Urolithiasis Patients Research Articles

Perception and awareness towards urolithiasis among the public at Bisha city; a cross-sectional study

Objective: This study aimed to estimate the level of awareness about urolithiasis among the Bisha population. Methods: This cross-sectional study was conducted through an online questionnaire between June 2023 and July 2023 in Bisha, Saudi Arabia. The electronic questionnaire consisted of 28 questions and was distributed via multiple social media platforms. Results: A total of 1,002 participants were included with a mean age of 26.1 ± 13.9 years old. About 55% were males and 927 (92.5%) were Saudi nationals. Regarding awareness, 405 (40.4%) were in the low awareness level, 575 (57.4%) were in the medium level, and only 22 (2.2%) participants were in the high level of awareness. Also, 83 (8.3%) were hypertensive, 75 (7.5%) had hyperparathyroidism, and 69 (6.9%) were diabetic, while 634 (63.3%) had no chronic health problems. A participant with a history of renal stones was associated with a low level of awareness, and there was a negative association between age and awareness level. Moreover, most participants were aware that there was a relationship between dietary habits and renal stone formation. Conclusion: The study shows a low to medium level of awareness among study participants, especially among urolithiasis patients. In terms of risk factors, there is a low level of awareness about the family history, weight gain, and hot climate. Finally, we recommend adequate public education about urolithiasis and its risk factors.

Predictors for Distinguishing Renal Infarction From Urolithiasis in the Emergency Department: A Randomly Matched Retrospective Case-Control Study

BackgroundEmergency department (ED) clinicians may misdiagnose renal infarction (RI) as urolithiasis because RI is a rare disease with presenting symptoms similar to the symptoms of urolithiasis. However, earlier diagnosis of RI can improve patient prognosis. ObjectivesWe investigated potential predictors for distinguishing RI from urolithiasis based on clinical findings and laboratory results. MethodsThis randomly matched retrospective case-control study included patients who had been diagnosed with acute RI or acute urolithiasis between January 2016 and March 2020. Patients were excluded if they were aged under 18 years, had a history of trauma, or had incomplete medical records. Using a matching ratio of 1:4, RI patients were randomly matched to urolithiasis patients. Multivariable logistic regression was performed to identify factors that could distinguish RI from urolithiasis. ResultsIn total, 48 patients were included in the RI group and 192 patients were included in the urolithiasis group. Multivariable logistic regression showed that age ≥ 65 years (odds ratio [OR] 6.155; p = 0.022), atrial fibrillation (OR 18.472; p = 0.045), current smoking (OR 17.070; p = 0.001), costovertebral angle tenderness (OR 0.179; p = 0.037), aspartate aminotransferase level ≥ 27.5 U/L (OR 6.932; p = 0.009), sodium level ≥ 138.5 mEq/L (OR 0.079; p = 0.004), and hematuria (OR 0.042; p = 0.001) were significant predictors that could distinguish RI from urolithiasis. Based on these results, a nomogram was constructed. ConclusionAge ≥ 65 years, atrial fibrillation, current smoking, absence of costovertebral angle tenderness, aspartate aminotransferase level ≥ 27.5 U/L, sodium level < 138.5 mEq/L, and absence of hematuria were predictors that can distinguish between RI and urolithiasis.

Rapid binary visual detection of oxalate in urine samples of urolithiasis patients via competitive recognition and distance reading test strips.

Urolithiasis is a common disease with wide ranging effects, with oxalate stones being the most prevalent type. Existing clinical diagnostic methods rely on complex instruments and professionals, are difficult to distinguish between stone types, and have insufficient sensitivity. Moreover, high-sensitivity point-of-care testing (POCT) methods remain scarce. We constructed a rapid homogeneous dual fluorescence and binary visualization analysis system to diagnose oxalate urolithiasis because oxalate can efficiently reduce Cu2+ to Cu+, which can be selectively competitively recognized by both calcein and cadmium telluride quantum dots (CdTe QDs). Under optimized conditions, the system exhibited high sensitivity to oxalate ranging from 10 pM to 10 nM within 3 min. Following that, visualized test strips of calcein and QDs were generated by inkjet printing; oxalate concentrations as low as 10 nM can be easily identified by reading the quenching distance on the strip. We then analyzed 66 clinical urine samples: 11 healthy, 10 oxalate-negative, and 45 oxalate-positive samples. The fluorescence and visual mode results were highly consistent with clinical computed tomography (CT) images and clinical diagnostics. Therefore, our analysis strategy has the potential to use POCT for the assessment of oxalate urolithiasis.

ASSESSMENT OF FLUID INTAKE IN UROLITHIASIS PATIENTS ATTENDING UROLOGY CLINIC AT A TERTIARY CARE CENTERIN NORTH KARNATAKA

Urolithiasis is a highly prevalent disease all over the world. The prevalence of kidney stone disease in India is around 12%. Fluid intake is one of the important modifiable risk factors in kidney stone disease which can be considered for preventive measures. Nevertheless, various kinds of fluids cannot have the same effect on stone formation. North Karnataka region is more prone to stone formation due to a lack of fluid intake in several parts. We aim to assess the intake of various fluids and beverages along with water in urolithiasis patients attending the urology clinic at the tertiary care centre. A total of 240 kidney stone patients attending a urology clinic at a tertiary care centre were enrolled for the study between the period of 2020 to 2021. Structured and validated questionnaires comprising detailed information about brief medical history, lifestyle habits and fluid intake habits were provided to the subjects. Kidney stones were collected from all 240 patients to analyse the chemical composition and spectral studies. Out of 240 patients, 152 were male patients and 88 were females. The overall male-to-female ratio was 1.72: 1. The mean Body Mass Index (BMI) of all the patients was 25.83. The highest numbers of cases (43.3%) were seen in the age group above 50. Around 65.8% of cases used to consume less than an adequate amount of water. In stone analysis, 58.3% were calcium oxalates and 16.6% were uric acid stones which was the second-highest among cases. Fluids like milk, tea, and fruit juices are shown to reduce the risk of stone formation to some extent whereas less water intake was a major risk factor. Alcohol and aerated beverages are still having controversial results in stone formation. So, more studies have to be conducted in different geographic regions which may help to prevent the reoccurrence and may reduce the burden of urolithiasis.

Detection of Urolithiasis Using Non-Contrast Computed Tomography

Kidney stone disease is one of the most frequent urinary system disorders, ranking third following urinary tract infection and prostate disease in urology departments, and is the most frequent by 10-15%. Objective: To detect urolithiasis in individuals with flank discomfort and renal colic using non-contrast computed tomography. Methods: A cross-sectional study was conducted at Chattha Hospital, Gondal Hospital, and Al-Amin diagnostic center. Prior to the non-contrast computed tomography KUB examination, a formal informed consent form was signed by each patient. In this study, a total of 126 individuals were examined, and all of them were diagnosed with urolithiasis and their incidental findings are evaluated on non-contrast computed tomography KUB. The average patient age was 44.2. For data analysis, the Statistical Package for the Social Sciences version 26.0 was used. The eligibility of patients remained determined using inclusion criteria. Results: According to the results of 126 urolithiasis patients, n = 71 (56.3%) were males, n = 55 (43.7%) were women, and the greatest ratio was n = 23, (18.3%) in the 51-60 year age group. The most prevalent clinical symptom of urolithiasis was renal colic n=74(35.1%).The right side (45.24%) was more affected than the left side (34.13%). The right renal pelvis (18.2%), has the highest percentage, and right vesico-ureter junction and left upper pole calyces (3.3%) has the lowest percentage. Patients having 1 stone has highest frequency (58.7%). since most of patients developed mild (8.7%) or moderate (16.7%) or severe (11.9%) of Hydronephrosis and mostly (74.6%) negative Hydro-ureter. Conclusions: In the research, males and patients aged 51–60 were more likely than females to have urolithiasis. The right side were more related to the NCCT KUB findings.

Urolithiasis: a descriptive study in a single urological unit at a tertiary care hospital

Introduction: Urolithiasis is the most prevalent surgical disorder of urinary tract in Asia. The prevalence of urolithiasis varies with demographic factors. There are many treatment options feasible. The specific treatment approach depends on composition, location, size of the stones and preferences of the patients and hospital capability. Objective: The aim of the study was to assess the demographic details, clinical presentation, and management of patients with urolithiasis in a single urological unit at a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted in a total of 247 diagnosed urolithiasis patients in a single urological unit at a tertiary care hospital from August 2021 to July 2022. Data were collected from patients' records; demographic details, clinical presentation and management of urolithiasis were retrieved. Collected data were analyzed with SPSS 26.0. Results: Among the 247 patients, the majority were males (n=159, 64.4%). Patients ranged from the age of 13-83 years, with a mean age of 48.8 (SD: 15.2) years. The most common presenting symptom was pain (n=150, 60.7%). In 45.3% (n=112) comorbidities such as diabetic mellitus (n=64), hypertension (n=77), hyperlipidemia (n=29), chronic kidney disease (n=15) and ischemic heart disease (n=12) were seen. The majority had single stones (n=171, 69.2%). The commonest site of stones was on the left urinary tract (n=101, 40.9%) followed by right (n=95, 38.5%), and bilateral (11.3%), Bladder (8.5%) and urethra (0.8%) were the other sites. The ureteric stones (n=125, 50.6%), and a mean size of 14.8mm (SD: 11.7) were more common than renal stones (n=74, 30.0%), and a mean size of 19.9mm (SD 11.8). The majority (n=186, 75.3%) were treated surgically. Conclusion: Urolithiasis was more commonly seen in males. The commonest presentation was pain, and the site was ureter. Nearly half of the patients had at least one non-communicable comorbidity, and the majority were treated surgically.

Risk factors and characteristics of gut microbiota and metabolites in inflammatory bowel diseases patients with urolithiasis

Objective: To identify the related factors and characteristics of gut microbiota and metabolites in inflammatory bowel disease (IBD) patients with urolithiasis. Methods: A total of 68 IBD patients with urolithiasis and 136 gender-and age-matched IBD patients without urolithiasis in the Department of Gastroenterology, Peking Union Medical College Hospital from January 2014 to December 2019 were recruited. The diagnosis of urolithiasis was confirmed by plain films, ultrasonography, abdominal computed tomography or intravenous urography. The clinical data of patients were collected, and the association between the clinical characteristics and urolithiasis was further analyzed. The fecal samples were collected from 10 patients with urolithiasis and 18 patients without urolithiasis, and the gut microbiota and metabolites composition were analyzed. Results: There were 49 male and 19 female IBD patients with urolithiasis, with a mean age of (36.0±12.4) years, and 98 male and 38 female patients without urolithiasis, with a mean age of (36.1±12.5) years. Univariate analysis revealed that the rate of ileostomy and the resection of small intestine in Crohn's disease (CD) patients with urolithiasis (n=34) was significantly higher than CD patients without urolithiasis (n=68) (26.5% vs 7.4%, P=0.019). And the erythrocyte sedimentation rate was also higher [26.5 (12.0, 40.8) vs 13.0 (7.2, 32.5) mm/1 h, P=0.022] in CD patients with urolithiasis. There were no significant differences in clinical characteristics and biochemical parameters between the ulcerative colitis (UC) patients with urolithiasis (n=34) and without urolithiasis (n=68) (all P>0.05). The multivariate logistic regression analysis indicated that ileostomy and the resection of small intestine were the independent related factors for urolithiasis in CD patients (OR=4.619, 95%CI: 1.178-18.111, P=0.028). There was no significant difference in α and β diversity between the two groups (all P>0.05). At the phylum level, there was no significant difference in the abundance of microbiota (all P>0.05). At the genus level, the abundance of Enterococcus (P=0.049), Eubacterium_eligens (P=0.036) was significantly decreased. At the species level, the abundance of Bacteroides_coprocola was increased in urolithiasis group (P=0.035), while the abundance of Blautia_caecimuris was significantly decreased (P=0.042). No significant difference was found in fecal metabolites between the two groups (all P>0.05). According to LDA effect size (Lefse) analysis, taxa including Sphingomonadales, Fenollaria, Bacteroides_coprocola contributed greatly to the difference between the two groups. Conclusions: Ileostomy and the resection of small intestine are related factors for urolithiasis in patients with CD. Gut microbiota may be involved in the occurrence of urolithiasis in patients with IBD.

Ambient heat stress and urolithiasis attacks in China: Implication for climate change

BackgroundAlthough the existing studies have suggested a significant association between high temperatures and urolithiasis, no nationwide studies have quantified the burden attributable to environmental heat stress and explored how the urolithiasis burden would vary in a warming climate. MethodsWe collected data on urolithiasis attacks from 137 hospitals in 59 main cities from 20 provincial regions of China from 2000 to 2020. An individual-level case-crossover analysis was conducted to estimate the effect of daily wet-bulb globe temperature (WBGT), a heat stress index combining temperature and humidity, on urolithiasis attacks. Stratified analyses were performed by region, age, and sex. We further quantified the future WBGT-related burden of urolithiasis from the Coupled Model Intercomparison Project Phase 6 under three Shared Socioeconomic Pathway (SSP) scenarios. ResultsIn total, 118,180 urolithiasis patients were evaluated. The exposure-response curve for the association between WBGT and urolithiasis attacks was J-shaped, with a significantly increased risk for WBGT higher than 14.8 °C. The middle-aged and elderly group (≥45 years old) had a higher risk of WBGT-related urolithiasis attacks than in the younger group, while no significant sex difference was observed. The attributable fraction (AF) due to high WBGT would increase from 10.1% in the 2010s to 16.1% in the 2090s under the SSP585 scenario. Warm regions were projected to experience disproportionately higher AFs and larger increments in the future. ConclusionsThis nationwide investigation provides novel evidence on the acute effect of high WBGT on urolithiasis attacks and demonstrates the increasing disease burden in a warming climate.

Effectiveness of 3D Pageflip Professional electronic module to prevent urolithiasis recurrent among urolithiasis patients

Introduction: Non-communicable diseases are one of the targets of the Sustainable Development Goals (SDGs), including health problems related to urinary tract stones (urolithiasis). Urolithiasis has a high recurrence rate within 3-5 years after recovery from the disease. This study aimed to develop an Electronic Module (E-module) as a medium for preventing urolithiasis patients and assessed the effectiveness of this professional E-Module 3D pageflip media.

RF16 | PSUN155 Empagliflozin and the risk of nephrolithiasis

Abstract Aims Nephrolithiasis is a common disease, estimated to affect 10% of the US population. In addition to pain, often severe, it can lead to urinary tract infections and acute kidney injury, while contributing to health care costs from emergency room visits and follow-up interventions necessary to relieve stone burden. Type 2 diabetes (T2D) is a well-known risk factor for nephrolithiasis. Recently in an observational study of patients with T2D, use of sodium-glucose transport protein 2 (SGLT2) inhibitors as glucose lowering agents was associated with a 49% lower risk of nephrolithiasis when compared with use of glucagon like peptide 1 (GLP-1) receptor agonists. We examined, prospectively, the association between renal stone disease and the use of the SGLT2 inhibitor empagliflozin, using existing data from randomized clinical trials. Methods Pooled data from 15,081 patients with T2D treated with empagliflozin (10,177) or placebo (4,904) from 20 phase I-IV randomized, placebo-controlled trials including the large cardiovascular outcome trial, EMPA-REG OUTCOME, were included in this analysis. Incident urinary tract stone events were captured using a pre-defined collection of MedDRA terms: nephrolithiasis, renal colic, ureterolithiasis, calculus bladder, calculus urinary, calculus urethral, and nephrocalcinosis (MedDRA version 22.1). A sensitivity analysis used a narrower definition by excluding the terms renal colic and nephrocalcinosis. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were calculated using the relative risk estimate stratified by study. Results The median exposure to study drug was 543 (placebo) and 549 (empagliflozin 10 or 25 mg) days We found that a total of 183 patients experienced an incident urolithiasis during follow-up (79 in placebo, 104 in pooled empagliflozin) yielding annual incidence rates of 1.01 versus 0.63 events per 100 patient years in placebo and empagliflozin, respectively. All but one event occurred in patients with no prior history of urinary tract stones. The IRR was 0.64 (95% CI 0.48, 0.86), in favor of empagliflozin. In the sensitivity analysis, now restricted to nephrolithiasis, ureterolithiasis, calculus bladder, calculus urinary, and calculus urethral, the results were similar (IRR, empagliflozin vs. placebo, 0.62 [95% CI 0.45, 0.85]). Conclusion As compared to placebo, use of empagliflozin was associated with an approximate 40% reduction in the risk of urolithiasis in patients with T2D. Alterations in lithogenic profile of the urine (including dilutional effects) of potential stone formers after SGLT2 inhibition may explain this finding. Based on these initial observations, mechanistic studies to elucidate the mediator(s) of this seemingly protective effect and dedicated randomized prospective clinical trials appear warranted in patients with renal stone disease. As with follow-up SGLT2 inhibitor investigations conducted in patients with heart failure and chronic kidney disease, such trials should include individuals who do not have T2D. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 1:12 p.m. - 1:17 p.m.

Psychological Distress in Patients With Urolithiasis: A Systematic Review and Meta-analysis.

Urolithiasis can be a painful condition associated with significant individual and health care burdens. Several studies have shown that anxiety and depression, termed psychological distress, may be associated with urolithiasis. However, there is little consensus on this relationship. We performed a systematic review and meta-analysis on the relationship between urolithiasis and psychological distress and examined rates of psychological distress in this population. We searched online databases including MEDLINE (via PubMed), Embase (via Ovid), Web of Science, and the Cochrane Library with predefined search criteria up to March 2022 utilizing the Preferred Reporting Items for Systematic Review and Meta-analyses. Forty-nine peer-reviewed publications were included in this review. We performed a narrative synthesis on included studies, and a random-effects meta-analysis to obtain a single summary estimate for the relationship between urolithiasis and anxiety. Narrative synthesis found evidence for a relationship between urolithiasis and psychological distress, both anxiety and depression. Meta-analysis of 7 studies found a moderate pooled association between urolithiasis and state anxiety. Additionally, higher proportions of urolithiasis patients experienced psychological distress compared to nonurolithiasis samples across studies. Our findings are limited by the observed heterogeneity in assessment protocols within the data set. Our findings suggest a moderate but significant association between anxiety and urolithiasis, as well as a greater than expected number of urolithiasis patients experiencing psychological distress. More high-quality research studies are required to better understand factors that may influence the relationship between urolithiasis and psychological distress.

Long-term evaluation of outcomes and costs of urolithiasis re-interventions after ureteroscopy, extracorporeal shockwave lithotripsy and percutaneous nephrolithotomy based on German health insurance claims data

PurposeComparisons of ureteroscopy (URS), extracorporeal shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL) for urolithiasis considering long-term follow-up are rare. We aimed to analyze re-intervention rates, costs and sick leave days of URS, SWL and PCNL patients within 7 years.MethodsThis retrospective cohort study was based on German health insurance claims data. We included 54,609 urolithiasis patients incidentally treated in 2008–2010. We investigated time to re-intervention, number of sick leave days and healthcare costs. We applied negative binomial, extended Cox regression and gamma models.Results54% were incidentally treated with URS, 40% with SWL and 6% with PCNL. 15% of URS, 26% of SWL and 23% of PCNL patients were re-treated within 7 years. Time to re-intervention was significantly lower for PCNL (955 days) and SWL (937 days) than URS (1078 days) patients. Costs for incident treatment were significantly higher for PCNL (2760€) and lower for SWL (1342€) than URS (1334€) patients. Yet, total costs including re-interventions were significantly higher for PCNL (5783€) and SWL (3240€) than URS (2979€) patients. Total number of sick leave days was increased for PCNL (13.0 days) and SWL (10.1 days) compared to URS (6.8 days) patients.ConclusionThis study describes outcomes after use of different intervention options for urolithiasis. URS patients showed longest time free of re-interventions and lowest number of sick leave days. Although SWL patients initially had lower costs, URS patients had lower costs in the long run. PCNL patients showed high costs and sick leave days.

376 Point-of-Care Ultrasound-First for the Evaluation of Urolithiasis in Patients Who Fit Choosing Wisely Criteria: National Cost Savings and Length of Stay Reduction

Study ObjectivesChoosing Wisely guidelines recommend against ordering non-contrast computed tomography (NCCT) for patients with suspected urolithiasis who are under the age of 50 and have a history of recurrent kidney stones. Our primary objective was to estimate the annual national cost savings and reduction in emergency department (ED) length of stay (LOS) from using a point-of-care ultrasound (POCUS)-first approach for patients with urolithiasis meeting Choosing Wisely criteria.MethodsWe created and ran 1,000 trials of a Monte Carlo simulation. The study population included all patients who presented to the ED and were diagnosed with urolithiasis. Using this simulation, we modeled national cost savings in averted advanced imaging from a POCUS-first approach for urolithiasis. The model assumes that patients with indeterminate or negative POCUS studies underwent NCCT for further evaluation. We applied the same Monte Carlo model to estimate the reduction in ED LOS.ResultsUsing this model, a POCUS-first approach in our select patient population for diagnosing urolithiasis was estimated to save a mean (±SD) of $25.5 million (±$2.7 million) by avoiding 203,000 (±21,000) NCCT scans. This resulted in a national cumulative decrease of 205,000 (±874,000) ED bed-hours.ConclusionsIf adopted widely, a POCUS-first approach for suspected urolithiasis in patients who meet Choosing Wisely criteria could yield significant cost savings and reduction in ED LOS. Further research is needed to explore drivers of the lack of widespread adoption of this clinical workflow.No, authors do not have interests to disclose Study ObjectivesChoosing Wisely guidelines recommend against ordering non-contrast computed tomography (NCCT) for patients with suspected urolithiasis who are under the age of 50 and have a history of recurrent kidney stones. Our primary objective was to estimate the annual national cost savings and reduction in emergency department (ED) length of stay (LOS) from using a point-of-care ultrasound (POCUS)-first approach for patients with urolithiasis meeting Choosing Wisely criteria. Choosing Wisely guidelines recommend against ordering non-contrast computed tomography (NCCT) for patients with suspected urolithiasis who are under the age of 50 and have a history of recurrent kidney stones. Our primary objective was to estimate the annual national cost savings and reduction in emergency department (ED) length of stay (LOS) from using a point-of-care ultrasound (POCUS)-first approach for patients with urolithiasis meeting Choosing Wisely criteria. MethodsWe created and ran 1,000 trials of a Monte Carlo simulation. The study population included all patients who presented to the ED and were diagnosed with urolithiasis. Using this simulation, we modeled national cost savings in averted advanced imaging from a POCUS-first approach for urolithiasis. The model assumes that patients with indeterminate or negative POCUS studies underwent NCCT for further evaluation. We applied the same Monte Carlo model to estimate the reduction in ED LOS. We created and ran 1,000 trials of a Monte Carlo simulation. The study population included all patients who presented to the ED and were diagnosed with urolithiasis. Using this simulation, we modeled national cost savings in averted advanced imaging from a POCUS-first approach for urolithiasis. The model assumes that patients with indeterminate or negative POCUS studies underwent NCCT for further evaluation. We applied the same Monte Carlo model to estimate the reduction in ED LOS. ResultsUsing this model, a POCUS-first approach in our select patient population for diagnosing urolithiasis was estimated to save a mean (±SD) of $25.5 million (±$2.7 million) by avoiding 203,000 (±21,000) NCCT scans. This resulted in a national cumulative decrease of 205,000 (±874,000) ED bed-hours. Using this model, a POCUS-first approach in our select patient population for diagnosing urolithiasis was estimated to save a mean (±SD) of $25.5 million (±$2.7 million) by avoiding 203,000 (±21,000) NCCT scans. This resulted in a national cumulative decrease of 205,000 (±874,000) ED bed-hours. ConclusionsIf adopted widely, a POCUS-first approach for suspected urolithiasis in patients who meet Choosing Wisely criteria could yield significant cost savings and reduction in ED LOS. Further research is needed to explore drivers of the lack of widespread adoption of this clinical workflow.No, authors do not have interests to disclose If adopted widely, a POCUS-first approach for suspected urolithiasis in patients who meet Choosing Wisely criteria could yield significant cost savings and reduction in ED LOS. Further research is needed to explore drivers of the lack of widespread adoption of this clinical workflow.

Факторы риска нефролитиаза после радикальной цистэктомии с кишечной пластикой мочевого пузыря.

Introduction. Some studies have shown that urolithiasis is much more common in the group of patients who underwent radical cystectomy (RC) with intestinal plastic bladder than the average for the population. The aim of this study included the search of the frequency of urinary stones formation in patients after RC, depending on the type of intestinal plasty of the bladder and the type of urinary diversion, the analysis of risk factors for lithogenesis, the search for metabolic lithogenic disorders in this category of patients, and the assessment of the severity of the identified changes. Materials and methods. The work analyzed the data of 214 patients (169 men and 45 women) who were operated from 2008 to 2021 with a diagnosis of bladder cancer. Patients underwent RC with the formation of a hetero- or orthotopic ileoconduit. We analyzed the indicators of general urine analysis, biochemical blood test, bacteriological analysis of urine for flora, performed both before RC and in the late postoperative period. Also The results of ultrasound of the kidneys, bladder (reservoir), MSCT of the kidneys performed before RC and in the late postoperative period were studied. We selected 37 patients from the general group in random order, who prospectively underwent a biochemical blood test, a biochemical analysis of daily urine, and an assessment of the acid-base composition of venous blood. Statistical analysis was performed by calculating the relative risk, as well as calculating the t-test for independent groups using the computer program Statistica 10.0 (StatSoft USA). Results. Urinary stones of the upper urinary tract after RC, ortho- and heterotopic intestinal plastics of the bladder in the late postoperative period (more than 1 year) were diagnosed in 27 out of 214 patients (12.6%). The relative risk of urolithiasis in patients with pyelectasis before surgery is 3.87 times higher than in patients without changes in pelvicalyceal system at the preoperative stage (p=0.0004). In patients after RC with impaired renal function in stages III-V (GFR 60 ml/min (p=0.005). RC patients with a BMI &gt;30 had a 2.431-fold higher risk of urinary stone formation than those with a BMI 7.0, diagnosed after surgical treatment (p=0.003). The relative risk of developing urolithiasis in patients with urine pH &gt;7.0 detected before surgery is 4.85 (p&lt;0.0001). There was a trend towards an increase in the number of urolithiasis cases in patients who underwent RC with bacteriuria diagnosed after surgery according to urine culture (in patients with identified Enterococcus spp., Enterobacter cloacae, Providencia rettgeri (p&lt;0.05)) compared with patients in of which sterile urine was detected. In patients suffering from urolithiasis after undergoing RC, compared with the control group of patients in the biochemical analysis of blood, there is a statistically significant difference between the level of creatinine (p=0.033), a decrease in the level of GFR from 79.9 to 68.7 (p=0.046). There was a statistically significant increase in the pH level of the urine (p=0.0025), an increase in the level of oxalates in the daily urine (p=0.0035), a decrease in the concentration of uric acid (p= 0.039), calcium (p=0.024) in urolithiasis patients after RCE compared with patients in the control group in biochemical analysis of daily urine. Conclusion. The presence of an expansion of the pelvicalyceal system before surgery, the patient's BMI&gt; 30, urine pH&gt; 7.0 both before and after the operation, a decrease in the patient's GFR &lt;60 ml / min and the presence of bacteriuria in the general analysis of urine after RC are the risk factors for the urolithiasis after RC, intestinal plasty of the bladder.

Oral 33 - Urolithiasis in Patients with Inherited Disorders of Coagulation: Our Experience

Oral 33 - Urolithiasis in Patients with Inherited Disorders of Coagulation: Our Experience

Clinical Score Application for Abdominopelvic Computed Tomography Used in the Diagnosis of Renal Colic Patients

Abstract Background To develop risk scoring for the use of computed tomography (CT) imaging using the visual analog scale (VAS), physical examination, and laboratory findings of renal colic patients admitted to the emergency department (ED). Materials and Methods This is prospective observational study. Among the patients who presented to the ED with abdominal or flank pain, patients who were scheduled for CT imaging for urolithiasis were included in the study. The mean VAS pain scores, physical examination findings, laboratory parameters, and macroscopic and microscopic values in urinalysis were compared between the two groups with and without stones on CT. Results Of the 196 urolithiasis patients included in the study, 165 had ureteral stones, 76 had renal stones, and 45 had renal and ureteral stones. While the difference between the urine erythrocyte averages of the two groups was borderline significant (p = 0.04), there was a high difference between the urinary hemoglobin amounts (p &lt; 0.001). In patients with urinary system stone disease, hydronephrosis, and ureteral dilatation, hemoglobin ++ and above were more significant (p &lt; 0.001). For ureteral stones, pain intensity increased as the size increased (r = 0.34 p &lt; 0.001). White blood cells &gt; 10,000 103/mL, and C-reactive protein (CRP) ≤ 5 mg/L were more significant in patients with acute renal colic. Conclusions Although we cannot develop a clinical scoring system for renal colic patients, the meaningful results we found for urinary stone disease can be used in a newly developed scoring system. It can be used in new scoring systems in the ED using a high VAS score, presence and amount of urine hemoglobin, CRP) ≤ 5 mg/L, and creatinine value.

Knowledge, Awareness and Practice on Dietary Management Among Patients with Urolithiasis: A Scoping Review

Urolithiasis or kidney stone has strong association with lifestyle. The pattern of recurrent episodes reported is alarming and if left untreated will lead to serious conditions such as cancer or ablative surgical intervention. Therefore, this scoping review was performed to provide an overview on knowledge, awareness and practice (KAP) of dietary management among patients with urolithiasis. Published studies within 2010 until 2020 on KAP among urolithiasis patients globally and Malaysia were searched through five databases including ProQuest Health and Medical Complete, Wiley Online Library, EBSCO Host, Science Direct and Scopus. The quality appraisal was performed using Freestyle Critical Appraisal. Two of the authors involved in screening the relevant literature while the supervisor involved in peer checking the appraisal performed. A total of eight publications; five original studies and three review papers were obtained but none was from Malaysia. Only five were reviewed systematically on the basis of its completeness for quantitative synthesis on design, population, methodology and instrumentation. The scope of interest was awareness of urolithiasis, knowledge on risk factors, sign and symptoms, treatment and preventive measure, as well as the relationship between urolithiasis and socio-demographic background. The findings highlighted an association between socio-demographic background such as age, gender, education level, income status, literacy level towards KAP among urolithiasis patients on dietary management. Lifestyle pattern such as food intake and weight management were crucial to prevent recurrent episode Proper dietary management was an early intervention to prevent recurrent episodes of urolithiasis. Health education efforts may be helpful to increase awareness and knowledge among patients and this need to be performed by multidisciplinary effort.

Observation and identification of autofluorescent urine crystals may be linked to a sign of urolithiasis.

Urolithiasis is a common disease of the urinary system. Its recurrence rate is high and may increase medical expenses. Urine stones are composed of urine crystals and other impurities. We discovered the existence of autofluorescence in some of the urine crystals, especially in urolithiasis patients. The fluorescent molecule existed in urine crystals was verified and identified. We have applied micro-Raman and fluorescence microscopy to classify the urine crystals, used confocal laser scanning microscopy (CLSM) to examine the 3D images and spectra of autofluorescence in crystals, used Fourier-transform infrared spectroscopy (FTIR) and mass spectrometry (MS) to identify the type of fluorophore in the autofluorescent urine crystals in urine. Riboflavin was identified as one of the major fluorophores in these autofluorescent urine crystals. The prevalence rates of the autofluorescent crystals in urolithiasis patients and subjects without the history of urolithiasis were to gather statistics. We observed that 80% of urolithiasis patients had autofluorescent crystals. Contrastingly, such crystals existed in only 7% of subjects without the history of urolithiasis. The presence of autofluorescent urine crystals may be linked to a sign of urolithiasis.

Initial Safety and Feasibility of Steerable Ureteroscopic Renal Evacuation: A Novel Approach for the Treatment of Urolithiasis.

Background:There is a need to reliably render urolithiasis patients completely stone free with minimal morbidity. We report on the initial safety and feasibility with steerable ureteroscopic renal evacuation (SURE) in a prospective study using basket extraction as a comparison.Materials and Methods:A pilot randomized controlled study was conducted comparing SURE with basket extraction postlaser lithotripsy. SURE is performed using the CVAC™ Aspiration System, a steerable catheter (with introducer). The safety and feasibility of steering CVAC throughout the collecting system under fluoroscopy and aspirating stone fragments as it was designed to do were evaluated. Fluoroscopy time, change in hemoglobin, adverse events through 30 days, total and proportion of stone volume removed at 1 day, intraoperative stone removal rate, and stone-free rate (SFR) at 30 days through CT were compared.Results:Seventeen patients were treated (n = 9 SURE, n = 8 Basket). Baseline demographics and stone parameters were not significantly different between groups. One adverse event occurred in each group (self-limiting ileus for SURE and urinary tract infection for Basket). No mucosal injury and no contrast extravasation were observed in either group. The CVAC catheter was steered throughout the collecting system and aspirated fragments. There was no significant difference in fluoroscopy time, procedure time, change in hemoglobin, or stone removal rate between groups. SURE removed more and a greater proportion of stone volume at day 1 vs baskets (202 mm3 vs 91 mm3, p < 0.01 and 84% vs 56%, p = 0.022). SURE achieved 100% SFR at 30 days vs 75% for baskets, although this difference was not statistically significant (p = 0.20).Conclusions:This initial study suggests SURE is safe, feasible, and may be more effective in stone removal postlaser lithotripsy compared to basketing. More development is needed, and larger clinical studies are underway.

Clinical Features and Surgical Outcomes of the Children With Urolithiasis at a Tertiary Care Hospital: First Report From Somalia.

IntroductionThere are very few studies regarding pediatric urolithiasis (PU) reported from Africa, and to date, no data have been presented from Somalia. This study evaluated the sociodemographic and radiological characteristics, treatment, and outcome data of the PU patients treated at Somalia's only tertiary care center.MethodThe data of all patients diagnosed with urolithiasis during a 6-year period were reviewed. Only pediatric (age <18) urolithiasis patients were included. Demographic parameters, radiological features, stone characteristics, treatment, and outcome data were collected and analyzed.ResultsOverall, 227 (127 male, 100 female) patients were included. The rate of PU was 8.1%. The mean patient age was 12.7 ± 3.2. More than two-thirds of the patients (n = 161, 70.9%) were adolescents. The stones were located in the kidney in 50.7%, the ureter in 33%, and the bladder in 14.5%. Distal ureteral stones (36%) accounted for the majority of ureteral stones, followed by the ureterovesical junction (26.7%) and proximal ureteral (24%) stones. The mean stone size was 16.2 mm. Most (42.3%) stones had a 10–20 mm diameter, while 23.3% were sized between 6 and 10 mm. Renal insufficiency was present in 5.3%. Among 227 patients, 101 (44.5%) underwent minimally invasive procedures including ureterorenoscopic lithotripsy (n = 40, 18%), retrograde intrarenal surgery (n = 30, 13.2%) and percutaneous nephrolithotomy (n = 31, 14%). Open pyelolithotomy was the most common surgery performed (n = 53, 22.3%). Surgical site infection developed following 3.5% of the open surgery cases. The stone-free rate was 91.3%. It was significantly higher in open cases (98%) compared to the cases performed via a minimally invasive approach (83%) (p = 0.02).ConclusionIn Somalia, PU is more common than in many other countries. Open surgery continues to be the primary treatment modality for children with urolithiasis due to the restricted endourology resources. However, minimally invasive approaches have evolved over the last years.