Frontiers of stone management
- PMID: 31725002
- DOI: 10.1097/MOU.0000000000000698
Frontiers of stone management
Abstract
Purpose of review: The surgical tool-box for urinary stone disease is growing. In this review, we discuss recent developments in the surgical management of urolithiasis, with emphasis on tailoring the management to the individual patient, and attention to the quality of care.
Recent findings: Shockwave lithotripsy remains a popular noninvasive treatment option for patients, with new data emerging on how to improve treatment outcomes as well as its limitations. Next-generation holmium lasers are expanding the role of dusting techniques for ureteroscopy but further studies are needed to assess safety and clinical outcomes. Advances in miniaturization and patient positioning are propelling percutaneous renal stone surgery toward endoscopic combined intrarenal and simultaneous bilateral surgery for patients with complex stone disease.
Summary: Stone management will be increasingly personalized to the unique qualities of the patient, stone, desired outcome, and available expertise and technology. Future studies assessing the quality of stone surgery should incorporate objective metrics to better delineate the success and cost of the different techniques available.
References
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- Chung KJ, Kim JH, Min GE, et al. Changing trends in the treatment of nephrolithiasis in the real world. J Endourol 2019; 33:248–253.
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- Lv JL. A new optical coupling control technique and application in SWL. Urolithiasis 2016; 44:539–544.
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- Alavi Tamaddoni H, Roberts WW, Duryea AP, et al. Enhanced high-rate shockwave lithotripsy stone comminution in an in vivo porcine model using acoustic bubble coalescence. J Endourol 2016; 30:1321–1325.
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