Nephrolithiasis - Reviews in Urology

All articles from this key word are listed below.

"Nephrolithiasis is a common problem associated with significant costs to the health care system. Its prevalence continues to increase, particularly in women, which is attributed to changes in diet and lifestyle. The costs associated with the evaluation and management of nephrolithiasis in the United States has been estimated to be $1.83 billion, and, without any intervention, the risk of recurrence is high. This article reviews the management options for nephrolithiasis including a new formulation of potassium citrate, UrocitÆ-K 15 mEq, that allows for dosing flexibility which can lead to improved compliance and tolerability. [Rev Urol. 2011;13(1):34-38 doi: 10.3909/riu0522]"

Nephrolithiasis Standard metabolic evaluation Hypercalcuria

Volume 14, Number 3 Case Review

Multibacterial Growth From a Surgical Renal Stone Culture: A Case Report and Literature Review

Majid Mirzazadeh Patrick W Mufarrij Jessica N Lange Ross P Holmes Dean G Assimos

Urinary calculi may harbor bacteria, and this may lead to deleterious events during stone fragmentation and removal. The isolation of such bacteria from surgically extracted calculi allows for the specific tailoring of antimicrobial therapy. Here, we describe a case involving percutaneous stone removal from which the stone culture demonstrated growth of five different microorganisms. The results of this culture prompted a change in the antibiotic coverage, resulting in a more targeted treatment and improved patient care. [Rev Urol. 2012;14(3/4):108-114 doi: 10.3909/riu0561] © 2013 MedReviews®, LLC

Urinary tract infection Nephrolithiasis Stone culture

Volume 15, Number 2 Meeting Reviews

Best of the 2013 AUA Annual Meeting

Highlights From the 2013 American Urological Association Meeting, May 4-8, 2013, San Diego, CA

Adam JM Kern

Prostate cancer PSA screening Nephrolithiasis Overactive bladder PCA3 Interstitial cystitis Prostate biopsy Transrectal ultrasound Erectile dysfunction Cystectomy Chronic pelvic pain syndrome Shock wave lithotripsy Prostate markers

Volume 17, Number 3 Review Articles

Metabolic Syndrome and Nephrolithiasis Risk: Should the Medical Management of Nephrolithiasis Include the Treatment of Metabolic Syndrome?

TW Jarrett John Michael DiBianco Patrick Mufarrij

This article reviews the relationship between metabolic syndrome (MetS) and nephrolithiasis, as well as the clinical implications for patients with this dual diagnosis. MetS, estimated to affect 25% of adults in the United States, is associated with a fivefold increase in the risk of developing diabetes, a doubling of the risk of acquiring cardiovascular disease, and an increase in overall mortality. Defined as a syndrome, MetS is recognized clinically by numerous constitutive traits, including abdominal obesity, hypertension, dyslipidemia (elevated triglycerides, low high-density lipoprotein cholesterol), and hyperglycemia. Urologic complications of MetS include a 30% higher risk of nephrolithiasis, with an increased percentage of uric acid nephrolithiasis in the setting of hyperuricemia, hyperuricosuria, low urine pH, and low urinary volume. Current American Urological Association and European Association of Urology guidelines suggest investigating the etiology of nephrolithiasis in affected individuals; however, there is no specific goal of treating MetS as part of the medical management. Weight loss and exercise, the main lifestyle treatments of MetS, counter abdominal obesity and insulin resistance and reduce the incidence of cardiovascular events and the development of diabetes. These recommendations may offer a beneficial adjunctive treatment option for nephrolithiasis complicated by MetS. Although definitive therapeutic recommendations must await further studies, it seems both reasonable and justifiable for the urologist, as part of a multidisciplinary team, to recommend these important lifestyle changes to patients with both conditions. These recommendations should accompany the currently accepted management of nephrolithiasis. [Rev Urol. 2015;17(3):117-128 doi: 10.3909/riu0650] © 2015 MedReviews®, LLC

Metabolic syndrome Nephrolithiasis Uric acid nephrolithiasis

Volume 18, Number 3 Meeting Reviews

Highlights From the 2016 American Urological Association Annual Meeting

Michael K Brawer Michael A Gorin Benjamin M Brucker J Curtis Nickel Stacy Loeb Michael B Chancellor Alan W Partin Ellen Shapiro Dean G Assimos

More than 2000 posters, abstracts, and videos were presented at the 2016 American Urological Association (AUA) Annual Meeting, held in San Diego, CA, from May 6 to 10, 2016. The editors of Reviews in Urology have culled an enormous volume of information from this premier source and present the findings that are most relevant to the practicing urologist. [Rev Urol. 2016;18(3):159-173 doi:10.3909/riu0717] © 2016 MedReviews®, LLC

Prostate cancer Active surveillance Disorders of sexual development Nephrolithiasis Overactive bladder Microbiome OnabotulinumtoxinA Hemorrhagic cystitis Inflammation Four kallikrein assay Genomic prostate score

Volume 19, Number 1 Review Articles

Urinary Tract Stone Development in Patients With Myelodysplasia Subjected to Augmentation Cystoplasty

Management Update

Courtney L Shephard Erika B Bunt Betsy D Hopson Guaqiao Wang Dean G Assimos

Patients with myelodysplasia who have undergone augmentation cystoplasty are at risk for urinary tract stones. We sought to determine the incidence and risk factors for stone development in this population. The charts of 40 patients with myelodysplasia who have undergone augmentation cystoplasty were reviewed. None had a prior history of urinary tract stones. All patients were seen on an annual basis with plain abdominal imaging, renal ultrasonography, and laboratory testing. Statistical analysis included a multivariable bootstrap resampling method and Student’s t-test. Fifteen (37.5%) patients developed stones, 14 with bladder stones and 1 with a solitary renal stone, at a mean of 26.9 months after augmentation. Five (33.3%) developed recurrent bladder stones. The patient with a renal stone never developed a bladder stone. The mean follow-up for the stone formers was 117.2 months and for non–stone formers was 89.9 months. The stone incidence per year was 6.8%. Risk factors included a decline in serum chloride after augmentation (P = .02), female sex, younger age at time of augmentation, longer time period since augmentation, and bowel continence. A significant proportion of patients with myelodysplasia subjected to augmentation cystoplasty develop urinary tract stones, predominantly in the bladder. Dehydration may play a role in development of lower urinary tract stones as the decline in serum chloride suggests contraction alkalosis, which could lead to constipation and improved bowel continence. Therefore, improved hydration should be a goal in this cohort. [Rev Urol. 2017;19(1):11-15 doi: 10.3909/riu0741] © 2017 MedReviews®, LLC

Nephrolithiasis Spina bifida Neurogenic bladder augmentation cystoplasty

Volume 20, Number 1 Review Articles

Factors Associated With Postoperative Infection After Percutaneous Nephrolithotomy

Risk Factor Analysis

Dean Assimos Win Shun Lai

Numerous studies have investigated risk factors for the development of postoperative infection in percutaneous nephrolithotomy (PCNL) patients. Herein, we describe our meta-analysis of the risk factors for the prediction of post-PCNL infectious complications. We searched electronic databases using a combination of the terms percutaneous nephrolithotomy, risk factors, infection, and sepsis. The primary outcome was post-PCNL infection as defined by fever greater than 38°C or sepsis as defined by the Sepsis Consensus Definition Committee. Risk factors for infection in each study were identified and included for analysis if present in at least two studies. We used quantitative effect sizes in odds ratio to assess each endpoint. After application of criteria, 24 studies were found, of which 12 were prospective and 12 were retrospective. Of the prospective studies, preoperative urine culture, renal pelvis culture, stone culture, number of access points, hydronephrosis, perioperative blood transfusion, and struvite stone composition were found to be significantly associated with postoperative infection. Of the 12 retrospective studies, preoperative urine culture, stone cultures, number of access points, blood transfusion, stone size, and staghorn formation were associated with infection. Preoperative urine culture, stone culture, number of access points, and need for blood transfusion were consistently found to be significant factors. This indicates that the presence of bacteria in the urine/stone preoperatively as well as the amount of trauma the kidney sustains during the procedure are major predictors of postoperative infection. [Rev Urol. 2018;20(1):7–11 doi: 10.3909/riu0778] © 2018 MedReviews®, LLC

Urinary tract infection Nephrolithiasis Lithotripsy Percutaneous nephrostomy

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Management Update

Highlights From the 2013 American Urological Association Meeting, May 4-8, 2013, San Diego, CA

Management Update

Risk Factor Analysis