David Stanley, MD, on current trends in the management of kidney stones

In a recent interview with Urology Times®, David Stanley, MD, FACS, discussed current trends and unmet needs in the treatment of patients with kidney stones. Stanley is a urologic surgeon at Georgia Urology in Atlanta, Georgia.

One of the biggest trends in the field right now, according to Stanley, is a focus on removing residual stone fragments. There are several new technologies to assist with this, including Calyxo’s tool that enables active aspiration as well as Dornier’s HOOVER suction access sheath.

“All of that technology, I think, is really going to help patients in the long run with being able to get a better stone free outcome,” Stanley noted.

In terms of unmet needs in the space, Stanley pointed to the need for a greater understanding of the optimal laser settings for each individual patient. “It’s not a cookie cutter, one-size-fits-all for that,” he explained.

“Cranking up the power where your watts are really high isn't always the right answer,” he said. “Sometimes you can manipulate the pulse frequency or the pulse length, and then, of course, the power and the frequency to get a better outcome.”

On that note, he also mentioned the need to adjust the heat that’s being generated, as well as the pressure. For the urologist treating these patients, all of these aspects need to be considered in the context of the individual patient, choosing the right settings for each case.

“It's not the same thing every time, and you have to be able to adapt in order to achieve the goal of getting the patient stone free a lot of times,” Stanley concluded.