The origins of urinary stone disease

This is a descriptive paper of micro CT scans of tubular mineralisation in 12 nephrectomy specimens. The authors noted that: in the small number of specimens examined, mineralisation started in the outer medulla and appeared to proceed distally along the...

Bedside teaching

All of us are involved in the teaching and training of under or postgraduate medical students and nurses. This article gives a patient’s perspective and thoughts on being an ‘interesting’ patient within a ward or clinic setting. Important points to...

Emergency department revisits for patients with ureteral stones

The authors aimed to identify clinical predictors for emergency department (ED) revisits in patients diagnosed with ureteral stones. Patients presenting between 2010 and 2013 were included. Those who were admitted at the initial presentation were excluded. CT scans were reviewed...

Uncovering the fate of small residual fragments

The concept of ‘stone free’ remains an enigma. To some urologists this refers to complete removal of all visible fragments, to others its removal of all ‘clinically significant’ fragments (generally regarded as fragments >2mm), and to some it is absence...

Urology patient assessment – importance of holistic approach – new paradigm

Mild cognitive impairment (MCI) seems to affect 30% of the general population above 65 and its presence has a wide range of significance. This is a prospective single centre study to look at MCI in adult urological patients above 18...

Understanding gender differences in nephrolithiasis

Rates of nephrolithiasis are higher in males than females. The cause for this remains unclear, however animal models have demonstrated an association between sex steroid hormone levels and lithogenesis. This relationship in humans is less well established. This study from...

Factors associated with post ureteroscopy urosepsis

The authors investigate which factors were most likely to increase the risk of postoperative urosepsis within 28 days of ureteroscopy (URS) and laser stone fragmentation by analysing the 34 of 562 patients who developed this complication. Stone size, same session...

Effect of collimation on radiation dose during ureteroscopy

Over 60,000 ureteroscopies are performed annually in the UK. During these procedures radiation is used and there are concerns regarding the cumulative dose during a surgeon’s career. Common ways to minimise the dose to the theatre team are wearing lead...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Kidney stone basketing forces unmasked

Ureteral avulsion is the most dreaded situation for any urologist to be faced with. Although uncommon, with rates of ureteroscopy on the increase, the potential for this serious complication should also be recognised. To avoid such serious complications, smart devices...

Renal stones: an American perspective

This study is from Dallas, USA and appears on the front cover of the BMJ. About 1 in 11 people will have a kidney stone at some point in their lifetime. There is a linear increase in stone prevalence in...

Do stones still kill?

This paper is a retrospective analysis of deaths ascribed to stone disease in England and Wales over a 15-year period. The data was obtained from the Office of National Statistics, based on mortality derived from death certificates. One thousand, nine...