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Stenting prior to URS or ESWL – does it increase ED visits and opiate prescriptions?

Ureteral stents are used to bypass obstructive stones, to dilate the ureter in order to facilitate ureteroscopy (URS), and to maintain patency / low intrarenal pressure following stone surgery. However, there can be morbidity (pain / voiding symptoms). Tasian et...

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...

Smith’s Textbook of Endourology (3rd Edition)

Without doubt this represents the endourological bible for the urological fraternity and unquestionably reflects a labour of love for its authors. At approximately 1900 pages it is no pocket book of modern urology, and whilst clearly encyclopaedic in its content,...

Use of bone windows in urological CT

Introduction Unenhanced computed tomography of kidneys, ureter and bladder (CTKUB) is the recommended gold standard investigation in patients with acute renal colic. CT urography is now a commonly used technique in the investigation of haematuria, for surgical planning and for...

Demanding cases or nightmares in endourology? May/Jun 2016

In the third article in this series the authors describe their experience with the very rare indications for laparoscopic stone surgery. Case 1 A 44-year-old woman presented with several months of malaise and right flank pain. A CT scan demonstrated...

Cutting on the Staff

In this series of articles I am going to show you some of the exhibits contained in the BAUS Virtual Museum of the History of Urology which is part of the BAUS website (www.baus.org.uk). In the last article I described...

Factors associated with post ureteroscopy urosepsis

The authors investigate which factors were most likely to increase the risk of postoperative urosepsis within 28 days of ureteroscopy (URS) and laser stone fragmentation by analysing the 34 of 562 patients who developed this complication. Stone size, same session...

Read all about it Sep/Oct 2018

For this article we are ditching the usual format and looking instead at some the standout posters and papers from the recent BAUS meeting that have the potential to inform, change and influence your practice in the near future. Whilst...

Dietary citrate substitution in urolithiasis patients

Stone formation is dependent on supersaturation of urinary salts and urinary crystal retention. Urinary promoters (protein aggregates, cell debris) and inhibitors (citrate, magnesium, urinary macromolecules such as glycosaminoglycans and proteins) are involved in the process of stone formation [1]. Hypocitraturia...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Kidney stones in pregnancy

Case 1 A 28-year-old female, 19 weeks pregnant, presents with severe left loin pain. There is no past medical history of note. Blood tests show a white cell count of 14.1x109/L and creatinine of 56umol/L. An ultrasound scan (USS) reports...

Tackling stones in children: is it difficult to crack on?

The incidence of stone disease in the paediatric population has been increasing worldwide, particularly for the adolescent age group (12–17 years of age). In this article the authors discussed the evolutions of percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS) in children....