Pain relief after removal of non-obstructive renal calculi

Non-obstructing stones are often not considered to be the source of pain, and probably most are not. This is because flank pain associated with a stone is typically caused by a stone that obstructs urinary flow, which increases intraluminal pressure...

Loop-tail stents in reducing stent related symptoms – the search continues

Insertion of double J (DJ) stents is one of the most commonly performed procedures in urology. One of its major drawbacks is stent related symptoms (SRS) which has generated a lot of research in drugs, stent design and materials. One...

Risk stratified approach to early intervention for renal colic

Existing guidance on this topic is based on older and smaller studies, and there remains variation in practice. This review of database outcomes of 1168 out of 3081 (38%) patients who underwent early intervention after presentation to nine Canadian emergency...

Delayed decompression of the infected obstructed kidney increases fatality

Well, we know this, I hear you all say. It is standard practice that the obstructed kidney with associated infection requires prompt decompression, and this is drilled into all UK trainees. It is surprising therefore that although we frequently deal...

Do stones still kill?

This paper is a retrospective analysis of deaths ascribed to stone disease in England and Wales over a 15-year period. The data was obtained from the Office of National Statistics, based on mortality derived from death certificates. One thousand, nine...

Preventive pharmacological therapy for kidney stones

Kidney stones are common, painful and are a chronic disease with a high lifetime risk of recurrence. Without treatment 35-50% of patients experience a second stone within five years of their first experience. Thiazide diuretics, alkali citrate treatment and allopurinol...

Cystolithotripsy using the holmium laser: evolving uses for the laser lithotrite

This small prospective study examined 20 patients who were undergoing laser cystolithotripsy for bladder stones. Laser lithotripsy was performed using either a 365 or 550µm holmium:YAG laser fibre with a power setting of 1.0J and a frequency of 10Hz. Stone...

Efficacy of flexible ureteroscopy and laser lithotripsy for lower pole renal calculi

The management of lower pole renal stones (LPS) is often difficult. Extracorporeal shock wave lithotripsy (ESWL), flexible ureterorenoscopy (fURS) and percutaneous nephrolithotomy (PCNL) are all potential options with potential benefits and disadvantages. In order to assess the success of fURS...

Thiazide diuretic prophylaxis for kidney stones and the risk of diabetes mellitus

Thiazide diuretics have been used to reduce calcium nephrolithiasis recurrence as it is tolerated well, inexpensive and reduces calcium excretion in urine. It has been linked with increased risk of diabetes mellitus (DM) in the presence of hypertension (ALLHAT study),...