Abstract
Introduction: The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation (morphological and infrared). Before the stone destruction, the urologist has the opportunity to analyze the stone and the papillary abnormalities endoscopically (endoscopic papillary recognition (EPR) and endoscopic stone recognition (ESR)). Our objective was to evaluate the value for those endoscopic descriptions. Methods: The MEDLINE and EMBASE databases were searched in February 2021 for studies on endoscopic papillary recognition and endoscopic stone recognition. Results: If the ESR provided information concerning the main crystallization process, EPR provided information concerning the origin of the lithogenesis and its severity. Despite many actual limitations, those complementary descriptions could support the preventive care of the stone formers in improving the diagnosis of the lithogenesis mechanism and in identifying high-risk stone formers. Conclusion: Until the development of an Artificial Intelligence recognition, the endourologist has to learn EPSR to minimize the distortion effect of the new lasers on the stone analysis and to improve care efficiency of the stone formers patients.
Highlights
The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation
As previously demonstrated by Daudon et al [1–5], the morpho-constitutional stone analysis plays a major role in identifying its etiology and consider its risk of recurrence
The increasing efficiency of lasers in “dusting” and “popcorning” modes [6–9] and the improved performance of endoscopic devices led to smaller stone fragments, which reduce the accuracy of the microscopic study by the lack of components representativeness (48.6% of the stones have a mixed composition [10]))
Summary
The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation (morphological and infrared). Those complementary descriptions could support the preventive care of the stone formers in improving the diagnosis of the lithogenesis mechanism and in identifying high-risk stone formers. The increasing efficiency of lasers in “dusting” and “popcorning” modes [6–9] and the improved performance of endoscopic devices led to smaller stone fragments, which reduce the accuracy of the microscopic study (morphological and infrared) by the lack of components representativeness (48.6% of the stones have a mixed composition [10])). The advent quality of images with flexible retrograde ureteroscopy has allowed the in vivo description of papillary abnormalities [18–21] that can be related to various lithogenesis mechanisms [22–28]
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