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    Definition, treatment and outcome of residual fragments in staghorn stones
    (Elsevier Singapore Pte Ltd., 2020) Ermiş, Osman; Somani, Bhaskar; Reeves, Thomas; Güven, Selçuk; Pes, Pilar Laguna; Chawla, Arun; Hegde, Padmaraj; de la Rosette, Jean J. M. C. H.
    Technological advances in minimally invasive treatment of stone disease and its integration with concomitant clinical practice are amongst the most important achievements in urology. Despite the wealth of information accumulated over the years and the richness of existing literature, the knowledge about the definition, treatment and outcomes of residual stone fragments after percutaneous nephrolithotomy (PNL) is still insufficient. Due to the high stone load a lot of patients with staghorn stones have residual fragments (RFs) after treatment with PNL, which depends on the size of tract, definition of stone free rate (SFR), timing of evaluation and the imaging used. No consensus exists on the imaging modality or their timing in the evaluation of possible RFs. The treatment of residual stones is apparently different depending on the facilities of the department and the preference of the surgeon, which includes active surveillance, shock wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS) or a second look PNL.
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    European association of urology section of urolithiasis and international alliance of urolithiasis joint consensus on retrograde intrarenal surgery for the management of renal stones
    (Elsevier B.V., 2022) Zeng, Guohua; Zhao, Zhijian; Mazzon, Giorgio; Pearle, Margaret; Choong, Simon; Skolarikos, Andreas; Denstedt, John; Seitz, Christian; Olvera Pasada, Daniel; Fiori, Cristian; Bosio, Andrea; Papatsoris, Athanasios; Méndez Probst, Carlos Enrique; Perez Fentes, Daniel; Ann Git, Kah; Wu, Qinghui; Wiseman, Oliver; Emiliani, Esteban; Farahat, Yasser; Gökçe, Mehmet İlker; Giannakopoulos, Stilianos; Goumas Kartalas, Ioannis; Somani, Bhaskar; Knoll, Thomas; de la Rosette, Jean J. M. C. H.; Zhong, Jiehui; Vinicius Maroccolo, Marcus; Saltirov, lliya; Chew, Ben; Wang, Kunjie; Lahme, Sven; Giusti, Guido; Ferretti, Stefania; Yong Cho, Sung; Geavlete, Petrisor; Cansino, Ramon; Kamphuis, Guido M.; Smith, Daron; Matlaga, Brian R.; Ghani, Khurshid D.; Bernardo, Norberto; Silva, Andres D.; Ng, Anthony C.F.; Yang, Sixing; Gao, Xiaofeng; Traxer, Olivier; Miernik, Arkadiusz; Liatsikos, Evangelos; Priyakant Parikh, Kandarp; Duvdevani, Mordechai; Celia, Antonio; Yasui, Takahiro; Aquino, Albert; Alomar, Mohammad; Choonhaklai, Vorapot; Erkurt, Bulent; Glass, Jonathan; Sriprasad, Seshadri; Osther, Palle J.; Keeley, Francis X.; Preminger, Glenn M.; Cepeda Delgado, Marcos; Beltran Suarez, Edgar; Ye, Zhangqun; Sarica, Kemal
    Background: Retrograde intrarenal surgery (RIRS) has become the preferred treatment modality for nephrolithiasis. However, because of ongoing uncertainties regarding the optimal perioperative management, operative technique, and postoperative follow-up, as well as a lack of standardization for outcome reporting, consensus is needed to achieve more uniform clinical practice worldwide. Objective: To develop recommendations for RIRS on the basis of existing data and expert consensus. Design, setting, and participants: A protocol-driven, three-phase study was conducted by the European Association of Urology Section of Urolithiasis (EULIS) and the International Alliance of Urolithiasis (IAU). The process included: (1) a nonsystematic review of the literature to define domains for discussion; (2) a two-round modified Delphi survey involving experts in this field; and (3) an additional group meeting and third-round survey involving 64 senior representative members to formulate the final conclusions. Outcome measurements and statistical analysis: The results from each previous round were returned to the participants for re-evaluation of their decisions during the next round. The agreement threshold was set at 70%. Results and limitations: The panel included 209 participants who developed 29 consensus statements on the following topics of interest: (1) perioperative infection management; (2) perioperative antithrombotic therapy; (3) fundamentals of the operative technique; and (4) standardized outcome reporting. Although this consensus can be considered as a useful reference for more clinically oriented daily practice, we also acknowledge that a higher level of evidence from further clinical trials is needed. Conclusions: The consensus statements aim to guide and standardize clinical practice and research on RIRS and to recommend standardized outcome reporting. Patient summary: An international consensus on the best practice for minimally invasive surgery for kidney stones was organized and developed by two international societies. It is anticipated that this consensus will provide further guidance to urologists and may help to improve clinical outcomes for patients.
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    Radiomics in urolithiasis: Systematic review of current applications, limitations, and future directions
    (MDPI (Multidisipliner Digital Publishing Institute), 2022) Lim, Ee Jean; Castellani, Daniele; So, Wei Zheng; Fong, Khi Yung; Li, Jing Qiu; Tiong, Ho Yee; Gadzhiev, Nariman; Heng, Chin Tiong; Teoh, Jeremy Yuen-Chun; Naik, Nithesh; Ghani, Khurshid; Sarıca, Kemal; de la Rosette, Jean J. M. C. H.; Somani, Bhaskar; Gauhar, Vineet
    Radiomics is increasingly applied to the diagnosis, management, and outcome prediction of various urological conditions. Urolithiasis is a common benign condition with a high incidence and recurrence rate. The purpose of this scoping review is to evaluate the current evidence of the application of radiomics in urolithiasis, especially its utility in diagnostics and therapeutics. An electronic literature search on radiomics in the setting of urolithiasis was conducted on PubMed, EMBASE, and Scopus from inception to 21 March 2022. A total of 7 studies were included. Radiomics has been successfully applied in the field of urolithiasis to differentiate phleboliths from calculi and classify stone types and composition pre-operatively. More importantly, it has also been utilized to predict outcomes and complications after endourological procedures. Although radiomics in urolithiasis is still in its infancy, it has the potential for large-scale implementation. Its greatest potential lies in the correlation with conventional established diagnostic and therapeutic factors.
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    Super-mini PCNL (SMP) with suction versus standard PCNL for the management of renal calculi of 1.5 cm-3 cm: a randomized controlled study from a university teaching hospital
    (2024) Kankaria, Sanket; Gali, Kasi Viswanath; Chawla, Arun; Bhaskara, Sunil Pillai; Hegde, Padmaraj; Somani, Bhaskar; de la Rosette, Jean J. M. C. H.; del Pilar Laguna Pes, Maria
    Purpose: To assess the safety and efficacy of super-mini PCNL (SMP, 14 Fr) when compared to standard PCNL (sPCNL, 24–30 Fr) in the management of renal calculi of size ranging from 1.5 to 3 cm. Methods: From February 2021 to January 2022, a total of 100 patients were randomized to either SMP group or sPCNL group in a 1:1 ratio (50 in each group) using computer-generated simple randomization. Demographic data, stone characteristics, operative times, perioperative complications, blood transfusions, postoperative drop in haemoglobin, postoperative pain, duration of hospital stay and stone-free rates were compared between the two groups. Results: Mean stone volume (2.41 cm2 vs 2.61 cm2) and stone-free rates (98% vs 94%, p = 0.14) were similar in both the SMP and sPCNL groups, respectively. The SMP group had significantly longer mean operative times (51.62 ± 10.17 min vs 35.6 ± 6.8 min, p = 0.03). Intraoperative calyceal injury (1/50 vs 7/50, p = 0.42) and mean postoperative drop in haemoglobin (0.8 ± 0.7 g/dl vs 1.2 ± 0.81, p = 0.21) were lower in the SMP group, but not statistically significant. SMP group showed significantly lower mean postoperative pain VAS scores (5.4 ± 0.7 vs 5.9 ± 0.9, p = 0.03) and mean duration of hospital stay (28.38 ± 3.6 h vs 39.84 ± 3.7 h, p = 0.0001). Complications up to Clavien grade 2 were comparable, with grade ? 3 complications higher in the standard group, but not statistically significant. Conclusion: Super-mini PCNL is equally effective as standard PCNL in treating renal calculi up to 3 cm, with significantly reduced postoperative pain and duration of hospital stay and lower risk of Clavien grade ? 3 complications, although with higher operative times.
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    Will "Hybrid" meetings replace face-to-face meetings post COVID-19 era? Perceptions and views from the urological community
    (Elsevier Science Inc, 2021) Hameed, B. M. Zeeshan; Tanıdır, Yılören; Naik, Nithesh; Teoh, Jeremy Yuen-Chun; Shah, Milap; Wroclawski, Marcelo Langer; Castellani, Daniele; İbrahim, Sufyan; da Silva, Rodrigo Donalisio; Rai, Bhavan; de la Rosette, Jean J. M. C. H.; Rajeev, T. P.; Gauhar, Vineet; Somani, Bhaskar
    OBJECTIVE To understand the preference and role of 'hybrid' urological meetings compared to face-to-face and online meetings during and after COVID-19 pandemic. The secondary outcome was finding out the most preferable webinar setting. METHODS An online global survey was done between June 06 and July 05, 2020, using SurveyMonkey. The target participants were urology healthcare providers. The survey was disseminated via mailing lists and the Twitter platform. RESULTS A total of 526 urology providers from 56 countries responded to the survey and it was completed by 73.3%. Participants' overall experience was better in a face-to-face meeting, followed by a hybrid and webinar only meeting. While opportunities for networking was identified as high in face-to-face meeting, online webinars were more cost effective, and learning opportunity and reach of audience was higher for hybrid meetings. For online webinar format, Zoom platform was used by 73% and majority (69%) saw it on their laptop or desktop. The preference was for a 1-hour webinar in the evenings with 3-5 speakers. Urology residents rated face-to-face meetings to have better cost-effectiveness when compared to consultants. Post COVID-19, more than half of all respondents would prefer hybrid meetings compared to the other formats. CONCLUSION While there will be a place for face-to-face meetings, COVID-19 situation has led to a preference towards hybrid meetings which is ideal for a global reach in the future. It is plausible that most urological associations will move towards a hybrid model for their meetings.