Pub Date : 2026-01-14DOI: 10.1007/s00240-025-01932-9
Leilei Xiao, Miaolin Guo, Juxiang Xie, Jie Deng, Yuxuan You
Percutaneous nephrolithotomy (PCNL) is the gold-standard treatment for large renal and upper ureteral stones. Continuous irrigation is essential for visualization, thermal control, and fragment clearance but carries risks such as hypothermia, electrolyte imbalance, elevated intrarenal pressure, and infection. This review summarizes current evidence on irrigation strategies during PCNL and provides recommendations to mitigate these risks. A systematic literature search was conducted for English-language full-text articles published up to January 2025, using terms related to PCNL and irrigation. Eligible designs included randomized controlled trials, cohort studies, case-control studies, and case series. Reviews, editorials, and duplicates were excluded. A total of 553 abstracts were screened by a single reviewer, with 28 studies meeting inclusion criteria. Reference lists were hand-searched for additional sources. Evidence highlights multiple determinants of irrigation safety and efficacy. Distilled water and other hypotonic solutions were associated with electrolyte shifts, whereas saline maintained stability. Additives such as tranexamic acid reduced intraoperative blood loss, transfusion rates, and hospital stay without added complications, while povidone-iodine or antibiotic irrigation showed promise in reducing postoperative fever and sepsis. Warmed irrigation fluid mitigated hypothermia but raised concerns of bleeding and thermal injury. Excessive irrigation volume and prolonged operative duration consistently correlated with greater systemic absorption, hemodynamic instability, and electrolyte changes. Irrigation parameters directly influence perioperative safety and outcomes in PCNL. Although isotonic saline remains the standard, antifibrinolytic and antimicrobial additives, individualized temperature management, and optimized volume control represent promising strategies.
{"title":"Progress in the study of irrigation strategies for percutaneous nephrolithotomy: a narrative review of the current literature.","authors":"Leilei Xiao, Miaolin Guo, Juxiang Xie, Jie Deng, Yuxuan You","doi":"10.1007/s00240-025-01932-9","DOIUrl":"https://doi.org/10.1007/s00240-025-01932-9","url":null,"abstract":"<p><p>Percutaneous nephrolithotomy (PCNL) is the gold-standard treatment for large renal and upper ureteral stones. Continuous irrigation is essential for visualization, thermal control, and fragment clearance but carries risks such as hypothermia, electrolyte imbalance, elevated intrarenal pressure, and infection. This review summarizes current evidence on irrigation strategies during PCNL and provides recommendations to mitigate these risks. A systematic literature search was conducted for English-language full-text articles published up to January 2025, using terms related to PCNL and irrigation. Eligible designs included randomized controlled trials, cohort studies, case-control studies, and case series. Reviews, editorials, and duplicates were excluded. A total of 553 abstracts were screened by a single reviewer, with 28 studies meeting inclusion criteria. Reference lists were hand-searched for additional sources. Evidence highlights multiple determinants of irrigation safety and efficacy. Distilled water and other hypotonic solutions were associated with electrolyte shifts, whereas saline maintained stability. Additives such as tranexamic acid reduced intraoperative blood loss, transfusion rates, and hospital stay without added complications, while povidone-iodine or antibiotic irrigation showed promise in reducing postoperative fever and sepsis. Warmed irrigation fluid mitigated hypothermia but raised concerns of bleeding and thermal injury. Excessive irrigation volume and prolonged operative duration consistently correlated with greater systemic absorption, hemodynamic instability, and electrolyte changes. Irrigation parameters directly influence perioperative safety and outcomes in PCNL. Although isotonic saline remains the standard, antifibrinolytic and antimicrobial additives, individualized temperature management, and optimized volume control represent promising strategies.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":"31"},"PeriodicalIF":2.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-06DOI: 10.1007/s00240-026-01934-1
Nazım Furkan Günay
{"title":"Comment on: development and validation of an explainable machine learning model for predicting sepsis risk following flexible ureteroscopic lithotripsy.","authors":"Nazım Furkan Günay","doi":"10.1007/s00240-026-01934-1","DOIUrl":"https://doi.org/10.1007/s00240-026-01934-1","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":"29"},"PeriodicalIF":2.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the editor: A novel preoperative risk score for predicting Urosepsis after percutaneous nephrolithotomy: validation and clinical application.","authors":"Ruiyan Wang, Pengxin Liu, Chuan Zhou, Huihui Zhang","doi":"10.1007/s00240-025-01929-4","DOIUrl":"https://doi.org/10.1007/s00240-025-01929-4","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":"27"},"PeriodicalIF":2.2,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-03DOI: 10.1007/s00240-025-01925-8
Çağatay Özsoy
{"title":"Comment on \"A novel preoperative risk score for predicting urosepsis after percutaneous nephrolithotomy: validation and clinical application\".","authors":"Çağatay Özsoy","doi":"10.1007/s00240-025-01925-8","DOIUrl":"https://doi.org/10.1007/s00240-025-01925-8","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":"26"},"PeriodicalIF":2.2,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-03DOI: 10.1007/s00240-025-01928-5
Junkun Hou, Pan Liu, Sida Wang, Benhong Li, Jiawei Guan, Junfeng Yang
This case-control study investigated the association between calcium-sensing receptor (CaSR) gene polymorphisms and calcium-containing kidney stone susceptibility in 100 patients and 100 matched healthy controls from the Kunming Han Chinese population. Genotyping of three CaSR loci (rs1042636, rs1801725, and rs1801726) was performed using SNaPshot technology. The rs1801725 GT genotype significantly increased stone formation risk (odds ratio = 1.50, 95% confidence interval: 1.10-2.00, P = 0.042) and was associated with elevated 24-hour urinary calcium excretion compared with controls (10.683 ± 2.535 vs. 7.436 ± 1.742 mmol/24 h, P = 0.002), suggesting impaired renal tubular calcium reabsorption as the underlying mechanism. No significant association was found for rs1042636, while rs1801726 exhibited complete monomorphism (100% CC genotype) across all samples. This study provides the first evidence that the CaSR rs1801725 GT genotype serves as an independent genetic risk marker for urinary calcium stones in the Kunming Han Chinese population. Future research should integrate additional calcium transport pathway genes to develop polygenic risk prediction models and elucidate gene-environment interactions in stone pathogenesis.
本病例对照研究调查了来自昆明汉族人群的100例患者和100例匹配的健康对照者的钙敏感受体（CaSR）基因多态性与含钙肾结石易感性之间的关系。采用SNaPshot技术对三个CaSR位点（rs1042636、rs1801725和rs1801726）进行基因分型。rs1801725 GT基因型显著增加结石形成风险（优势比= 1.50,95%可信区间：1.10-2.00,P = 0.042），与对照组相比，24小时尿钙排泄量升高（10.683±2.535 vs. 7.436±1.742 mmol/24 h, P = 0.002），提示肾小管钙重吸收障碍是其潜在机制。rs1042636未发现显著相关性，而rs1801726在所有样本中表现为完全单态（100% CC基因型）。本研究首次证明CaSR rs1801725 GT基因型是昆明汉族人群尿钙结石的独立遗传风险标记。未来的研究应整合更多的钙转运途径基因，以建立多基因风险预测模型，并阐明结石发病机制中基因与环境的相互作用。
{"title":"Association between calcium-Sensing receptor gene polymorphisms and urinary calcium stone formation in the Han Chinese population from a High-Altitude region (Kunming) in China.","authors":"Junkun Hou, Pan Liu, Sida Wang, Benhong Li, Jiawei Guan, Junfeng Yang","doi":"10.1007/s00240-025-01928-5","DOIUrl":"10.1007/s00240-025-01928-5","url":null,"abstract":"<p><p>This case-control study investigated the association between calcium-sensing receptor (CaSR) gene polymorphisms and calcium-containing kidney stone susceptibility in 100 patients and 100 matched healthy controls from the Kunming Han Chinese population. Genotyping of three CaSR loci (rs1042636, rs1801725, and rs1801726) was performed using SNaPshot technology. The rs1801725 GT genotype significantly increased stone formation risk (odds ratio = 1.50, 95% confidence interval: 1.10-2.00, P = 0.042) and was associated with elevated 24-hour urinary calcium excretion compared with controls (10.683 ± 2.535 vs. 7.436 ± 1.742 mmol/24 h, P = 0.002), suggesting impaired renal tubular calcium reabsorption as the underlying mechanism. No significant association was found for rs1042636, while rs1801726 exhibited complete monomorphism (100% CC genotype) across all samples. This study provides the first evidence that the CaSR rs1801725 GT genotype serves as an independent genetic risk marker for urinary calcium stones in the Kunming Han Chinese population. Future research should integrate additional calcium transport pathway genes to develop polygenic risk prediction models and elucidate gene-environment interactions in stone pathogenesis.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":"28"},"PeriodicalIF":2.2,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Learning curves after position switch in PCNL: prone- vs. supine-trained surgeons.","authors":"Mucahit Gelmis, Ali Ayten, Oguzhan Yildiz, Hakan Ceylan, Kanan Maharramov, Enver Ozdemir","doi":"10.1007/s00240-025-01924-9","DOIUrl":"https://doi.org/10.1007/s00240-025-01924-9","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":"24"},"PeriodicalIF":2.2,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1007/s00240-025-01915-w
Muhammad Usman, Zhouhang Li, Qingyou Zheng, Yang Cui, Changlong Cai, Wang He, Kewei Xu
{"title":"Efficacy and safety of super-pulse thulium fiber laser compared to holmium: YAG laser for ureteral and renal stones: a multicenter retrospective study.","authors":"Muhammad Usman, Zhouhang Li, Qingyou Zheng, Yang Cui, Changlong Cai, Wang He, Kewei Xu","doi":"10.1007/s00240-025-01915-w","DOIUrl":"10.1007/s00240-025-01915-w","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":"23"},"PeriodicalIF":2.2,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1007/s00240-025-01926-7
İbrahim Altundağ
{"title":"Letter to the editor: The association between frailty index and all-cause mortality in US individuals with kidney stones.","authors":"İbrahim Altundağ","doi":"10.1007/s00240-025-01926-7","DOIUrl":"https://doi.org/10.1007/s00240-025-01926-7","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"54 1","pages":"22"},"PeriodicalIF":2.2,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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