Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and ...Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.展开更多
Introduction:Existing literature has highlighted disparities in acute pain management across racial and sex groups in both emergency department and pre-hospital settings.This study aimed to evaluate prescribing patter...Introduction:Existing literature has highlighted disparities in acute pain management across racial and sex groups in both emergency department and pre-hospital settings.This study aimed to evaluate prescribing patterns among physicians and advanced practice providers for patients with upper tract urolithiasis in an academic emergency department.Materials and Methods:Retrospective chart review of patients diagnosed with upper tract urolithiasis was performed to evaluate age,sex,race,ethnicity,stone size and location,presence of hydronephrosis,admission status,history of prior nephrolithiasis,medications administered in the emergency department(ED),requests for urology consult or referral,and discharge medications.Results and Conclusions:In this single-center,propensity-matched analysis,we found no significant sex,race,or provider level of training-based differences in prescribing patterns for patients presenting with renal colic secondary to upper urinary tract stones in our academic emergency department.展开更多
Th e International Alliance of Urolithiasis(IAU)consensus on miniaturized percutaneous nephrolithotomy(mPCNL)[1]is produced by an experienced international panel of experts in kidney stone surgery and is based on a sy...Th e International Alliance of Urolithiasis(IAU)consensus on miniaturized percutaneous nephrolithotomy(mPCNL)[1]is produced by an experienced international panel of experts in kidney stone surgery and is based on a systematic review of literature and a Delphi process,ensuring that recommendations are grounded in evidence.展开更多
Objective: Urolithiasis formation has been attributed to environmental and dietary factors. However, evidence is accumulating that genetic background can contribute to urolithiasis formation. Advancements in the ident...Objective: Urolithiasis formation has been attributed to environmental and dietary factors. However, evidence is accumulating that genetic background can contribute to urolithiasis formation. Advancements in the identification of monogenic causes using high-throughput sequencing technologies have shown that urolithiasis has a strong heritable component.Methods: This review describes monogenic factors implicated in a genetic predisposition to urolithiasis. Peer-reviewed journals were evaluated by a PubMed search until July 2023 to summarize disorders associated with monogenic traits, and discuss clinical implications of identification of patients genetically susceptible to urolithiasis formation.Results: Given that more than 80% of urolithiases cases are associated with calcium accumulation, studies have focused mainly on monogenetic contributors to hypercalciuric urolithiases, leading to the identification of receptors, channels, and transporters involved in the regulation of calcium renal tubular reabsorption. Nevertheless, available candidate genes and linkage methods have a low resolution for evaluation of the effects of genetic components versus those of environmental, dietary, and hormonal factors, and genotypes remain undetermined in the majority of urolithiasis formers.Conclusion: The pathophysiology underlying urolithiasis formation is complex and multifactorial, but evidence strongly suggests the existence of numerous monogenic causes of urolithiasis in humans.展开更多
Objective:To provide a comprehensive review on the existing literature on medical management of urolithiasis.Methods:A thorough literature review was performed using Medline,PubMed/PMC,Embase,and the Cochrane Database...Objective:To provide a comprehensive review on the existing literature on medical management of urolithiasis.Methods:A thorough literature review was performed using Medline,PubMed/PMC,Embase,and the Cochrane Database of Systematic Reviews up to December 2022 to identify publications on the medical management of urolithiasis.Studies that assessed dietary and pharmacologic management of urolithiasis were reviewed;studies on medical expulsive therapy were not included in this review.Results:Medical management of urolithiasis ranges from the prophylactic management of kidney stone disease to dissolution therapies.While most treatment concepts have been long established,large randomized controlled trials are scarce.Dietary modification and increased fluid intake remain cornerstones in the conservative management of urolithiasis.A major limitation for medical management of urolithiasis is poor patient compliance.Conclusion:Medical management of urolithiasis is more important in patients with recurrent urolithiasis and patients with metabolic abnormalities putting them at higher risk of developing stones.Although medical management can be effective in limiting stone recurrence,medical interventions often fail due to poor compliance.展开更多
Objective: To assess if there is a preferable intervention between retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) tube, in cases of upper urinary tract stone obstruction with complications requirin...Objective: To assess if there is a preferable intervention between retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) tube, in cases of upper urinary tract stone obstruction with complications requiring urgent drainage, by evaluating outcomes regarding urinary symptoms, quality of life (QoL), spontaneous stone passage, and length of hospital stays, since there is no literature stating the superiority of one modality over the other.Methods: We searched MEDLINE and other sources for relevant articles in June 2019 without any date restrictions or filters applied. The selection was done first by the title and abstract screening and then by full-text assessment for eligibility. Only randomized controlled trials or cohort studies in patients with hydronephrosis secondary to obstructive urolithiasis that presented comparative data between PCN and RUS placement concerning at least one of the defined outcome measures were included. Lastly, MEDLINE database and PubMed platform were screened again using the same terms, from June 2019 until November 2022.Results: Of 556 initial articles, seven were included in this review. Most works were considered of moderate-to-high quality. Three studies regarding QoL showed a tendency against stenting, even though only one demonstrated statistically significant negative impact on overall health state. Two works reported significantly more post-intervention urinary symptoms in stenting patients. One article found that PCN is a significant predictor of spontaneous stone passage, when adjusted for stone size and location. Findings on length of hospital stays were not consistent among articles.Conclusion: PCN appears to be the intervention better tolerated, with less impact on the patient’s perceived QoL and less post-operative urinary symptoms, in comparison with RUS. Nevertheless, further studies with larger samples and a randomized controlled design are suggested.展开更多
We report the first case of a ureteric stone containing gas. This rare stone with gas within it was found during the management of a diabetic patient with urosepsis as the initial presentation. Literature review of ca...We report the first case of a ureteric stone containing gas. This rare stone with gas within it was found during the management of a diabetic patient with urosepsis as the initial presentation. Literature review of cases of renal stone containing gas, mechanisms of gas within the stone, and clinical implications of stone containing gas are discussed. Also, a new terminology is proposed to describe this phenomenon.展开更多
In Asia,about 1%-19.1% of the population suffer fromurolithiasis.However,due to variations in socio-economic status and geographic locations,the prevalence and incidence have changed in different countries or regions ...In Asia,about 1%-19.1% of the population suffer fromurolithiasis.However,due to variations in socio-economic status and geographic locations,the prevalence and incidence have changed in different countries or regions over the years.The research for risk factors of urinary tract stones is of predominant importance.In this review,we find the prevalence of urolithiasis is 5%-19.1% in West Asia,Southeast Asia,South Asia,aswellas somedevelopedcountries(SouthKorea and Japan),whereas,it is only 1%e8%inmost part of East Asia and North Asia.The recurrence rate ranges from 21% to 53% after 3e5 years.Calciumoxalate(75%-90%)is themost frequent component of calculi,followed by uric acid(5%-20%),calciumphosphate(6%-13%),struvite(2%-15%),apatite(1%)and cystine(0.5%-1%).The incidence of urolithiasis reaches its peak in population agedover 30 years.Males aremore likely to suffer fromurinary calculi.Because of different dietary habits or genetic background,differences of prevalence among races or nationalities also exist.Geneticmutation of specific locus may contribute to the formation of different kinds of calculi.Dietary habits(westernized dietary habits and less fluid intake),as well as climatic factors(hot temperature andmany hours of exposure to sunshine)play a crucial role in the development of stones.Other diseases,especially metabolic syndrome,may also contribute to urinary tract stones.展开更多
Ever since the ureteral stent design was fitted with a curl on both sides to prevent it from migrating up or down the ureter some 40 years ago,its use has gained tremendous momentum,aiding in the rise and evolution of...Ever since the ureteral stent design was fitted with a curl on both sides to prevent it from migrating up or down the ureter some 40 years ago,its use has gained tremendous momentum,aiding in the rise and evolution of endourology and has confidently kept its place in modern time urology.Over the past four decades,several designs,coating and biomaterials have been developed,trying to reduce infection,encrustation and other stent related symptoms.As the ideal stent has not yet been discovered,different ways of helping patients with their complaints have been researched.This review will cover these aspects of stent use in urolithiasis.展开更多
The last 3 decades have witnessed great improvements in the technology and clinical applications of many minimally invasive procedures in the urological field.Flexible ureteroscopy(fURS)has advanced considerably to be...The last 3 decades have witnessed great improvements in the technology and clinical applications of many minimally invasive procedures in the urological field.Flexible ureteroscopy(fURS)has advanced considerably to become a widely utilized diagnostic and therapeutic tool for multiple upper urinary tract pathologies.The most common indication for fURS is the treatment of upper urinary tract stones with the aid of Holmium:Yttrium Aluminium Garnet(YAG)laser lithotripsy.Advancements in endoscope technologies and operative techniques have lead to a broader application of fURS in the management of urolithiasis to include larger and more complex stones.fURS has proved to be an effective and safe procedure with few contraindications.Continued progression in fURS may increase its clinical applicability and supplant other procedures as the first line treatment option for urolithiasis.展开更多
Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epi...Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.展开更多
During the past 3 decades,the surgical management of kidney stones has undergone many technological advances and one is the development of the flexible ureteroscopy.The development of this instrument as well as ancill...During the past 3 decades,the surgical management of kidney stones has undergone many technological advances and one is the development of the flexible ureteroscopy.The development of this instrument as well as ancillary equipment such as baskets,graspers,and others,and improvements in lithotripsy with Holmium:YAG laser have led to expand its indications with diagnostic and therapeutic management of medical issues of the upper urinary tract such as urolithiasis and urothelial tumors.The objective of this review is to describe its indications and results in the different scenarios for the treatment of urinary stones.展开更多
AIM To analyse current literature focusing on pathogenesis and therapeutic aspects of urolithiasis with inflammatory bowel disease(IBD) and following bariatric surgery. METHODS A systematic literature search was perfo...AIM To analyse current literature focusing on pathogenesis and therapeutic aspects of urolithiasis with inflammatory bowel disease(IBD) and following bariatric surgery. METHODS A systematic literature search was performed using PubMed, supplemented with additional references. Studies assessing the association of IBD or bariatric surgery with renal stones in both paediatric and adulthood were included. RESULTS Certain types of stones are seen more frequently with IBD. Hyperoxaluria and hypocitraturia are the main metabolic changes responsible for urolithiasis. The incidence of renal stones in malabsorptive types of bariatric surgery such as gastric bypass is high; this is not as common in modern restrictive surgical methods. Preventative methods and urine alkalinisation have been shown to be beneficial.CONCLUSION Both conditions are associated with renal stones. Patients' counselling and prevention strategies are the mainstay of urolithiasis management in these patients.展开更多
In the past few decades pediatric urolithiasis has become more frequent. The reason for this increase is not completely clear but has been attributed to changes in climate, nutritional habits and possibly other enviro...In the past few decades pediatric urolithiasis has become more frequent. The reason for this increase is not completely clear but has been attributed to changes in climate, nutritional habits and possibly other environ-mental factors. Although less frequent than adult stone disease, urolithiasis in the pediatric age group is also related to significant morbidity, particularly since stones tend to recur, and, thus, should not be underestimated. Most children with idiopathic stone disease have an underlying metabolic abnormality substantiating the importance of metabolic evaluation already following initial diagnosis of urolithiasis. Identification of the metabolic abnormality allows for more specifc prescription of non pharmacological and pharmacological interventions aimed at preventing recurrent stone formation. A better understanding of the causes of kidney stone disease will provide better strategies for stone prevention in children.展开更多
Canine urolithiasis is a common disease of the urinary system, referring to the hemorrhage, inflammation and stagnation of the urinary tract caused by the mineral congelation centered with the dediduous epithelial cel...Canine urolithiasis is a common disease of the urinary system, referring to the hemorrhage, inflammation and stagnation of the urinary tract caused by the mineral congelation centered with the dediduous epithelial cel s and other foreign matters surrounded by the salt crystal ization from the urine when the in the case of mineral metabolism disorder of canine. ln this paper, the causes, classification, treatment and prevention of canine urolithiasis were reviewed.展开更多
Urinary prothrombin fragment 1 （UPTFl） is a potent inhibitor of urinary stone formation. UPTF1 exerts such inhibitory effect by effective 7-carboxylation in which vitamin K epoxide reductase complex subunit 1 （VKO...Urinary prothrombin fragment 1 （UPTFl） is a potent inhibitor of urinary stone formation. UPTF1 exerts such inhibitory effect by effective 7-carboxylation in which vitamin K epoxide reductase complex subunit 1 （VKORC1）, the rate-limiting enzyme, is involved. This study examined the correlation between VKORC1 expression and calcium oxalate urolithiasis. The renal cortex samples were obtained from patients undergoing nephrectomy and then divided into 3 groups： urolithiasis group, control group A [hydronephrosis-without-stone （HWS） group], control group B （normal control group）, The localization and expression of VKORC1 in renal tissues were determined by using immunohistochemistry, immunofluorescence microscopy, Western blotting and SYBR Green I real-time reverse-transcription PCR. The rapid amplification of cDNA ends （RACE） were conducted to obtain the 3＇- and 5＇-untranslated region （UTR） of VKORC1. The results showed that VKORC1 was located in the cytoplasm of renal tubular epithelial cells. The expression of VKORC1 in the uro- lithiasis group was significantly lower than that in the other two control groups （P〈0.05）. Moreover, the 3＇- and 5＇-UTR sequence of the VKORC1 gene was successfully cloned. No insertion or deletion was found in the 3＇- and 5＇-UTR. However, a 171-bp new base sequence was discovered in the up- stream of 5＇-UTR end in the urolithiasis group. It was concluded that the decreased expression of VKORC 1 may contribute to the development of calcium oxalate urolithiasis in the kidney.展开更多
Objective:To investigate the antilithiatic effect of the whole Leea macrophylla(L macrophylla) Roxb(Leeaeeae) ethanol extract in ediylene glycol-induced urolithiasis model of rats.Methods: Forty two seven weeks old ma...Objective:To investigate the antilithiatic effect of the whole Leea macrophylla(L macrophylla) Roxb(Leeaeeae) ethanol extract in ediylene glycol-induced urolithiasis model of rats.Methods: Forty two seven weeks old male wistar albino rats were randomly divided into two major groups namely:preventive(n=18) and therapeutic(n=24).Preventive group was further subdivided into 3 groups of 6 rats namely:preventive control(PC),preventive lithiatic control(PLC) and preventive lithiatic L.macrophylla(PLLM).Similarly,therapeutic group was also subdivided into 4 groups of 6 rats namely:therapeutic control(TC),therapeutic lithiatic control(TLC).therapeutic lithitatic L macrophylla(TLLM) and therapeutic lithiatic cystone(TLCYS).The lithiasis was induced by 0.75%(v/v) ethylene glycol in the drinking water of all groups except the PC and TC groups.The urinary ionic parameters such as calcium,inorganic phosphate,oxalate,magnesium & creatinine and renal morphology were altered by ediylene glycol,which were partially recovered by 14 d preventive and almost fully recovered by 28 d therapeutic intervention trials with L macrophylla extract(500 mg/kg BW daily).Results:Significant difference on recovery was observed between preventive and dierapeutic interventional trials.Anti-urolithiatic effect of cystone was significantly(P【0.001) higher than extracts.L macrophylla extract was found nontoxic in the acute toxicity test.Conclusions:The results of this study demonstrated very promising antiurolithiatic effect of L.macrophylla extract with preventive and therapeutic treatments in this experimental condition.展开更多
Objective To determine the prevalence of urolithiasis in young children fed infant formula（IF） contaminated with melamine,and the association between IF consumption and urolithiasis.Design A total of 2 733 children ...Objective To determine the prevalence of urolithiasis in young children fed infant formula（IF） contaminated with melamine,and the association between IF consumption and urolithiasis.Design A total of 2 733 children ≤3 years of age on September 1,2008 in two townships of Gansu Province,China were studied.Cases of urolithiasis were diagnosed by ultrasonography.Milk product consumption was determined by their caregivers.Remaining IF samples were tested for melamine and cyanuric acid.Results Of 2 733 eligible children in the two townships,2 186（80%） were enrolled in our study.Overall,16.6%（362） of 2 186 children had urolithiasis.The prevalence was 24.6% in children exclusively fed Sanlu brand IF,9.7% in those fed other IF,and 8.5% in those fed exclusively on other milk products.For children exclusively breast-fed,no urolithiasis was found（P0.05）.The prevalence of urolithiasis was 11.4% in children fed 400 g of Sanlu IF,rising to 37.5% in children fed over 25 600 g.Of 48 Sanlu IF samples,91.7% contained melamine（median=1 800 ppm;range=45-4 700） and 66.7% contained cyanuric acid（median=1.2 ppm;range=0.4-6.3）.Melamine was also detected in 22.2% of 36 other brand IF（median=27.5 ppm,range=4-50）.Conclusions Urolithiasis was associated with melamine-contaminated IF.Although one product caused most morbidity,other milk products may have also contributed to the outbreak.展开更多
120 cases of urolithlasis were randomly divided into 3 groups of 40 persons each.The first group was solely treated with an improved acupuncture method,the second group was treatedwith Chinese herbal medicine,and the ...120 cases of urolithlasis were randomly divided into 3 groups of 40 persons each.The first group was solely treated with an improved acupuncture method,the second group was treatedwith Chinese herbal medicine,and the third group was treated with both of the above methods.Results showed that the improved acupuncture method possessed better stone-removing effect thanthe herbal medicine method and no much difference occurred between the patients treated withacupuncture and those treated with both above methods.Besides,the authors also experienced the excellentanalgesic and stone-dissolving effect of acupuncture in this study.展开更多
This study examined the association of pregnancy with urolithiasis and provided new insights into urolithiasis in pregnancy. A total of 462 subjects were studied from January 2004 to December 2009 in Foshan Maternal a...This study examined the association of pregnancy with urolithiasis and provided new insights into urolithiasis in pregnancy. A total of 462 subjects were studied from January 2004 to December 2009 in Foshan Maternal and Child Health Hospital, China. Among the 462 subjects, 162 cases of urolithiasis during pregnancy （UPG） were selected as the observation group, 150 cases of no urolithiasis during pregnancy （NUPG） served as pregnancy control group, and 150 cases of no pregnancy （NPG） at reproductive age who took part in physical examination were randomly assigned into non-pregnant control group. At the same time, the patients in observation group were divided into the following sub-groups： no symptomatic urinary calculus （NSUC） and symptomatic urinary calculus （SUC） groups; SUC group was further divided into surgical intervention （SI） and conservative management （CM） groups. The general information and the data of blood and urine were collected and compared among the groups. The results showed that the incidence of urinary calculi in pregnant women was lower than that in non-pregnant women, the formation of urinary stone was associated with the change of metabolism of protein and sugar in pregnant women, and the surgical intervention was a practicable alternative to treat the clinical intractable symptomatic urinary calculi in pregnancy.展开更多
基金supported(in part)by the National Key Research and Development Program(2022YFC3600700)the Fundamental Research Funds for the Central Universities(2042024YXA008)the Young Top-Notch Talent Cultivation Program of Hubei Province(for Prof.Xian-Tao Zeng).
文摘Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.
文摘Introduction:Existing literature has highlighted disparities in acute pain management across racial and sex groups in both emergency department and pre-hospital settings.This study aimed to evaluate prescribing patterns among physicians and advanced practice providers for patients with upper tract urolithiasis in an academic emergency department.Materials and Methods:Retrospective chart review of patients diagnosed with upper tract urolithiasis was performed to evaluate age,sex,race,ethnicity,stone size and location,presence of hydronephrosis,admission status,history of prior nephrolithiasis,medications administered in the emergency department(ED),requests for urology consult or referral,and discharge medications.Results and Conclusions:In this single-center,propensity-matched analysis,we found no significant sex,race,or provider level of training-based differences in prescribing patterns for patients presenting with renal colic secondary to upper urinary tract stones in our academic emergency department.
文摘Th e International Alliance of Urolithiasis(IAU)consensus on miniaturized percutaneous nephrolithotomy(mPCNL)[1]is produced by an experienced international panel of experts in kidney stone surgery and is based on a systematic review of literature and a Delphi process,ensuring that recommendations are grounded in evidence.
文摘Objective: Urolithiasis formation has been attributed to environmental and dietary factors. However, evidence is accumulating that genetic background can contribute to urolithiasis formation. Advancements in the identification of monogenic causes using high-throughput sequencing technologies have shown that urolithiasis has a strong heritable component.Methods: This review describes monogenic factors implicated in a genetic predisposition to urolithiasis. Peer-reviewed journals were evaluated by a PubMed search until July 2023 to summarize disorders associated with monogenic traits, and discuss clinical implications of identification of patients genetically susceptible to urolithiasis formation.Results: Given that more than 80% of urolithiases cases are associated with calcium accumulation, studies have focused mainly on monogenetic contributors to hypercalciuric urolithiases, leading to the identification of receptors, channels, and transporters involved in the regulation of calcium renal tubular reabsorption. Nevertheless, available candidate genes and linkage methods have a low resolution for evaluation of the effects of genetic components versus those of environmental, dietary, and hormonal factors, and genotypes remain undetermined in the majority of urolithiasis formers.Conclusion: The pathophysiology underlying urolithiasis formation is complex and multifactorial, but evidence strongly suggests the existence of numerous monogenic causes of urolithiasis in humans.
文摘Objective:To provide a comprehensive review on the existing literature on medical management of urolithiasis.Methods:A thorough literature review was performed using Medline,PubMed/PMC,Embase,and the Cochrane Database of Systematic Reviews up to December 2022 to identify publications on the medical management of urolithiasis.Studies that assessed dietary and pharmacologic management of urolithiasis were reviewed;studies on medical expulsive therapy were not included in this review.Results:Medical management of urolithiasis ranges from the prophylactic management of kidney stone disease to dissolution therapies.While most treatment concepts have been long established,large randomized controlled trials are scarce.Dietary modification and increased fluid intake remain cornerstones in the conservative management of urolithiasis.A major limitation for medical management of urolithiasis is poor patient compliance.Conclusion:Medical management of urolithiasis is more important in patients with recurrent urolithiasis and patients with metabolic abnormalities putting them at higher risk of developing stones.Although medical management can be effective in limiting stone recurrence,medical interventions often fail due to poor compliance.
文摘Objective: To assess if there is a preferable intervention between retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) tube, in cases of upper urinary tract stone obstruction with complications requiring urgent drainage, by evaluating outcomes regarding urinary symptoms, quality of life (QoL), spontaneous stone passage, and length of hospital stays, since there is no literature stating the superiority of one modality over the other.Methods: We searched MEDLINE and other sources for relevant articles in June 2019 without any date restrictions or filters applied. The selection was done first by the title and abstract screening and then by full-text assessment for eligibility. Only randomized controlled trials or cohort studies in patients with hydronephrosis secondary to obstructive urolithiasis that presented comparative data between PCN and RUS placement concerning at least one of the defined outcome measures were included. Lastly, MEDLINE database and PubMed platform were screened again using the same terms, from June 2019 until November 2022.Results: Of 556 initial articles, seven were included in this review. Most works were considered of moderate-to-high quality. Three studies regarding QoL showed a tendency against stenting, even though only one demonstrated statistically significant negative impact on overall health state. Two works reported significantly more post-intervention urinary symptoms in stenting patients. One article found that PCN is a significant predictor of spontaneous stone passage, when adjusted for stone size and location. Findings on length of hospital stays were not consistent among articles.Conclusion: PCN appears to be the intervention better tolerated, with less impact on the patient’s perceived QoL and less post-operative urinary symptoms, in comparison with RUS. Nevertheless, further studies with larger samples and a randomized controlled design are suggested.
文摘We report the first case of a ureteric stone containing gas. This rare stone with gas within it was found during the management of a diabetic patient with urosepsis as the initial presentation. Literature review of cases of renal stone containing gas, mechanisms of gas within the stone, and clinical implications of stone containing gas are discussed. Also, a new terminology is proposed to describe this phenomenon.
基金supported by 1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University,China[No.ZY2016104]Central Financial Fund,Guangzhou Medical University,China[No.2010A060801016].
文摘In Asia,about 1%-19.1% of the population suffer fromurolithiasis.However,due to variations in socio-economic status and geographic locations,the prevalence and incidence have changed in different countries or regions over the years.The research for risk factors of urinary tract stones is of predominant importance.In this review,we find the prevalence of urolithiasis is 5%-19.1% in West Asia,Southeast Asia,South Asia,aswellas somedevelopedcountries(SouthKorea and Japan),whereas,it is only 1%e8%inmost part of East Asia and North Asia.The recurrence rate ranges from 21% to 53% after 3e5 years.Calciumoxalate(75%-90%)is themost frequent component of calculi,followed by uric acid(5%-20%),calciumphosphate(6%-13%),struvite(2%-15%),apatite(1%)and cystine(0.5%-1%).The incidence of urolithiasis reaches its peak in population agedover 30 years.Males aremore likely to suffer fromurinary calculi.Because of different dietary habits or genetic background,differences of prevalence among races or nationalities also exist.Geneticmutation of specific locus may contribute to the formation of different kinds of calculi.Dietary habits(westernized dietary habits and less fluid intake),as well as climatic factors(hot temperature andmany hours of exposure to sunshine)play a crucial role in the development of stones.Other diseases,especially metabolic syndrome,may also contribute to urinary tract stones.
文摘Ever since the ureteral stent design was fitted with a curl on both sides to prevent it from migrating up or down the ureter some 40 years ago,its use has gained tremendous momentum,aiding in the rise and evolution of endourology and has confidently kept its place in modern time urology.Over the past four decades,several designs,coating and biomaterials have been developed,trying to reduce infection,encrustation and other stent related symptoms.As the ideal stent has not yet been discovered,different ways of helping patients with their complaints have been researched.This review will cover these aspects of stent use in urolithiasis.
文摘The last 3 decades have witnessed great improvements in the technology and clinical applications of many minimally invasive procedures in the urological field.Flexible ureteroscopy(fURS)has advanced considerably to become a widely utilized diagnostic and therapeutic tool for multiple upper urinary tract pathologies.The most common indication for fURS is the treatment of upper urinary tract stones with the aid of Holmium:Yttrium Aluminium Garnet(YAG)laser lithotripsy.Advancements in endoscope technologies and operative techniques have lead to a broader application of fURS in the management of urolithiasis to include larger and more complex stones.fURS has proved to be an effective and safe procedure with few contraindications.Continued progression in fURS may increase its clinical applicability and supplant other procedures as the first line treatment option for urolithiasis.
基金supported by the National Key Research and Development Plan of China(Technology helps Economy 2020)the Fundamental Research Funds for the Central Universities(2042020kf1081)+2 种基金the Nature Science Foundation of Hubei Province(2019CFB760)the Translational Medicine and Interdisciplinary Research Joint Fund of Zhongnan Hospital of Wuhan University(ZNJC201917)the Health Commission of the Hubei Province Scientific Research Project(WJ2019H035)。
文摘Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.
基金supported by a Travel Grant from the University Hospital Zurich and a grant from the Kurt and Senta Herrmann Foundationsupported by a EUSP scholarship from the EAU and a grant from the Belgische Vereniging voor Urologie(BVU).
文摘During the past 3 decades,the surgical management of kidney stones has undergone many technological advances and one is the development of the flexible ureteroscopy.The development of this instrument as well as ancillary equipment such as baskets,graspers,and others,and improvements in lithotripsy with Holmium:YAG laser have led to expand its indications with diagnostic and therapeutic management of medical issues of the upper urinary tract such as urolithiasis and urothelial tumors.The objective of this review is to describe its indications and results in the different scenarios for the treatment of urinary stones.
文摘AIM To analyse current literature focusing on pathogenesis and therapeutic aspects of urolithiasis with inflammatory bowel disease(IBD) and following bariatric surgery. METHODS A systematic literature search was performed using PubMed, supplemented with additional references. Studies assessing the association of IBD or bariatric surgery with renal stones in both paediatric and adulthood were included. RESULTS Certain types of stones are seen more frequently with IBD. Hyperoxaluria and hypocitraturia are the main metabolic changes responsible for urolithiasis. The incidence of renal stones in malabsorptive types of bariatric surgery such as gastric bypass is high; this is not as common in modern restrictive surgical methods. Preventative methods and urine alkalinisation have been shown to be beneficial.CONCLUSION Both conditions are associated with renal stones. Patients' counselling and prevention strategies are the mainstay of urolithiasis management in these patients.
文摘In the past few decades pediatric urolithiasis has become more frequent. The reason for this increase is not completely clear but has been attributed to changes in climate, nutritional habits and possibly other environ-mental factors. Although less frequent than adult stone disease, urolithiasis in the pediatric age group is also related to significant morbidity, particularly since stones tend to recur, and, thus, should not be underestimated. Most children with idiopathic stone disease have an underlying metabolic abnormality substantiating the importance of metabolic evaluation already following initial diagnosis of urolithiasis. Identification of the metabolic abnormality allows for more specifc prescription of non pharmacological and pharmacological interventions aimed at preventing recurrent stone formation. A better understanding of the causes of kidney stone disease will provide better strategies for stone prevention in children.
文摘Canine urolithiasis is a common disease of the urinary system, referring to the hemorrhage, inflammation and stagnation of the urinary tract caused by the mineral congelation centered with the dediduous epithelial cel s and other foreign matters surrounded by the salt crystal ization from the urine when the in the case of mineral metabolism disorder of canine. ln this paper, the causes, classification, treatment and prevention of canine urolithiasis were reviewed.
基金supported by a grant from the National Natural Science Foundation of China(No.30901482)
文摘Urinary prothrombin fragment 1 （UPTFl） is a potent inhibitor of urinary stone formation. UPTF1 exerts such inhibitory effect by effective 7-carboxylation in which vitamin K epoxide reductase complex subunit 1 （VKORC1）, the rate-limiting enzyme, is involved. This study examined the correlation between VKORC1 expression and calcium oxalate urolithiasis. The renal cortex samples were obtained from patients undergoing nephrectomy and then divided into 3 groups： urolithiasis group, control group A [hydronephrosis-without-stone （HWS） group], control group B （normal control group）, The localization and expression of VKORC1 in renal tissues were determined by using immunohistochemistry, immunofluorescence microscopy, Western blotting and SYBR Green I real-time reverse-transcription PCR. The rapid amplification of cDNA ends （RACE） were conducted to obtain the 3＇- and 5＇-untranslated region （UTR） of VKORC1. The results showed that VKORC1 was located in the cytoplasm of renal tubular epithelial cells. The expression of VKORC1 in the uro- lithiasis group was significantly lower than that in the other two control groups （P〈0.05）. Moreover, the 3＇- and 5＇-UTR sequence of the VKORC1 gene was successfully cloned. No insertion or deletion was found in the 3＇- and 5＇-UTR. However, a 171-bp new base sequence was discovered in the up- stream of 5＇-UTR end in the urolithiasis group. It was concluded that the decreased expression of VKORC 1 may contribute to the development of calcium oxalate urolithiasis in the kidney.
文摘Objective:To investigate the antilithiatic effect of the whole Leea macrophylla(L macrophylla) Roxb(Leeaeeae) ethanol extract in ediylene glycol-induced urolithiasis model of rats.Methods: Forty two seven weeks old male wistar albino rats were randomly divided into two major groups namely:preventive(n=18) and therapeutic(n=24).Preventive group was further subdivided into 3 groups of 6 rats namely:preventive control(PC),preventive lithiatic control(PLC) and preventive lithiatic L.macrophylla(PLLM).Similarly,therapeutic group was also subdivided into 4 groups of 6 rats namely:therapeutic control(TC),therapeutic lithiatic control(TLC).therapeutic lithitatic L macrophylla(TLLM) and therapeutic lithiatic cystone(TLCYS).The lithiasis was induced by 0.75%(v/v) ethylene glycol in the drinking water of all groups except the PC and TC groups.The urinary ionic parameters such as calcium,inorganic phosphate,oxalate,magnesium & creatinine and renal morphology were altered by ediylene glycol,which were partially recovered by 14 d preventive and almost fully recovered by 28 d therapeutic intervention trials with L macrophylla extract(500 mg/kg BW daily).Results:Significant difference on recovery was observed between preventive and dierapeutic interventional trials.Anti-urolithiatic effect of cystone was significantly(P【0.001) higher than extracts.L macrophylla extract was found nontoxic in the acute toxicity test.Conclusions:The results of this study demonstrated very promising antiurolithiatic effect of L.macrophylla extract with preventive and therapeutic treatments in this experimental condition.
文摘Objective To determine the prevalence of urolithiasis in young children fed infant formula（IF） contaminated with melamine,and the association between IF consumption and urolithiasis.Design A total of 2 733 children ≤3 years of age on September 1,2008 in two townships of Gansu Province,China were studied.Cases of urolithiasis were diagnosed by ultrasonography.Milk product consumption was determined by their caregivers.Remaining IF samples were tested for melamine and cyanuric acid.Results Of 2 733 eligible children in the two townships,2 186（80%） were enrolled in our study.Overall,16.6%（362） of 2 186 children had urolithiasis.The prevalence was 24.6% in children exclusively fed Sanlu brand IF,9.7% in those fed other IF,and 8.5% in those fed exclusively on other milk products.For children exclusively breast-fed,no urolithiasis was found（P0.05）.The prevalence of urolithiasis was 11.4% in children fed 400 g of Sanlu IF,rising to 37.5% in children fed over 25 600 g.Of 48 Sanlu IF samples,91.7% contained melamine（median=1 800 ppm;range=45-4 700） and 66.7% contained cyanuric acid（median=1.2 ppm;range=0.4-6.3）.Melamine was also detected in 22.2% of 36 other brand IF（median=27.5 ppm,range=4-50）.Conclusions Urolithiasis was associated with melamine-contaminated IF.Although one product caused most morbidity,other milk products may have also contributed to the outbreak.
文摘120 cases of urolithlasis were randomly divided into 3 groups of 40 persons each.The first group was solely treated with an improved acupuncture method,the second group was treatedwith Chinese herbal medicine,and the third group was treated with both of the above methods.Results showed that the improved acupuncture method possessed better stone-removing effect thanthe herbal medicine method and no much difference occurred between the patients treated withacupuncture and those treated with both above methods.Besides,the authors also experienced the excellentanalgesic and stone-dissolving effect of acupuncture in this study.
文摘This study examined the association of pregnancy with urolithiasis and provided new insights into urolithiasis in pregnancy. A total of 462 subjects were studied from January 2004 to December 2009 in Foshan Maternal and Child Health Hospital, China. Among the 462 subjects, 162 cases of urolithiasis during pregnancy （UPG） were selected as the observation group, 150 cases of no urolithiasis during pregnancy （NUPG） served as pregnancy control group, and 150 cases of no pregnancy （NPG） at reproductive age who took part in physical examination were randomly assigned into non-pregnant control group. At the same time, the patients in observation group were divided into the following sub-groups： no symptomatic urinary calculus （NSUC） and symptomatic urinary calculus （SUC） groups; SUC group was further divided into surgical intervention （SI） and conservative management （CM） groups. The general information and the data of blood and urine were collected and compared among the groups. The results showed that the incidence of urinary calculi in pregnant women was lower than that in non-pregnant women, the formation of urinary stone was associated with the change of metabolism of protein and sugar in pregnant women, and the surgical intervention was a practicable alternative to treat the clinical intractable symptomatic urinary calculi in pregnancy.
