Kidney Stone Research

The Use of Alpha-Blockers for the Treatment of Nephrolithiasis

The Use of Alpha-Blockers for the Treatment of Nephrolithiasis

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Alpha blockers may also be a useful adjunct in the treatment of both ureteral and renal stones with SWL. They may also reduce the urinary symptoms and pain associated with double-J ureteral stents. Further investigation is necessary to define the role of  blockers in the treatment of proximal ureteral and renal stones, and to elucidate the potential mechanisms of renal stone clearance after surgical stone intervention.
Medical expulsive therapy

Medical expulsive therapy

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The AUA/EAU guidelines suggest MET as a reasonable treatment choice in select patients. Previous studies have demonstrated a significant benefit in stone expulsion rates with the use of MET. A review of the data suggests greater success rates occur with the use of alpha antagonist compared to calcium channel blockers. The use of MET is not limited to just those patients attempting passage of calculi without other interventions; there is also an advantage to MET in those subjects treated with other modalities (i.e. SWL and ureteroscopy).
Even with multiple studies demonstrating the benefits of MET, it still is underutilized as a treatment modality. Education in the hospital setting appears to be beneficial in changing practice behaviors. MET may reduce medical costs and prevent unnecessary surgeries and the associated risks.
How can and should we optimize extracorporeal shockwave lithotripsy?

How can and should we optimize extracorporeal shockwave lithotripsy?

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The purpose of this article is to emphasize some important aspects on how SWL best should be used. Based on decades of experience, it stands to reason that success with SWL does not come automatically and attention has to be paid to all details of this technique.
Optical puncture combined with balloon dilation PCNL vs. conventional puncture dilation PCNL for kidney stones without hydronephrosis: a retrospective study

Optical puncture combined with balloon dilation PCNL vs. conventional puncture dilation PCNL for kidney stones without hydronephrosis: a retrospective study

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Optical puncture combined with balloon dilation PCNL could be associated with good therapeutic effect and low frequency of complications for the treatment of kidney stones without hydronephrosis.
Retrograde intrarenal surgery for lower pole renal calculi smaller than one centimeter

Retrograde intrarenal surgery for lower pole renal calculi smaller than one centimeter

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RIRS continues to undergo signiÞ cant advancements and is emerging as a Þ rst-line procedure for challenging stone cases. The treatment of choice for LC calculi < 1 cm depends on patient’s preference and the individual surgeon’s preference and level of expertise.

Effect of perioperative selective alpha-1 blockers in non-stented ureteroscopic laser lithotripsy for ureteric stones: a randomized controlled trial

Effect of perioperative selective alpha-1 blockers in non-stented ureteroscopic laser lithotripsy for ureteric stones: a randomized controlled trial

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Administration of perioperative Flomax seems to not only to significantly decrease the need for intra-operative dilatation and hence operative time, but also leads to a significant decrease in the development of postoperative LUTs, postoperative pain and the need for analgesia and hospital stay.

Retrograde versus Antegrade Approach for the Management of Large Proximal Ureteral Stones

Retrograde versus Antegrade Approach for the Management of Large Proximal Ureteral Stones

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Antegrade ureteroscopy is an efficient and safe option for the management of large proximal ureteral stones. It may achieve high stone-free rates compared to retrograde ureteroscopy with the drawback of longer operative time, fluoroscopy time, and length of hospitalization.

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