of life (HRQOL) is decreased in patients with kidney stones at all stages of stone disease, even when asymptomatic. Stress is thought to contribute to HRQOL, although there has been minimal investigation into the effect of stress on stone-related quality of life (QOL). We used the Wisconsin Stone Quality of Life Questionnaire (WISQOL) to assess the relationship of stress to stone-related QOL in kidney stone patients. METHODS As part of the WISQOL Research Consortium, patients were approached in outpatient clinics and completed the WISQOL and the Perceived Stress Scale 10-item questionnaire (PSS-10). Patients with stones at enrollment were divided into those with symptoms and those without, while patients with no current stones formed another group. Questionnaire scores from each group were compared statistically and correlations between the groups were calculated. RESULTS Patients (n=704) were enrolled from six centers. The WISQOL successfully discriminated between patients with current stones and those without (p<0.0001), while the PSS-10 did not (p=0.0869). The PSS-10 revealed patients with symptomatic kidney stones experienced higher levels of general stress than asymptomatic subjects (p<0.0001). However, a Pearson correlation test comparing the responses from each instrument revealed no overall correlation between general stress and HRQOL (r=0.05). CONCLUSIONS Symptomatic kidney stones increase general stress, as these patients demonstrate higher PSS-10 scores. Despite this, no correlation exists between general stress and stone-related QOL in patients with stone disease regardless of their stone and symptom status. This implies the existence of other factors impacting QOL in these patients, which warrants further exploration.
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Affiliation(s)
- Colin Lundeen
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Jonathan R Z Lim
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Kymora B Scotland
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Reza Safaee Ardekani
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Kristina L Penniston
- Department of Urology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Thomas Chi
- Department of Urology, University of California San Francisco, San Francisco, CA, United States
| | - Jaime Landman
- Department of Urology, University of California Irvine, Irvine, CA, United States
| | - Davis P Viprakasit
- Department of Urology, University of North Carolina, Chapel Hill, NC, United States
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
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Atis G, Culpan M, Ucar T, Sendogan F, Kazan HO, Yildirim A. The effect of shock wave lithotripsy and retrograde intrarenal surgery on health-related quality of life in 10-20 mm renal stones: a prospective randomized pilot study. Urolithiasis 2020; 49:247-253. [PMID: 33074423 DOI: 10.1007/s00240-020-01219-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 10/08/2020] [Indexed: 12/23/2022]
Abstract
The effects of treatment modalities such as retrograde intrarenal surgery (RIRS) and shock wave lithotripsy (SWL) on health-related quality of life (HRQoL) were determined in patients with renal stones between 10 and 20 mm. A total of 120 patients were included in the study and prospectively randomized to RIRS or SWL group. A total of 39 patients experienced treatment failure and finally 81 patients (45 patients in the RIRS group, 36 patients in the SWL group) were analyzed for HRQoL. SF-36 survey was used to determine HRQoL pre-operatively, post-operative day 1 and 1 month. The patient and stone characteristics such as age, gender, stone size, grade of hydronephrosis and body mass index were similar between the two groups. At post-operative day 1, the RIRS group was associated with lower scores of role functioning/physical (p = 0.008), role functioning/emotional (p = 0.047) energy/fatigue (p = 0.011), social functioning (p = 0.003) and pain (p = 0.003) when compared to the SWL group. At post-operative 1 month, only pain and emotional well-being scores (p = 0.012 and p = 0.011, respectively) in the RIRS group were statistically lower according to the SWL group. In our study, patients in the SWL group showed more favorable HRQoL scores when compared to the patients in the RIRS group in short-term follow-up.
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Affiliation(s)
- Gokhan Atis
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey
| | - Meftun Culpan
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey.
| | - Taha Ucar
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey
| | - Furkan Sendogan
- Department of Urology, Ardahan State Hospital, Ardahan, Turkey
| | - Huseyin Ozgur Kazan
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey
| | - Asif Yildirim
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Eğitim Mah. Dr. Erkin Cad. Kadıköy, 34722, Istanbul, Turkey
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Talwar R, Dobbs RW, Stambakio H, Lin G, Tasian GE, Ziemba JB. A Longitudinal Cohort Study of Pain Intensity and Interference After Ureteroscopy for Nephrolithiasis Without Postoperative Opioids. Urology 2020; 147:81-86. [PMID: 33049231 DOI: 10.1016/j.urology.2020.09.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/26/2020] [Accepted: 09/29/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To better understand the degree and time to resolution of pain in the postoperative period, we captured patient-reported pain intensity and interference prospectively in patients following ureteroscopy for nephrolithiasis. MATERIALS AND METHODS Adults undergoing ureteroscopy for renal/ureteral stones from 11/2018 to 1/2020 were eligible for inclusion. All received nonopioid postoperative pain control. Patients prospectively completed Patient-Reported Outcome Measurement Information System-Pain Intensity and Patient-Reported Outcome Measurement Information System-Pain Interference instruments preoperatively on postoperative day (POD) 0 and via email on POD 1, 7, and 14. Scores are reported as T-scores (normalized to US population, mean = 50) with changes of 5 (0.5 standard deviation) considered clinically significant. RESULTS A total of 126 patients completed enrollment at POD 0 (POD 1 = 74, POD 7 = 61, POD 14 = 47). Compared to US means, intensity and interference were significantly different at all time point comparisons (Wilcoxon rank test; all P <.001) except intensity at POD 7 (P = .09) and interference at POD 14 (P = .12). For both, there was a significant difference at each time comparison (repeated measures ANOVA; all P <.05). Increasing age was predictive of lower intensity (Confidence Interval (CI): -0.31 to -0.04; P = .012) and interference (CI: -0.36 to -0.06; P =.01) at POD 1. The presence of a postoperative stent was predictive of higher intensity (CI: 0.68-10.81; P = .03) and interference (CI: 0.61-12.96; P = .03) at POD 7. Increasing age remained a predictor of lower interference at POD 1 on multivariable analysis (CI: -0.46 to -0.01; P = .03). CONCLUSION Pain intensity and interference are elevated immediately, but intensity normalizes by POD 7, while interference remains elevated until POD 14. Age and indwelling ureteral stent influence both intensity and interference.
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Affiliation(s)
- Ruchika Talwar
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute for Health Economics, The Wharton School, University of Pennsylvania, Philadelphia, PA.
| | - Ryan W Dobbs
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Hanna Stambakio
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - George Lin
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Gregory E Tasian
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Division of Urology, Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Justin B Ziemba
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Boyd CJ, Wood KD, Singh N, Whitaker D, McGwin G, Chen H, Assimos DG. Screening for primary hyperparathyroidism in a tertiary stone clinic, a useful endeavor. Int Urol Nephrol 2020; 52:1651-1655. [PMID: 32358674 DOI: 10.1007/s11255-020-02476-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES Primary hyperparathyroidism (1HPT) is associated with the risk of developing kidney stones. Our objective was to determine the prevalence of 1HPT amongst SF evaluated at a tertiary stone clinic and determine if it is cost-effective to screen for this condition. METHODS We retrospectively reviewed 742 adult SF seen by a single urologic surgeon from 2012 to 2017 all of who were screened for 1HPT with an intact serum PTH (iPTH) and calcium. The diagnosis of 1HPT was based on the presence of hypercalcemia with an inappropriately elevated iPTH or a high normal serum calcium and an inappropriately elevated iPTH. The diagnosis was confirmed by surgical neck exploration. Published cost data and stone recurrence rates were utilized to create a cost-effectiveness decision tree. RESULTS OBTAINED Fifty-three (7.1%) were diagnosed with 1HPT. 15 (28%) had hypercalcemia and inappropriately elevated iPTH, 38 (72%) had high normal serum calcium levels and inappropriately elevated iPTH. The potential diagnosis was ignored/missed by primary care physicians in 9 (17.0%) based on a review of prior lab results. Cost modeling was undertaken for 5, 10, 15, and 20-year intervals after screening. Based on our prevalence data, historical risks for recurrence and published cost data for stone treatments, cost savings in screening are realized at 10 years. CONCLUSION These results support screening for primary hyperparathyroidism in patients evaluated in a tertiary referral setting.
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Affiliation(s)
- Carter J Boyd
- University of Alabama-Birmingham School of Medicine, Birmingham, AL, USA
| | - Kyle D Wood
- Department of Urology, University of Alabama-Birmingham, Faculty Office Tower 1107, 510 20th Street South, Birmingham, AL, 35249, USA
| | - Nikhi Singh
- University of Alabama-Birmingham School of Medicine, Birmingham, AL, USA
| | - Dustin Whitaker
- University of Alabama-Birmingham School of Medicine, Birmingham, AL, USA
| | - Gerald McGwin
- Department of Epidemiology, University of Alabama-Birmingham, Birmingham, AL, USA
| | - Herbert Chen
- Department of Surgery, University of Alabama-Birmingham, Birmingham, AL, USA
| | - Dean G Assimos
- Department of Urology, University of Alabama-Birmingham, Faculty Office Tower 1107, 510 20th Street South, Birmingham, AL, 35249, USA.
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Zisman AL, Coe FL, Cohen AJ, Riedinger CB, Worcester EM. Racial Differences in Risk Factors for Kidney Stone Formation. Clin J Am Soc Nephrol 2020; 15:1166-1173. [PMID: 32561654 PMCID: PMC7409744 DOI: 10.2215/cjn.12671019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 05/15/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Incidence of kidney stone disease is rising. It is not known whether mechanisms of stone formation differ across racial groups. Our objective was to identify differing lithogenic risk factors across racial groups in idiopathic nephrolithiasis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We conducted a retrospective cohort study evaluating metabolic risk factors in black and age-matched white idiopathic stone formers at our tertiary referral center. We compared serum and urine metabolic risk factors pre- and post-treatment across racial groups using analysis of covariance. Generalized linear modeling was used to build regression models for risk of stone formation in both groups. RESULTS Among 117 black and 172 white stone formers, urine volume was lower in black stone formers (1.4±0.8 versus 2.0±0.8 L/d, P<0.001). Urine calcium was lower in black stone formers (116±70 versus 217±115 mg/d, P<0.001). Supersaturations for calcium oxalate were similar among the groups, whereas calcium phosphate supersaturation was higher in white stone formers, and uric acid supersaturation was higher in black stone formers. Electrolyte free water clearance was significantly lower in black stone formers (207±780 versus 435±759 ml/d, P=0.02). In the subgroup of 77 black patients and 107 white patients with post-treatment evaluations, urine volume rose significantly and similarly in both groups. Urine sodium was unchanged in whites but increased in blacks by 40 mmol/d (95% confidence interval, 32 to 48 mmol/d). Electrolyte free water clearance remained lower in black stone formers (385±891 versus 706±893 ml/d, P=0.02). Post-treatment supersaturations were similar across the groups except for calcium phosphate, which improved with treatment in whites. CONCLUSIONS Black stone formers have lower 24-hour urine calcium excretion and urine volume. Increases in urine volume with treatment were associated with increased solute, but not free water, excretion in black stone formers.
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Affiliation(s)
- Anna L Zisman
- Department of Medicine, Section of Nephrology, University of Chicago, Chicago, Illinois
| | - Fredric L Coe
- Department of Medicine, Section of Nephrology, University of Chicago, Chicago, Illinois
| | - Andrew J Cohen
- Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland
| | | | - Elaine M Worcester
- Department of Medicine, Section of Nephrology, University of Chicago, Chicago, Illinois
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Qiang YC, Guo YG, Wang YQ. The effectiveness and safety of extracorporeal shock wave lithotripsy for the management of kidney stones: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e19915. [PMID: 32384436 PMCID: PMC7220461 DOI: 10.1097/md.0000000000019915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study will assess the effectiveness and safety of extracorporeal shock wave lithotripsy (ESWL) for patients with kidney stones (KS). METHODS A comprehensive and systematic literature records search for studies will be conducted in MEDLINE, EMBASE, Cochrane Library, WANGFANG, VIP, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All these databases will be searched from inception to the present without language limitation. Cochrane risk of bias tool will be used to assess the methodological quality for all included studies. Statistical analysis is performed using RevMan 5.3 software. RESULTS This study will provide synthesis of current evidence of ESWL for patients with KS through assessing primary outcomes of overall stone-free rate, and secondary outcomes of mean stone size (mm), pain intensity, urinary biochemical variables, mean hospital stay (day), quality of life, and adverse events. CONCLUSION This study will provide recommendations for the effectiveness and safety of ESWL for patients with KS, which may help to guide clinician. PROSPERO REGISTRATION NUMBER PROSPERO CRD42019157243.
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Affiliation(s)
- Yong-chun Qiang
- Department of Urology, Xianyang Hospital of Yan’an University
| | - Yu-ge Guo
- Department of Obstetrics and Gynecology
| | - Yun-qi Wang
- Department of Urology, Yangling Demonstration District Hospital, Xianyang, China
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30
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Translation and Linguistic Validation of the Korean Version of the Wisconsin Stone Quality of Life Questionnaire. Int Neurourol J 2020; 24:77-83. [PMID: 32252189 PMCID: PMC7136447 DOI: 10.5213/inj.1836238.119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 08/28/2019] [Indexed: 11/08/2022] Open
Abstract
Purpose Although cure rate and efficacy of treatment for urinary stone disease have been improved, clinicians have been indifferent to the quality of life (QoL) of stone patients in Korea. The objective of this study was to develop a Korean version of Wisconsin questionnaire about quality of life questionnaire (K-WISQOL) of stone patients for use in Korea. Methods Linguistic validation was permitted for translation by its developers. Three bilingual nonspecialists and 11 panels who were actively involved in treating urinary stone patients performed the translation and linguistic validations. A trained interviewer and 5 Korean patients carried out cognitive debriefing. Results Noun words such as “energy” and “responsibilities” were very difficult to translate to Korean. They were substituted by more comprehensive words. After backward translation, translated sentences showed a good agreement with the original WISQOL. During backward translation and the second reconciliation, previously translated Korean version was revised in 5 sentences. In the cognitive debriefing process, all 5 patients thought that these questions explained the patient’s situation well. Most of these respondents answered that explanatory notes of questionnaire were well written and the format of the questionnaire was easy to follow. Conclusions The present study demonstrated that, despite language differences, translation and linguistic validation of the K-WISQOL were successfully performed. This K-WISQOL could be useful tools for treatment plan and patient care.
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Jacobs JBM, Weltings S, Pelger RCM, Schout BMA. Patient reported outcome measures (PROMs) and patient reported experience measures (PREMs) for Dutch urolithiasis patients. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s13629-019-00278-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
AbstractMeasuring quality of care with Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs) is becoming increasingly important. With this study we evaluated ESWL and URS treatments with PROMs/PREMs and gained experience with the execution and implementation of PROMs/PREMs in daily practice. A longitudinal survey study was performed with ESWL and URS urolithiasis patients, using a questionnaire directly (T0-response 69.8%, n = 51) and 10 days after treatment (T1-response 56%, n = 42). Problems on performing daily activities were experienced by 54.2% of ESWL and 61.1% of URS-patients. In the two weeks after treatment 45.8% of the ESWL group and 70.6% of the URS-patients uses pain medication. URS-patients miss more workdays (5.61 versus 1.26 p = 0.025). Patient satisfaction is similar in both groups. With this study we have made a start with PROMs and PREMs for urolithiasis patients. It shows that urolithiasis treatment has influence on patient’s life. More knowledge in this area will improve shared decision making.
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Geraghty R, Abdi A, Somani B, Cook P, Roderick P. Does chronic hyperglycaemia increase the risk of kidney stone disease? results from a systematic review and meta-analysis. BMJ Open 2020; 10:e032094. [PMID: 31959605 PMCID: PMC7044910 DOI: 10.1136/bmjopen-2019-032094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
DESIGN Systematic review and meta-analysis of observational studies was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies reporting on diabetes mellitus (DM) or metabolic syndrome (MetS) and kidney stone disease (KSD). OBJECTIVE To examine the association between chronic hyperglycaemia, in the form of DM and impaired glucose tolerance (IGT) in the context of MetS and KSD. SETTING Population-based observational studies. Databases searched: Ovid MEDLINE without revisions (1996 to June 2018), Cochrane Library (2018), CINAHL (1990 to June 2018), ClinicalTrials.gov, Google Scholar and individual journals including the Journal of Urology, European Urology and Kidney International. PARTICIPANTS Patients with and without chronic hyperglycaemic states (DM and MetS). MAIN OUTCOME MEASURES English language articles from January 2001 to June 2018 reporting on observational studies. EXCLUSIONS No comparator group or fewer than 100 patients. Unadjusted values were used for meta-analysis, with further meta-regression presented as adjusted values. Bias was assessed using Newcastle-Ottawa scale. RESULTS 2340 articles were screened with 13 studies included for meta-analysis, 7 DM (three cohort) and 6 MetS. Five of the MetS studies provided data on IGT alone. These included: DM, n=28 329; MetS, n=31 767; IGT, n=12 770. CONTROLS DM, n=5 89 791; MetS, n=1 78 050; IGT, n=2 93 852 patients. Adjusted risk for DM cohort studies, RR=1.23 (0.94 to 1.51) (p<0.001). Adjusted ORs for: DM cross-sectional/case-control studies, OR=1.32 (1.21 to 1.43) (p<0.001); IGT, OR=1.26 (0.92 to 1.58) (p<0.0001) and MetS, OR=1.35 (1.16 to 1.54) (p<0.0001). There was no significant difference between IGT and DM (cross-sectional/case-control), nor IGT and MetS. There was a moderate risk of publication bias. Statistical heterogeneity remained significant in adjusted DM cohort values and adjusted IGT (cross-sectional/case-control), but non-signficant for adjusted DM (cross-sectional/case-control). CONCLUSION Chronic hyperglycaemia increases the risk of developing kidney stone disease. In the context of the diabetes pandemic, this will increase the burden of stone related morbidity and mortality. PROSPERO REGISTRATION NUMBER CRD42018093382.
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Affiliation(s)
| | | | - Bhaskar Somani
- Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Paul Cook
- Clinical Biochemistry, University Hospital Southampton, Southampton, Hampshire, UK
| | - Paul Roderick
- Health Care Research Unit, University of Southampton, Southampton, UK
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Ragab M, Baldin N, Collie J, Tran MG, Al‐Hayek S, S. Parsy K, Armitage J, Wiseman O. Qualitative exploration of the renal stone patients’ experience and development of the renal stone‐specific patient‐reported outcome measure. BJU Int 2019; 125:123-132. [DOI: 10.1111/bju.14873] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Mostafa Ragab
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | - Nikolay Baldin
- Department of Applied Mathematics and Theoretical Physics University of Cambridge CambridgeUK
| | - Jane Collie
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | | | - Sami Al‐Hayek
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | - Kasra S. Parsy
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | - James Armitage
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
| | - Oliver Wiseman
- Cambridge University Hospitals NHS Foundation Trust CambridgeUK
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Assessment of Kidney Function and 24-Hour Urine of the Patients with Renal Stone; Women Have Lower Urine Volume and Higher Urine Citrate. WOMEN’S HEALTH BULLETIN 2019. [DOI: 10.5812/whb.88048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Raffin EP, Penniston KL, Antonelli JA, Viprakasit DP, Averch TD, Bird VG, Chew BH, Sivalingam S, Sur RL, Nakada SY, Pais VM. The Effect of Thiazide and Potassium Citrate Use on the Health Related Quality of Life of Patients with Urolithiasis. J Urol 2018; 200:1290-1294. [PMID: 29913138 DOI: 10.1016/j.juro.2018.06.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE To our knowledge it is unknown whether the benefits of medical management of urolithiasis outweigh the potential side effects of the medications used, including potassium citrate and thiazide diuretics. Therefore, we evaluated the relationship between potassium citrate or thiazides and overall stone related health related quality of life. MATERIALS AND METHODS Cross-sectional data were obtained on stone forming enrollees in the North American Stone Quality of Life Consortium. We used the WISQOL (Wisconsin Stone Quality of Life) questionnaire to compare health related quality of life between patients treated and not treated with potassium citrate or thiazide type diuretics. Additionally, the likelihood of gastrointestinal complaints was compared between those prescribed and not prescribed potassium citrate. The likelihood of fatigue and sexual complaints was also compared in those prescribed and not prescribed thiazides. RESULTS Of the 1,511 subjects, including 787 males and 724 females, 279 were on potassium citrate and 238 were on thiazides at study enrollment. Patients prescribed potassium citrate had higher health related quality of life in each domain vs those not prescribed potassium citrate (p <0.001). Patients prescribed thiazides had higher health related quality of life in each domain compared to those not prescribed thiazide (all p <0.01). Those prescribed potassium citrate were less likely than those not prescribed potassium citrate to report nausea, stomach upset or cramps (OR 0.57, p <0.001). Patients prescribed thiazides were less likely than those not prescribed thiazides to report fatigue (OR 0.63, p = 0.004) or reduced sexual interest and/or activity (OR 0.64, p = 0.005). CONCLUSIONS Among stone formers the use of potassium citrate and thiazides was associated with better health related quality of life across all WISQOL domains without an increased likelihood of gastrointestinal complaints and fatigue or sexual complaints, respectively. These findings may be useful when counseling patients regarding the initiation of potassium citrate or thiazides for medical management of nephrolithiasis.
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Affiliation(s)
- Eric P Raffin
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.
| | - Kristina L Penniston
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Davis P Viprakasit
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Timothy D Averch
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Vincent G Bird
- University of Florida College of Medicine, Gainesville, Florida
| | - Ben H Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sri Sivalingam
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Roger L Sur
- University of California-San Diego School of Medicine, San Diego, California
| | - Stephen Y Nakada
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Vernon M Pais
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
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Abstract
BACKGROUND Some centres favour early intervention for ureteral colic while others prefer trial of spontaneous passage, and relative outcomes are poorly described. Calgary and Vancouver have similar populations and physician expertise, but differing approaches to ureteral colic. We studied 60-day hospitalization and intervention rates for patients having a first emergency department (ED) visit for ureteral colic in these diverse systems. METHODS We used administrative data and structured chart review to study all Vancouver and Calgary patients with an index visit for ureteral colic during 2014. Patient demographics, arrival characteristics and triage category were captured from ED information systems, while ED visits and admissions were captured from linked regional hospital databases. Laboratory results were obtained from electronic health records and stone characteristics were abstracted from diagnostic imaging reports. Our primary outcome was hospitalization or urological intervention from 0 to 60 days. Secondary outcomes included ED revisits, readmissions and rescue interventions. Time to event analysis was conducted and Cox Proportional Hazards modelling was performed to adjust for covariate imbalance. RESULTS We studied 3283 patients with CT-defined stones. Patient and stone characteristics were similar for the cities. Hospitalization or intervention occurred in 60.9% of Calgary patients and 31.3% of Vancouver patients (p<0.001). Calgary patients had higher index intervention rates (52.1% v. 7.5%), and experienced more ED revisits and hospital readmissions during follow-up. The data suggest that outcome events were associated with overtreatment of small stones in one city and undertreatment of large stones in the other. CONCLUSIONS An early interventional approach was associated with higher ED revisit, hospitalization and intervention rates. If these events are markers of patient disability, then a less interventional approach to small stones and earlier definitive management of large stones may reduce system utilization and improve outcomes for patients with acute ureteral colic.
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38
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Talwar R, Ziemba J. Validated Methods of Assessing Quality of Life in Stone Disease. Curr Urol Rep 2018; 19:25. [DOI: 10.1007/s11934-018-0776-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ellison JS, Williams M, Keeley FX. Patient-Reported Outcomes in Nephrolithiasis: Can We Do Better? J Endourol 2018; 32:10-20. [DOI: 10.1089/end.2017.0241] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jonathan S. Ellison
- Division of Pediatric Urology, Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - Marc Williams
- Department of Urology, Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
| | - Francis X. Keeley
- Department of Urology, Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
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Boyd C, Wood K, Whitaker D, Ashorobi O, Harvey L, Oster R, Holmes RP, Assimos DG. Accuracy in 24-hour Urine Collection at a Tertiary Center. Rev Urol 2018; 20:119-124. [PMID: 30473637 PMCID: PMC6241899 DOI: 10.3909/riu0807] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is a paucity of studies addressing the accuracy of 24-hour urine collection for assessing stone risk parameters. Collection accuracy is thought to be essential for assigning optimal therapy for stone prevention. The objective of this study was to determine factors associated with accurate and inaccurate collections. During a 2-year period (2015-2016), 241 stone formers completed 24-hour urine collections. They were divided into accurate collectors (AC), defined as at least one accurate urine collection, and inaccurate collectors (IC). Accuracy was assessed by 24-hour urine creatinine (Cr) excretion indexed to body weight (normal: males, 20-25 mg Cr/kg; females, 15-20 mg Cr/kg). Demographic data analyzed included age, gender, race, insurance status, partner status, income, and education. Statistical analysis methods included the chi-square test, Fisher's exact test, and the two-group t-test. Average age was 50.7 years at the time of collection; 50.2% were men, 86% were white, and 14% were black. Overall, 51.0% of collections were inaccurate. There was no statistical significance between AC and IC for gender (P = 0.85), race (P = 0.90), insurance status (P = 0.85), recurrence (P = 0.87), stone type (P = 0.57), education (P = 0.35), income (P 5 0.42), or poverty (P = 0.35). Older age (P = 0.017) and having a partner (P = 0.022) were significantly associated with AC. The high rate of inaccurate 24-hour urine collections is a concern. The only factors we identified as influencing collection accuracy were age and partner status. These results underscore the importance of developing methods to improve the accuracy of collecting 24-hour urine samples.
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Affiliation(s)
- Carter Boyd
- University of Alabama-Birmingham School of Medicine Birmingham, AL
| | - Kyle Wood
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
| | - Dustin Whitaker
- University of Alabama-Birmingham School of Medicine Birmingham, AL
| | - Omotola Ashorobi
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
| | - Lisa Harvey
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
| | - Robert Oster
- Department of Medicine, University of Alabama-Birmingham Birmingham, AL
| | - Ross P Holmes
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
| | - Dean G Assimos
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
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Sheth KR, White JT, Perez-Orozco AF, Debolske ND, Hyde CR, Geistkemper C, Roth DR, Austin PF, Gonzales ET, Janzen NK, Tu DD, Mittal AG, Koh CJ, Ryan SL, Jorgez C, Seth A. Evaluating Natural History and Follow Up Strategies for Non-obstructive Urolithiasis in Pediatric Population. Front Pediatr 2018; 6:353. [PMID: 30505832 PMCID: PMC6250749 DOI: 10.3389/fped.2018.00353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/29/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: While small non-obstructive stones in the adult population are usually observed with minimal follow-up, the same guidelines for management in the pediatric population have not been well-studied. We evaluate the clinical outcomes of small non-obstructing kidney stones in the pediatric population to better define the natural history of the disease. Methods: In this IRB-approved retrospective study, patients with a diagnosis of kidney stones from January 2011 to March 2017 were identified using ICD9 and ICD10 codes. Patients with ureteral stones, obstruction, or stones >5 mm in size were excluded. Patients with no follow-up after initial imaging were also excluded. Patients with a history of stones or prior stone interventions were included in our population. Frequency of follow-up ultrasounds while on observation were noted and any ER visits, stone passage episodes, infections, and surgical interventions were documented. Results: Over the 6-year study period, 106 patients with non-obstructing kidney stones were identified. The average age at diagnosis was 12.5 years and the average stone size was 3.6 mm. Average follow-up was 17 months. About half of the patients had spontaneous passage of stones (54/106) at an average time of 13 months after diagnosis. Stone location did not correlate with spontaneous passage rates. Only 6/106 (5.7%) patients required stone surgery with ureteroscopy and/or PCNL at an average time of 12 months after initial diagnosis. The indication for surgery in all 6 cases was pain. 17/106 (16%) patients developed febrile UTIs and a total of 43 ER visits for stone-related issues were noted, but no patients required urgent intervention for an infected obstructing stone. Median interval for follow-up was every 6 months with renal ultrasounds, which then was prolonged to annual follow up in most cases. Conclusions: The observation of pediatric patients with small non-obstructing stones is safe with no episodes of acute obstructive pyelonephritis occurring in these patients. The sole indication for intervention in our patient population was pain, which suggests that routine follow-up ultrasounds may not be necessary for the follow-up of pediatric non-obstructive renal stones ≤5 mm in size.
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Affiliation(s)
- Kunj R Sheth
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Jeffrey T White
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Andre F Perez-Orozco
- Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Natalie D Debolske
- Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Christopher R Hyde
- Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Christine Geistkemper
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - David R Roth
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Paul F Austin
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Edmond T Gonzales
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Nicolette K Janzen
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Duong D Tu
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Angela G Mittal
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Chester J Koh
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Sheila L Ryan
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Carolina Jorgez
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States
| | - Abhishek Seth
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.,Division of Urology, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
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Patel N, Brown RD, Sarkissian C, De S, Monga M. Quality of life and urolithiasis: the patient - reported outcomes measurement information system (PROMIS). Int Braz J Urol 2017; 43:880-886. [PMID: 28792186 PMCID: PMC5678519 DOI: 10.1590/s1677-5538.ibju.2016.0649] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 04/24/2017] [Indexed: 11/22/2022] Open
Abstract
Background: With a high rate of recurrence, urolithiasis is a chronic disease that impacts quality of life. The Patient Reported Outcomes Measurement Information System is an NIH validated questionnaire to assess patient quality of life. We evaluated the impact of urolithiasis on quality of life using the NIH-sponsored PROMIS-43 questionnaire. Materials and Methods: Patients reporting to the kidney stone clinic were interviewed to collect information on stone history and demographic information and were asked to complete the PROMIS-43 questionnaire. Quality of life scores were analyzed using gender and age matched groups for the general US population. Statistical comparisons were made based on demographic information and patient stone history. Statistical significance was P<0.05. Results: 103 patients completed the survey. 36% of respondents were male, the average age of the group was 52 years old, with 58% primary income earners, and 35% primary caregivers. 7% had never passed a stone or had a procedure while 17% passed 10 or more stones in their lifetime. Overall, pain and physical function were worse in patients with urolithiasis. Primary income earners had better quality of life while primary caregivers and those with other chronic medical conditions were worse. Patients on dietary and medical therapy had better quality of life scores. Conclusions: Urolithiasis patients subjectively have worse pain and physical function than the general population. The impact of pain on quality of life was greatest in those patients who had more stone episodes, underscoring the importance of preventive measures. Stone prevention measures improve quality of life.
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Affiliation(s)
- Nishant Patel
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Robert D Brown
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Carl Sarkissian
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Shubha De
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Manoj Monga
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
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Jiang H, Huang D, Yao S, Liu S. Improving Drainage After Percutaneous Nephrolithotomy Based on Health-Related Quality of Life: A Prospective Randomized Study. J Endourol 2017; 31:1131-1138. [PMID: 28891320 DOI: 10.1089/end.2017.0444] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The impact of drainage type after percutaneous nephrolithotomy (PCNL) on the health-related quality of life (HRQoL) has been rarely studied. We conducted a prospective randomized study to evaluate the differences in HRQoL among patients who received different drainage types. METHODS A total of 90 patients who underwent PCNL were randomized into three groups to receive a nephrostomy tube (Group 1), a Double-J (JJ) stent (Group 2), and an open-ended ureteral catheter (Group 3) after PCNL, respectively. We compared the perioperative characteristics, surgical outcomes, and HRQoL using Wisconsin Stone Quality of Life (WiSQoL) questionnaire among three groups. RESULTS There were no significant differences in patients' characteristics such as age, gender ratio, body mass index, stone burden, and so on. Majority of the surgical outcomes (operative time, estimated blood loss, hemoglobin drop, postoperative complications, and stone-free rate) were also comparable, except for the duration of hospitalization, visual analog scale, and analgesic required. The preoperative WiSQoL scores were similar among the three groups, but significant differences occurred postoperation (Groups 1, 2, and 3, 122.0 vs 105.6 vs 124.4, p < 0.001). Besides, patients in Group 2 had lower willingness (Groups 1, 2, and 3, 86.7% vs 70.0% vs 96.7%, p = 0.02) to undergo the same procedure as future treatment, if needed. CONCLUSIONS Our study suggested that the drainage types after PCNL using a nephrostomy tube or a JJ stent or an open-ended ureteral catheter were equally safe and efficacious, but patients who received a nephrostomy tube or an open-ended ureteral catheter had better HRQoL.
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Affiliation(s)
- Huiming Jiang
- 1 Department of Urology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Diandong Huang
- 1 Department of Urology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Shiwu Yao
- 1 Department of Urology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Siping Liu
- 1 Department of Urology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
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Abstract
Nephrolithiasis is highly prevalent across all demographic groups in the Western world and beyond, and its incidence rates are rising. In addition to the morbidity of the acute event, stone disease often becomes a lifelong problem that requires preventative therapy to diminish ongoing morbidity. Across the majority of stone types, increased fluid intake and targeted dietary modifications are mainstays of therapy. Specific dietary interventions associated with reduced calcium stone risk include adequate dietary calcium intake and restriction of sodium, protein, and oxalate intake, among others. Pharmaceutical therapy may be required if lifestyle changes are insufficient to minimize risk of stone recurrence, and must be targeted to the specific metabolic abnormalities portending risk for a given patient. Therapeutic options for idiopathic calcium stone disease include thiazides, citrate salts, and uric acid-lowering agents. Alkali salts are also the treatment of choice for uric acid stone disease. Management of struvite stone disease is largely surgical, but acetohydroxamic acid is a proven second line therapy. Cystinuria requires lifestyle modifications and may call for thiol-binding agents. Significant heterogeneity of the clinical population with stone disease has previously limited opportunities for large randomized controlled trials. However, as clinical phenotypes and genotypes are increasingly clarified, there are mounting opportunities for targeted randomized controlled trials in stone prevention. In the meantime, the currently available evidence for both lifestyle and pharmacologic interventions is reviewed herein.
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Affiliation(s)
- Anna L Zisman
- Section of Nephrology, Department of Medicine, University of Chicago, Chicago, Illinois
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45
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Sridharan K, Sivaramakrishnan G. Medical expulsive therapy in urolithiasis: a mixed treatment comparison network meta-analysis of randomized controlled clinical trials. Expert Opin Pharmacother 2017; 18:1421-1431. [DOI: 10.1080/14656566.2017.1362393] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Kannan Sridharan
- School of Health Sciences, Fiji National University, Suva, Fiji Islands
| | - Gowri Sivaramakrishnan
- School of Oral Health, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji Islands
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46
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Ceylan Y, Ucer O, Bozkurt O, Gunlusoy B, Mertoglu O, Zumrutbas AE, Yildiz G, Irer B, Muezzinoglu T, Demir O. The effect of SWL and URS on health-related quality of life in proximal ureteral stones. MINIM INVASIV THER 2017; 27:148-152. [DOI: 10.1080/13645706.2017.1350719] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Yasin Ceylan
- Department of Urology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Oktay Ucer
- Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Ozan Bozkurt
- Department of Urology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Bulent Gunlusoy
- Department of Urology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Oguz Mertoglu
- Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ali Ersin Zumrutbas
- Department of Urology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Guner Yildiz
- Department of Urology, Dr Suat Seren Chest Diseases and Surgery Training, Research Hospital, İzmir, Turkey
| | - Bora Irer
- Department of Urology, Esrefpaşa Hospital, Izmir, Turkey
| | - Talha Muezzinoglu
- Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Omer Demir
- Department of Urology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Penniston KL, Antonelli JA, Viprakasit DP, Averch TD, Sivalingam S, Sur RL, Pais VM, Chew BH, Bird VG, Nakada SY. Validation and Reliability of the Wisconsin Stone Quality of Life Questionnaire. J Urol 2017; 197:1280-1288. [DOI: 10.1016/j.juro.2016.11.097] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Davis P. Viprakasit
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | - Sri Sivalingam
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Roger L. Sur
- University of California San Diego School of Medicine, San Diego, California
| | - Vernon M. Pais
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Ben H. Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vincent G. Bird
- University of Florida College of Medicine, Gainesville, Florida
| | - Stephen Y. Nakada
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Streeper NM, Wertheim ML, Nakada SY, Penniston KL. Cystine Stone Formers Have Impaired Health-Related Quality of Life Compared with Noncystine Stone Formers: A Case-Referent Study Piloting the Wisconsin Stone Quality of Life Questionnaire Among Patients with Cystine Stones. J Endourol 2017; 31:S48-S53. [DOI: 10.1089/end.2016.0564] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Necole M. Streeper
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Margaret L. Wertheim
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Stephen Y. Nakada
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Kristina L. Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Determinants of health-related quality of life for patients after urinary lithotripsy: ureteroscopic vs. shock wave lithotripsy. Urolithiasis 2017; 46:203-210. [DOI: 10.1007/s00240-017-0972-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 03/03/2017] [Indexed: 10/19/2022]
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50
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New F, Somani BK. A Complete World Literature Review of Quality of Life (QOL) in Patients with Kidney Stone Disease (KSD). Curr Urol Rep 2016; 17:88. [PMID: 27771854 PMCID: PMC5075340 DOI: 10.1007/s11934-016-0647-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose of Review The purpose of this study was to review the current evidence for quality of life (QOL) in patients with kidney stone disease (KSD). Recent Findings A review of literature from inception to May 2016 for all prospective English language articles on QOL in patients with KSD was done. QOL studies post urological procedures or ureteric stents were excluded. Nine studies (1570 patients) were included of which most (n = 6) used the SF-36 QOL tool. Overall, seven of the nine studies demonstrated a lower QOL in patients with KSD. Bodily pain and general health were significantly lower in patients with KSD compared to their control groups. Summary Patients with KSD have an overall lower QOL with most impact on bodily pain and general health domains. Compared to the scale of patients suffering from KSD, more work needs to be done in measuring QOL both in terms of ‘Stone specific’ QOL measuring tools and the quality/number of studies in this field.
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Affiliation(s)
- Francesca New
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UK
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UK.
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