Kidney Stones

"CPT codes 50080 and 50081 describe the antegrade approach to stone removal requiring lithotripsy through a nephrostomy tract, with 50080 being reported for stones less than 2 cm in size in a single location, whereas 50081 would be reported for large or complex stones, stones in multiple locations, or stones in the ureter (such as in the example provided)," write Jonathan Rubenstein, MD, and Mark Painter.

The trial assessed outcomes in patients who had kidney stones between 1 to 2 cm.

“Our data indicate that usage of a PCNL equipment whiteboard led to significant improvements in team perception of inter-disciplinary communication and case item selection accuracy," says Jenny N. Guo, MD.

"While CBD oil appears safe, it does not seem to reduce pain or discomfort during the typically brief recovery period after this common procedure,” says Karen Stern, MD.

The highest cumulative 120-day rates of ED visits and HA were observed in patients who underwent percutaneous nephrolithotomy procedures.

"This scope allowed me to maintain the intrarenal pressures lower than I would originally have done," says Naeem Bhojani, MD, FRCSC.

"The biggest take-home message for any urologist who's treating kidney stones is to understand that what we consider to be success may not be what our patients consider to be success," says John Michael DiBianco, MD.

We have a dedicated full-time team. We have three fellowship-trained urologic specialists in stone disease. We will offer every treatment for stone disease, including endoscopic surgery, percutaneous surgery, robotic surgery and shockwave therapy,” said urologist Stephen Savage, MD, who leads the center.

"This has the opportunity to really revolutionize the way we treat kidney stone disease via ureteroscopy," says Naeem Bhojani, MD.

The patient was treated as part of a clinical study of the novel MONARCH platform at UCI Health in California.

“We thought anesthesia type would be relevant. But both urologists and patients determined that it actually was not relevant to their decision making,” says John Michael DiBianco, MD.

The device has the ability to monitor intrarenal pressure (IRP) in real-time during kidney stone procedures.

“We aimed to develop a surgical decision aid to help facilitate this decision-making process for patients who are candidates for either shock wave lithotripsy or ureteroscopy with kidney stones,” says John Michael DiBianco, MD.

“As people think about how we can do stone surgery more effectively, less morbidly for our patients, and less invasively, I think we're going to see robots enter our picture,” says Thomas Chi, MD.

“We've got a lot of movement in terms of understanding how stones form, some pharmaceutical interventions that we can use to prevent stones, and then how we can get even less invasive to try to get stones in the least morbid way for our patients,” says Thomas Chi, MD.

As the year comes to a close, we revisit some of this year’s top content on urologic stones.

Thomas Chi, MD, discusses 2022 milestones in stone disease and looks ahead to what might be on the horizon for the field in the coming year.

"These technologies have the potential to provide an advantageous and patient-centered solution for the gap between expectant management and urologic intervention for symptomatic ureteral stones,” says M. Kennedy Hall, MD, MHS.

The team of investigators used the COST-FACIT tool to take into account both the time and money lost to treatment.

"Knowing the dietary factors that are most important for preventing kidney stone recurrence can help patients and providers know what to prioritize,” said Andrew Rule, MD.

"As more genes are classified and catalogued, diagnosis and treatment of kidney stones inches further and further toward 'precision medicine,' " write Rutul Patel, DO, MS, and Alexander Small, MD.

"We need to try to do as much as we can to limit sepsis, and basing it on the patient's preoperative risk factors can be very helpful," says Naeem Bhojani, MD, FRCSC.

“The take-home message is that there is a new form of lithotripsy,” says Jonathan D. Harper, MD.

“We saw that this appears to be a safe treatment with very little bleeding,” says Jonathan D. Harper, MD.

In this installment of Urology Times' 50th Anniversary Innovation Celebration, James E. Lingeman, MD, discusses the development of extracorporeal shock wave lithotripsy for the treatment of kidney stones.

"The seminal innovation was the idea that you could create a focused shock wave that could be delivered into the body in a non-invasive way that had sufficient energy to break up a stone but not damage other structures," says James E. Lingeman, MD.

“One thing from our study that you can take home [is] no matter what the surgery is, small changes right after surgery can actually tell you more than we usually give them credit for,” says Sevag Demirjian, MD.

“The take home message would be that in patients with prior history of kidney stone episodes…receiving 24-hour urine testing prior to starting pharmacologic preventive therapy is associated with a lower probability of a subsequent stone-related event,” says Ryan Hsi, MD, FACS.

In this interview, Caleb Nelson, MD, PhD, discusses the current state of evaluation and treatment of stones in pediatric patients.

Gregory Tasian, MD, MSc, MSCE, and Jason Kaufman co-authored a study that investigated the association between kidney stone presentations in South Carolina under 2 different climate change scenarios.