Survandita Dhawan¹, Ephrem O. Olweny²

Canadian Journal of Urology, Vol.27, No.2, pp. 10162-10166, 2020

Abstract Introduction: Phyllanthus niruri (P. niruri) is the most commonly listed active ingredient in commercially available herbal therapies for kidney stones, despite limited supporting clinical evidence. We performed a meta-analysis to evaluate its efficacy in reducing stone burden. We used Google Trends to analyze its relative popularity in internet searches relative to conventional stone therapies.
Materials and methods: A comprehensive literature search for controlled human studies containing data on the effect of P. niruri treatment on stone size and number was performed. Pooled analysis of change in mean stone size and number with P. niruri was performed using… More >

Kinan Bachour¹, Michael E. Rezaee², Amanda R. Swanton², Vernon M. Pais, Jr.^1,2

Canadian Journal of Urology, Vol.27, No.3, pp. 10238-10243, 2020

Abstract Introduction: To investigate the relationship between socioeconomic factors, specifically insurance status, and kidney stones using a nationally representative cohort.
Materials and methods: A retrospective secondary data analysis of National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2014 was performed. Using univariate statistics and multiple logistic regressions, we examined the relationship between socioeconomic factors and kidney stone history.
Results: The weighted national prevalence of nephrolithiasis between ages 20 and 64 was 7.7% of a population of over 95.3 million. Fifty-three percent of the total population was female. The mean age was 42 years and the mean… More >

Amy M. Reed¹, Eric C. Umbreit², James K. Aden¹, Christopher L. Allam¹

Canadian Journal of Urology, Vol.27, No.4, pp. 10317-10321, 2020

Abstract Introduction: To determine the efficacy and safety of using the semi-rigid ureteroscope as the only ureteral dilator for primary ureteroscopy (URS) in the treatment of renal stones.
Materials and methods: A retrospective review of primary URS for renal stone disease was performed on consecutive patients treated by a single provider from 2013 to 2017. Utilizing wire placement under fluoroscopic guidance and direct visual ureteroscopic dilation with a semi-rigid ureteroscope, primary outcome was successful completion of stone treatment. In addition, perioperative safety was evaluated.
Results: A total of 126 consecutive cases of primary URS using the semi-rigid ureteroscope as… More >

Jordan Allen, Necole M. Streeper

Canadian Journal of Urology, Vol.27, No.6, pp. 10488-10491, 2020

Abstract Obesity is a known risk factor for recurrent nephrolithiasis and it can be challenging to provide safe surgical intervention in the super obese population. Despite high weight limits on surgical beds, these often do not take into account positioning the patient on the end of the bed for dorsal lithotomy, which can risk an unsteady bed. In addition, depending on patient habitus the leg stirrups may not accommodate. There is limited literature that discusses the technical approach for positioning super obese patients in dorsal lithotomy when the weight limit approaches or exceeds the capacity of More >

Amihay Nevo¹, Jonathan P. Moore¹, Mitchell R. Humphreys¹, Saif Salih¹, Mira A. Keddis², Kyle M. Rose¹, Scott S. Cheney¹, Karen L. Stern¹

Canadian Journal of Urology, Vol.27, No.6, pp. 10450-10455, 2020

Abstract Introduction: Bladder stones have historically been associated with urinary stasis secondary to bladder outlet obstruction (BOO). Recent studies indicate that the role of BOO in bladder stone formation is minor. We evaluate the role of urinary lithogenic factors in bladder stone formation by comparing the compositions of bladder stones and kidney stones in patients with multi-site urinary calculi.
Materials and methods: We identified patients who were treated for concomitant bladder stones and kidney stones between 2008-2019 and had both stone compositions available. Patients with bladder stone size < 10 mm, urinary foreign bodies, encrusted stents, or tumors… More >

Kevan M. Sternberg¹, Andrew Pham¹, Theodore Cisu¹, Marissa L. Kildow², Kristina L. Penniston²

Canadian Journal of Urology, Vol.25, No.6, pp. 9585-9590, 2018

Abstract Introduction: Renal colic is commonly seen in the emergency department (ED), where the focus is on diagnosis and symptom control. Educational materials are sometimes provided upon discharge; however, no standard content has been established. We characterized the educational materials given to patients reporting to EDs in different regions across the U.S. for symptomatic kidney stones, specifically evaluating disease-specific information, symptom management, prevention strategies including dietary recommendations (DRs), and patient follow up plans.
Materials and methods: Generic discharge instructions for patients presenting to EDs with renal colic were obtained from community hospitals and academic medical centers between October… More >

Nazih Khater, Mohamed Keheila, Michelle Lightfoot, Jim Shen, Samuel Abourbih, Muhannad Alsyouf, Roger Li, D. Duane Baldwin

Canadian Journal of Urology, Vol.24, No.1, pp. 8634-8640, 2017

Abstract Introduction: Percutaneous nephrolithotomy (PCNL) is associated with significant variability in postoperative pain and subsequent narcotic use. The purpose of this study was to determine the factors associated with high narcotic use following PCNL.
Materials and methods: A single-center retrospective review of patients undergoing initial PCNL between 2004 and 2014 was performed. Preoperative, intraoperative and postoperative factors associated with postoperative narcotic usage were analyzed. The primary outcome variable was mean narcotic usage, standardized to intravenous morphine-equivalents. Patients in the lowest 75th percentile were compared to those in the highest 25th percentile. Univariate and multivariate statistical analyses were performed, with… More >

Amy H. Lim¹, Necole M. Streeper², Sara L. Best¹, Kristina L. Penniston¹, Stephen Y. Nakada¹

Canadian Journal of Urology, Vol.24, No.4, pp. 8890-8894, 2017

Abstract Introduction: Patient decision-making aids (PDMAs) help patients make informed healthcare decisions and improve patient satisfaction. The utility of PDMAs for patients considering treatments for urolithiasis has not yet been published. We report our experience using PDMAs developed at our institution in the outpatient clinical setting in patients considering a variety of treatment options for stones.
Materials and methods: Patients with radiographically confirmed urolithiasis were given PDMAs regarding treatment options for their stone(s) based on their clinical profile. We assessed patients' satisfaction, involvedness, and feeling of making a more informed decision with utilization of the PDMAs using a… More >

David E. Rapp^1,3, Nada L. Wood¹, Matthew Bassignani¹, Luke Gergoudis², Sarah Caulkins³, Eugene V. Kramolowsky^1,3

Canadian Journal of Urology, Vol.23, No.5, pp. 8441-8445, 2016

Abstract Introduction: Non-contrast CT (NCT) is commonly used to evaluate flank pain (FP). We sought to evaluate incidence of ureteral calculi on NCT in patients with FP, and to determine if clinical variables are associated with higher detection rates.
Materials and methods: Retrospective review identified 613 patients undergoing NCT for FP. Patient clinical data, NCT findings, and intervention were analyzed. Focus was placed on variables commonly associated with urolithiasis (V_stone), comprising hematuria, nausea/vomiting, and prior stone history. Statistical analysis was performed to identify risk of ureteral stones based on number and type of V_stone.
Results: No stone disease was identified… More >

Rachel A. Moses¹, Lawrence M. Dagrosa¹, Elias S. Hyams¹, Peter L. Steinberg², Vernon M. Pais¹

Canadian Journal of Urology, Vol.20, No.5, pp. 6939-6943, 2013

Abstract Introduction: The purpose of this study is to evaluate predictors of poor compliance after treatment of urinary stone disease.
Materials and methods: This study was a retrospective analysis of patients who underwent stent removal following percutaneous nephrolithotomy (PCNL) or ureteroscopy (URS) between 2008-2012. All patients were scheduled for follow up evaluation and renal ultrasound at 4-6 weeks following stent removal. Patients were stratified based on appointment compliance and demographic variables including gender, age, insurance type (Government Assisted Insurance [GAI] or Private Insurance [PI]), initial procedure, season, distance between home and clinic, average monthly gas price at follow… More >