Newsletter Dr. Emiliani

b Newsletter Dr. Emiliani

#19

February 17, 2024

Hello and welcome to the Stone News by Devicare, where we discuss every 2 months the most recent and relevant studies in stone disease.

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Welcome Stone Fans to this edition of Stone News!

Today, we will be discussing three recent papers from the latest literature. Firstly, we will explore the treatment of patients with pain and non-obstructive stones. Secondly, we will review a fascinating metabolic evaluation review. Finally, we will discuss a meta-analysis that addresses one of the most debated topics in endourology: Holmium vs TFL for stone treatment.

We hope you enjoy this edition of Stone News.

	Prospective Multicenter Evaluation of Pain Before and After Removal of Nonobstructing Renal Calculi: A CoRE Initiative. Bhojani N. et al. J Urol 2024	1'
	https://pubmed.ncbi.nlm.nih.gov/38100842/
There is constant debate over whether non-obstructing kidney stones can also induce pain, also it is common for endourologists do not offer surgical treatments in these patients. This study investigates whether treating small non-obstructing kidney stones improves pain and quality of life in patients with flank pain. It conducted a multicenter observational trial, recruiting patients with moderate to severe pain and kidney stones up to 10 mm in diameter. After treatment with ureteroscopy, patients reported significant reductions in pain scores and improvements in quality of life up to 12 weeks postoperatively. The study suggests that surgical removal of non-obstructing kidney stones can offer substantial benefits in pain relief and quality of life, supporting its consideration as a treatment option in this patient population. However, the study acknowledges certain limitations, such as its single-arm design and the need for further research to confirm long-term outcomes and generalizability.

	Bibliometric analysis of the relationship between metabolic study and urolithiasis. A key tool in patient management. Prieto-Angarita G. et al. Insight Urol. 2024.	2'
	https://he02.tci-thaijo.org/index.php/TJU/issue/view/18329
The article discusses the rising incidence of urolithiasis, or urinary stone disease, primarily in industrialized nations. The high burden of stone disease requires individualized treatment plans focusing on prevention. This bibliometric analysis evaluated research trends related to metabolic evaluation and urolithiasis. The authors noticed that The United States, Turkey, and Germany were the most productive publishers being the authors. Journals like the Journal of Urology and Pediatric Nephrology featured prominently in publishing articles on this topic. Most cited references focused on various aspects of urolithiasis diagnosis, treatment, and risk factors and keyword analysis revealed clusters related to medical treatment, pediatric risk factors, metabolic evaluation abnormalities, epidemiological studies, and surgical interventions. Emerging topics like obesity and metabolic risk factors are gaining attention in recent research which are highly related to the increased incidence in industrialized countries. The study underscores the importance of metabolic evaluation in managing urolithiasis, with a focus on tailored treatments and preventive measures. It highlights global research trends and emphasises the need for continued collaboration and exploration of emerging areas to improve patient care and outcomes.

	Thulium Fiber Laser Versus Holmium:Yttrium Aluminum Garnet for Lithotripsy: A Systematic Review and Meta-analysis Uleri A. et al. Euro Urol 202.	1'
	https://pubmed.ncbi.nlm.nih.gov/38290963/
The study evaluates the efficacy of Ho:YAG laser versus thulium fiber laser (TFL) for stone lithotripsy, particularly focusing on renal and ureteral stones. It includes a systematic review and meta-analysis of 11 studies involving over 2000 patients. TFL demonstrated higher stone-free rates (SFR) for renal stones compared to Ho:YAG, especially when performing flexible ureteroscopy. However, no significant difference was found in SFR for ureteral stones or when using a percutaneous approach. TFL was associated with shorter operative times and fewer intraoperative complications compared to Ho:YAG although no difference was found in major or overall complication rate, operative time and laser time. While TFL shows promise for stone treatment, further high-quality studies are needed to confirm these findings and optimize surgical settings.

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