Accuracy of ultrasonography for renal stone detection and size determination: is it good enough for management decisions?

Ganesan, Vishnu; De, Shubha; Greene, Daniel; Torricelli, Fábio César Miranda

doi:10.1111/bju.13605

Cited by 69 publications

(40 citation statements)

References 22 publications

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“…22 Another important note to make is that ultrasound imaging was used preoperatively in about onefourth of patients and may not accurately assess stone burden. 23 However, the ratio of imaging modality used was similar between the LithoVue and reusable cohorts. Therefore, any effect of imaging modality on assessment of stone burden should have been relatively uniform between the two cohorts.…”

Section: Discussionmentioning

confidence: 94%

A Prospective Case–Control Study Comparing LithoVue, a Single-Use, Flexible Disposable Ureteroscope, with Flexible, Reusable Fiber-Optic Ureteroscopes

Usawachintachit

Isaacson

Taguchi

et al. 2017

Journal of Endourology

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Objective: LithoVueÔ is a novel, single-use, digital flexible ureteroscope that was released to the US market in January 2016. There are scant data regarding its performance in humans. Procedural outcomes comparing LithoVue with reusable ureteroscopes are presented in patients undergoing ureteroscopy for upper urinary tract pathology. Patients and Methods: Clinical outcomes between two groups of patients undergoing flexible ureteroscopy for upper urinary tract pathology were analyzed. The first group underwent surgery utilizing LithoVue, and the second group used reusable fiber-optic flexible ureteroscopes. Differences in procedural outcomes, operative times, and time spent in hospital were analyzed using two-tailed t-tests and chi-squared and Fisher's exact tests. Results: One hundred fifteen cases utilizing LithoVue and 65 cases utilizing reusable ureteroscopes were included in this study. Demographics, surgical indications, stone size, location, total stone burden, composition, procedural outcomes, and complications were comparable between groups. For all cases, LithoVue procedures lasted 54.1 -25.7 minutes compared with 64.5 -37.0 minutes for reusable scope procedures ( p < 0.05) and for stone removal cases, 57.3 -25.1 vs 70.3 -36.9 minutes, respectively ( p < 0.05). Scope failure occurred in 4.4% of LithoVue cases and 7.7% of reusable cases ( p = 0.27). Conclusions: LithoVue represents a feasible alternative to reusable ureteroscopes with a low rate of scope failure comparable with reusable ureteroscopes. Its use shortens procedure duration, a finding that warrants further investigation.

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Section: Discussionmentioning

confidence: 94%

A Prospective Case–Control Study Comparing LithoVue, a Single-Use, Flexible Disposable Ureteroscope, with Flexible, Reusable Fiber-Optic Ureteroscopes

Usawachintachit

Isaacson

Taguchi

et al. 2017

Journal of Endourology

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“…These patients had been assessed with ultrasound scans which are notoriously unreliable in accurately diagnosing stones. 13 it was believed that all patients presenting with stone disease should have a CT scan to confirm diagnosis but are aware that the ease of obtaining such scans does lead to unnecessary exposure to ionising radiation. 14 Patient education regarding the risks of this exposure is important so that patients can inform doctors about their stone history and detail previous CT scans.…”

Section: Discussionmentioning

confidence: 99%

Shockwave lithotripsy for urolithiasis: a 12-month analysis of referral data to a metropolitan Australian Hospital

Jaya

Nguyen²,

Tran

et al. 2020

Int Surg J

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Background: Extracorporeal shockwave lithotripsy (SWL) is still an important option in the treatment of renal tract stones. SWL is not without its limitations and alternatives should be considered. This study investigates the referral data to a new SWL planning meeting to identify reasons why SWL was not offered.Methods: A review of 12 months of data prospectively collected at a weekly stone meeting was supplemented with a retrospective chart analysis to identify the source of all referrals for SWL. The principal reason for diverting a patient to other stone management was noted.Results: 142 patients (median age 52 years) were referred for SWL over the 12-month period. SWL was not recommended in 40 (28.2%) patients. SWL was most commonly contraindicated due to excessive stone size±position (32.5%), anatomical complexity (25.0%) and radiolucency on x-ray (10.0%). The majority of patients who were diverted away from SWL were referred from an emergency department (32.5%) and the general urology clinics (20.0%).Conclusions: A significant portion of patients referred for SWL prove unsuitable for this method of stone clearance. This highlights an educational gap amongst clinicians regarding the indications and more importantly contraindications for SWL. Only 6.3% of total referrals originated from general practice suggesting a lack of awareness of the process of direct referral for SWL. Improving this with guidelines will relieve demand in outpatient clinics and help streamline patient care.

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“…Maybe … but it certainly gives an evidence base for stone surgeons in making decisions in very high‐risk patients. Manoj Monga and his group recently reported on the accuracy of US for the detection of renal stones . This again is a very important topic and a question that commonly arises.…”

mentioning

confidence: 99%

Urolithiasis around the world

Bultitude

2017

BJU International

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Accuracy of ultrasonography for renal stone detection and size determination: is it good enough for management decisions?

Abstract: Using US to guide clinical decision-making for residual or asymptomatic calculi is limited by low sensitivity and inability to size the stone accurately. As a result, one in five patients may be inappropriately counselled when using US alone.

Cited by 69 publications

References 22 publications

A Prospective Case–Control Study Comparing LithoVue, a Single-Use, Flexible Disposable Ureteroscope, with Flexible, Reusable Fiber-Optic Ureteroscopes

A Prospective Case–Control Study Comparing LithoVue, a Single-Use, Flexible Disposable Ureteroscope, with Flexible, Reusable Fiber-Optic Ureteroscopes

Shockwave lithotripsy for urolithiasis: a 12-month analysis of referral data to a metropolitan Australian Hospital

Urolithiasis around the world

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