Epidemiological studies have reported an association between metabolic dysfunction-associated steatotic liver disease (MASLD) and the risk of urolithiasis. However, the magnitude of the risk and whether this risk varies with the severity of MASLD remains uncertain. We performed a meta-analysis of observational studies to quantify the magnitude of the association between MASLD and urolithiasis. We systematically searched PubMed, Scopus, and Web of Science from database inception to March 31, 2024, using predefined keywords to identify relevant observational studies in which imaging methods or survey questionnaires diagnosed MASLD and urolithiasis. Meta-analysis was performed using random-effects modelling. We identified seven cross-sectional studies and one prospective cohort study with aggregate data on 248,936 adults from different countries. MASLD was significantly associated with an increased risk of prevalent urolithiasis (pooled random-effects odds ratio 1.87, 95% CI 1.34-2.60; I2 = 91%). This association remained significant in those studies whose results were adjusted for age, sex, ethnicity, obesity, diabetes, and other potential confounders. There was a positive graded association between the ultrasonographic severity of MASLD and urolithiasis. Meta-analysis of the single prospective cohort study showed that MAFLD was not associated with risk of developing incident urolithiasis (pooled random-effects hazard ratio 1.08, 95% CI 0.90-1.30), although a significant association was reported in men. Sensitivity analyses did not modify these findings. The funnel plot did not reveal any significant publication bias. This updated meta-analysis provides evidence for a significant association between MASLD and the presence of urolithiasis. Whether MASLD is associated with a higher risk of developing incident urolithiasis remains to be established.

OBJECTIVE: We sought to prospectively evaluate the impact of previously failed SWL on subsequent URS outcomes in the treatment of upper urinary tract stones.
METHODS: Between May 2021 and May 2023, one hundred thirty-six patients with proximal ureteral stones < 1.5 cm and renal stones < 2.5 cm who were candidates for URS were prospectively assigned to a non-SWL group, which included patients without a history of failed SWL before URS, and a post-SWL group, which included patients with a history of failed SWL before URS. The success rate was the primary outcome. The perioperative data of the two groups were compared.
RESULTS: The stone-free rate was 83.3% in the post-SWL group versus 81.3% in the non-SWL group, and 8.3% in the post-SWL group versus 9.4% in the non-SWL group had clinically insignificant residual fragments. There was no significant difference in the stone-free rate or success rate between the groups. No significant differences in intraoperative fluoroscopy time, operative time, intraoperative stone appearance, perioperative complications, or the presence of embedded fragments in the ureteral mucosa were detected between the two groups.
CONCLUSIONS: Compared with patients who underwent primary URS, patients who underwent salvage URS for upper urinary tract stones had similar stone-free rates, success rates, operative times, fluoroscopy times, and complication rates without any significant differences.

Background Percutaneous nephrolithotomy (PCNL) is considered a standard treatment option for large-size renal stones but is associated with drawbacks such as bleeding and prolonged recovery. Mini-PCNL offers a less invasive alternative, but its efficacy compared to standard PCNL for renal stones larger than 2 cm remains under debate. This study aims to compare the efficacy and safety of standard PCNL versus mini-PCNL for renal stone sizes more than 2 cm. Methods This single-centre prospective interventional study will be conducted at Acharya Vinoba Bhave Rural Hospital (AVBRH). The study will include patients 18 to 70 years of age undergoing unilateral PCNL for renal calculi. Patients with renal stones larger than 2 cm will be enrolled. Data on stone-free rate (SFR), operative duration, hospital stay time, surgical site infection, haemoglobin (Hb) drop, need for blood transfusion, and post-surgery fever will be collected and compared between the two procedures. Statistical analysis of data will be performed using descriptive and analytical statistics. Results The study aims to enrol a total of 32 patients. Data analysis will be done using IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York). Conclusion This study will provide valuable insights into the comparative outcome in terms of efficacy and safety of standard PCNL and mini-PCNL for kidney stones larger than 2 cm.

UNASSIGNED: To determine the utilization of barley and parsley for managing urolithiasis among the Saudi Arabian population.
UNASSIGNED: This is a prospective cross-sectional survey-based study. The survey comprised questions about the use of barley, parsley, and other therapies for managing urolithiasis. A WhatsApp® message with the link to the study survey was sent out to family, friends, patients, and other acquaintances residing in the Kingdom of Saudi Arabia (KSA).
UNASSIGNED: A total of 1014 respondents completed the survey, of which 44.8% indicated that they utilized barley, 38.3% stated that they used parsley, and 4.2% indicated that they utilized other non-medical remedies to treat or prevent kidney stones. In contrast, only 29.5% stated that they utilized potassium citrate and/or magnesium citrate, and only 14.4% indicated that they consumed greater amounts of water to treat or prevent kidney stones.
UNASSIGNED: Our study findings indicate that among the Saudi Arabian population, non-conventional therapies such as barley and parsley are more commonly utilized for managing urolithiasis rather than established therapies such as increasing water intake and the use of potassium-citrate/ magnesium-citrate. There is a need to conduct large-scale clinical studies to evaluate the efficacy and safety of barley, parsley, and other non-conventional therapies for treating urolithiasis.

Renal stones are solid deposits formed from minerals and salts that develop within the kidneys and urinary tract. While the condition is more common among adults, children and even infants can also be affected. There is an increasing incidence of paediatric renal stones in Africa alongside multiple challenges faced in managing the condition. This scoping review aimed to provide an overview of the management modalities of paediatric renal stones in Africa. This study utilised Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. A systematic search was conducted in three electronic databases: PubMed, African Journal Online (AJOL), and Google Scholar, with 1,180 articles curated. After extensive examination, 10 articles satisfied the inclusion criteria. The review found that calcium oxalate stones were the most prevalent type, accounting for 34.03% of cases, followed by whewellite stones and ammonium urate stones. The most frequent location for stones was the kidney, and the most common symptom was pain. Abdominopelvic ultrasound was the most frequently utilised investigation. Of the 886 patients managed for renal stones, 75.4% were managed surgically, 2.9% medically, and 21.7% spontaneously resolved without intervention. This review identifies opportunities for improving the management of paediatric renal stones in Africa, including the need for standardised diagnostic and treatment protocols and the development of evidence-based guidelines tailored to the African context. Overall, this scoping review provides valuable insights into the patterns and management of paediatric renal stones in Africa and highlights the need for further research to improve the management of this condition in the region.

Background and objective Kidney stones, also referred to as nephrolithiasis or renal calculi, is a condition where crystal depositions are formed within the kidney and ideally excreted from the body via the urethra with no pain; however, larger calculi may cause significant pain and require further medical assistance. The vast majority of patients who develop renal calculi form calcium stones, which are either a composition of calcium oxalate or calcium phosphate. Other types include uric acid, struvite, and cysteine. While kidney stones are one of the most significant diseases among the Saudi population, which require an acute emergency intervention to prevent serious long-term complications, there are limited studies published regarding this condition in Saudi communities. In light of this, we performed this study to assess the prevalence, incidence, and risk factors of kidney stones among the population of Riyadh, Saudi Arabia. Methods This was a cross-sectional study conducted in Riyadh, Saudi Arabia between August and October 2023, aiming to estimate the prevalence and risk factors of nephrolithiasis among residents of the Riyadh province. Data were collected through an electronic questionnaire in both Arabic and English and distributed via social media in addition to barcode handouts in various selected venues in Riyadh. The questionnaire involved 12 questions categorized into three sections. The first section obtained demographical information while the second section collected data about the past medical history of the participants. Lastly, the third section aimed to assess the prevalence of nephrolithiasis among participants or any history of the condition among their families. Results A total of 1,043 participants were surveyed, of whom 533 were males (51.1%). The prevalence of kidney stones was reported in 98 individuals (9.4%) overall. Individuals in the age groups of 36-50, 51-60, and >60 years showed significantly more renal stone prevalence than those in younger age groups (p<0.001). The prevalence was found to be higher in participants who were smokers, diabetic, hypertensive, and those who suffered from inflammatory bowel disease (IBD), gout, chronic kidney disease (CKD), hyperthyroidism, and hyperparathyroidism. Participants who took calcium supplements or had a positive family history of renal stones were found to have a higher prevalence of renal stones as well. However, only hypertension, gout, and family history showed any statistical significance (p<0.05). Conclusions A direct correlation was observed between hypertension, gout, positive family history, and aging and an increased prevalence of kidney stones among the inhabitants of the Riyadh province. Therefore, we encourage the local authorities to raise awareness of kidney stones and their related risk factors among the general public. Moreover, further local studies need to be conducted to gain deeper insights into kidney stone prevalence, especially pertaining to associated comorbidities and the pattern of the disease itself.

OBJECTIVE: To evaluate the usage of shear wave elastography (SWE) in the prediction of the success rate of shock‑wave lithotripsy (SWL) treatment of renal stones.
METHODS: In the present study, SWL was performed for 100 patients presented with renal stones in the duration from May 2022 to August 2023. The patients were divided into 2 groups SWL responders and non-responders. The study compared between the 2 groups in terms of baseline parameters of the patients as age, sex, body mass index (BMI), stone size, stone location, stone density (HU), skin-to-stone distance (SSD), the degree of hydronephrosis and the stone elastography values.
RESULTS: There was no statistically significant relation between stone-free rate and degree of obstruction (p = 0.628), stone size (p = 0.390) upper calyceal location (p = 0.17), middle calyceal location (p = 0.66), and renal pelvis location (p = 1.0). Nevertheless, a statistically significant relation was found as regards lower calyceal location, stone density (HU), and stone Elastography values using multivariate analysis.
CONCLUSIONS: Measurement of stone density by shear wave elastography (SWE) can be used as an alternative to HU in decision-making before SWL. SWL success depends mainly on stone site, HU, and SWE values.

UNASSIGNED: Generally, there are many methods for the treatment of urinary stones, of which percutaneous nephrolithotomy (PCNL) is a minimally invasive and highly effective method, and now become the first-line management for urinary stones, especially in the cases of complex stones and staghorne calculi. Accurate assessment of stone location, stone morphology, degree of hydronephrosis as well as urinary system abnormalities is extremely important in the percutaneous nephrolithotomy strategy.
UNASSIGNED: The aim of this study was to evaluate the S.T.O.N.E score as well as other factors that influenced the effectiveness of PCNL.
UNASSIGNED: Descriptive study on 71 patients with kidney stones, who underwent multi-slice CT scan of the urinary system before PCNL and then PCNL at Hanoi Medical University Hospital from July 2022 to July 2023. All patients received the informed consent and agreed to participate in the study. The factors included the stone area, the track length (from the skin surface to the stone central), the degree of urinary tract dilatation, the number of involved calyces, the density of stone, the renal parenchyma thickness, the ureteral wall thickness and fat infiltration measured on MSCT non-contrast phase. These factors were used to predict the effectiveness of PCNL including the stone clearance rate (SCR) and the operation time.
UNASSIGNED: The mean age of the patient group was 53.8±12.3. The male/female ratio was 1.54. There was a significant difference (p<0.05) between the following factors and the operation time: the stone area (<400, 400-799, 800-1599 and >1600 mm2), the degree of urinary tract dilatation (no or might and moderate or severe dilatation), the number of involved calyces (≤ 2, 3 and staghorne calculi), the renal parenchyma thickness (<18 mm and ≥18mm). In contrast, there were no significant differences between the following factors and the surgery time (p>0.05): the track length (<100 and ≥100 mm), and the stone density (<950 and ≥950 HU). Regarding the S.T.O.N.E score (included five factors: Size, Track length, Obstruction, Number of involved calyces, and Evaluation of stone density), there was a strong correlation between S.T.O.N.E score and the surgery time (p<0.001, r=0.94), and the SCR (p=0.001, r=-0.97).
UNASSIGNED: The evaluation of these factors played an important role in the prediction of the effectiveness of PCNL.

OBJECTIVE: Medical device companies have introduced new TFL machines, including Soltive (Olympus, Japan), Fiber Dust (Quanta System, Italy), and TFLDrive (Coloplast, France). The primary objective of this study is to compare our initial clinical experiences with TFL using those devices. Through this historical comparison of Thulium Fiber Laser systems for stone lithotripsy, we aim to advance our understanding and approach toward achieving safe and effective TFL parameters.
METHODS: The data for this comparative analysis were extracted from three distinct prospective series that were previously published, outlining our initial clinical experience with the Soltive (Olympus, Japan), FiberDust laser (Quanta System, Italy), and TFLDrive laser (Coloplast, France). Parameters such as stone size, stone density, laser-on time (LOT), and laser settings were meticulously recorded. Additionally, we assessed critical variables such as ablation speed (expressed in mm3/s) and Joules/mm3 for each lithotripsy procedure.
RESULTS: A total of 149 patients were enrolled in this study. Among them, 120 patients were subjected to analysis concerning renal stones. Statistically significant differences were observed in the median (IQR) stone volume: 650 (127-6027) mm3 for TFLDrive, 1800 (682.8-2760) mm3 for Soltive, and 1125 (294-4000) mm3 for FiberDust (p: 0.007); while there were no differences regarding stone density among the groups. Significant variations were identified in median (IQR) pulse energy, frequency, and total power. The Soltive group exhibited lower energy levels (0.3 J vs. 0.6 J, p: 0.002) but significantly higher pulse frequency (100 Hz vs. 17.5 Hz, p: 0.003) and total power (24 W vs. 11W, p: 0.001) compared to the other groups. Laser-on time showed no substantial differences across all three groups. Additionally, a statistically significant difference was observed in median J/mm3, with the TFLDrive group using higher values (24 J/mm3, p: 0.001), while the Soltive group demonstrated a higher median ablation speed of 1.16 mm3/s (p: 0.001). The overall complication rate remained low for all groups, with comparable stone-free rates.
CONCLUSIONS: By reducing pulsed frequency, we improved laser efficiency, but smaller volumes lead to decreased efficiency due to increased retropulsion and fragment movement. Further studies are needed to identify and establish the appropriate laser settings for this new technology.

UNASSIGNED: The objective of the study y was to evaluate factors which can improve shock wave lithotripsy (SWL) results to keep up with COVID-19 pandemic.
UNASSIGNED: Between June 2020 and June 2021, patients with radio-opaque or faint radio-opaque upper urinary tract stones, stone attenuation value ≤1200 HU, and stones size <2.5 cm were treated by electrohydraulic SWL. Patients with respiratory tract symptoms elevated temperature, contact with COVID-19 patients, or positive COVID-19 swab 2 weeks preoperatively, skin-to-stone distance >11 cm, and body mass index >30 kg/m2 were excluded from the study. Patients were prospectively enrolled in SWL done at a rate of 40-50 SWs/min under combined ultrasound and fluoroscopy-guided, ramped into high power in the 1st 300 shocks. Success rate and complications were recorded.
UNASSIGNED: Five hundred and ninety patients completed the study. The success rate after 1st session was 408/590 patients (69.15%) which was augmented by 2nd session to reach 527/590 patients 89.3%. The success rate was 96.2% at 3 months postoperatively. Most complications were mild (Grade 1 or 2).
UNASSIGNED: SWL results improved using slow rate high power from the start of the session under combined fluoroscopy and ultrasound guidance. SWL may be a preferred option during a pandemic.