Scholars@Duke
Michael Eric Lipkin

Michael Eric Lipkin

Cary N. Robertson, MD, Associate Professor
Urology
michael.lipkin@duke.edu
40 Duke Medicine Circle, Box 3167, Durham, NC 27710

Selected Publications

Infection Risk in Patients with Mixed Flora in Urine Cultures Prior to Ureteroscopy.

Journal Article J Endourol · February 10, 2025 Purpose: Urine cultures are routinely used to inform preoperative antibiotic choice and duration prior to endourologic surgery. The presence of mixed flora in preoperative urine cultures holds unclear clinical significance. This study examines infectious o ... Full text Link to item Cite

The Role of Sleep Apnea in Postoperative Neurocognitive Disorders Among Older Noncardiac Surgery Patients: A Prospective Cohort Study.

Journal Article Anesth Analg · January 1, 2025 BACKGROUND: Obstructive sleep apnea is associated with increased dementia risk, yet its role in postoperative neurocognitive disorders is unclear. Here, we studied whether the severity of untreated obstructive sleep apnea is associated with the severity of ... Full text Link to item Cite

Three-Dimensional Super-Resolution Passive Cavitation Mapping in Laser Lithotripsy.

Journal Article IEEE Trans Ultrason Ferroelectr Freq Control · December 2024 Kidney stone disease is a major public health issue. By breaking stones with repeated laser irradiation, laser lithotripsy (LL) has become the main treatment for kidney stone disease. Laser-induced cavitation is closely associated with stone damage in LL. ... Full text Open Access Link to item Cite

Editorial Comment.

Journal Article J Urol · October 2024 Full text Link to item Cite

Work absence and productivity loss of patients undergoing a trial of spontaneous passage for ureteral stones.

Journal Article Urolithiasis · August 6, 2024 Patients with ureteral stones are often managed with a spontaneous trial of passage. While cost effective, the current literature has not examined the effects of a trial of passage on patients' work productivity. In this study, we aim to characterize work ... Full text Link to item Cite

The Impact of Single-Use Cystoscopes on Clinical Time Workflow in an Outpatient Setting.

Journal Article Urology · June 2024 OBJECTIVE: To evaluate the change in overall clinical encounter time and clinical capacity after transitioning to single-use cystoscopes (Ambu A/S, Ballerup, Denmark) in an outpatient urology setting. METHODS: A single-institution prospective study in an o ... Full text Link to item Cite

Translating ethical and quality principles for the effective, safe and fair development, deployment and use of artificial intelligence technologies in healthcare.

Journal Article J Am Med Inform Assoc · February 16, 2024 OBJECTIVE: The complexity and rapid pace of development of algorithmic technologies pose challenges for their regulation and oversight in healthcare settings. We sought to improve our institution's approach to evaluation and governance of algorithmic techn ... Full text Link to item Cite

Exploring optimal settings for safe and effective thulium fibre laser lithotripsy in a kidney model.

Journal Article BJU Int · February 2024 OBJECTIVES: To explore the optimal laser settings and treatment strategies for thulium fibre laser (TFL) lithotripsy, namely, those with the highest treatment efficiency, lowest thermal injury risk, and shortest procedure time. MATERIALS AND METHODS: An in ... Full text Open Access Link to item Cite

In vitro investigation of stone ablation efficiency, char formation, spark generation, and damage mechanism produced by thulium fiber laser.

Journal Article Urolithiasis · November 2, 2023 To investigate stone ablation characteristics of thulium fiber laser (TFL), BegoStone phantoms were spot-treated in water at various fiber tip-to-stone standoff distances (SDs, 0.5 ~ 2 mm) over a broad range of pulse energy (Ep, 0.2 ~ 2 J), frequency (F, 5 ... Full text Open Access Link to item Cite

Rural For-Profit Hospitals Are Associated With Higher Commercial Prices for 3 Common Urological Procedures.

Journal Article Urol Pract · November 2023 INTRODUCTION: Rural patients lack access to urological services, and high local prices may dissuade underinsured patients from surgery. We sought to describe commercially insured prices for 3 urological procedures at rural vs metropolitan and for-profit vs ... Full text Link to item Cite

In Pursuit of the Optimal Dusting Settings with the Thulium Fiber Laser: An In Vitro Assessment.

Journal Article J Endourol · August 2023 Objective: Low energy and high frequency settings are used in stone dusting for holmium lasers. Such settings may not be optimal for thulium fiber laser (TFL). With the seemingly endless combination of settings, we aim to provide guidance to the practicing ... Full text Link to item Cite

Advanced chronic kidney disease; A comparison between nephroureterectomy and nephron-sparing surgery for upper tract urothelial carcinoma.

Journal Article Urologic oncology · June 2023 PurposeRenal function outcomes between radical nephroureterectomy (RNU) and nephron-sparing surgery (NSS) for upper tract urothelial carcinoma (UTUC) patients are not well established. We sought to compare the incidence and factors associated with ... Full text Cite

Association of Rural Hospital for-Profit Status With Higher Publicly Reported Prices for the Components of Inpatient Hematuria Evaluation Among Commercially Insured Patients.

Journal Article Urol Pract · March 2023 INTRODUCTION: Rural patients have limited access to urological care and are vulnerable to high local prices. Little is known about price variation for urological conditions. We aimed to compare reported commercial prices for the components of inpatient hem ... Full text Link to item Cite

Benchtop Evaluation of Miniature Percutaneous Nephrolithotomy Lithotrites.

Journal Article J Endourol · November 2022 Introduction: Percutaneous nephrolithotomy (PCNL) is the preferred treatment for kidney stones >2 cm. While PCNL has traditionally been performed using 24F to 30F access sheaths, there is a trend toward smaller sheaths and scopes to perform mini-PCNL (mPCN ... Full text Link to item Cite

Cavitation Plays a Vital Role in Stone Dusting During Short Pulse Holmium:YAG Laser Lithotripsy.

Journal Article J Endourol · May 2022 Objective: To investigate the mechanism of stone dusting in Holmium (Ho): YAG laser lithotripsy (LL). Materials and Methods: Cylindrical BegoStone samples (6 × 6 mm, H × D) were treated in water using a clinical Ho:YAG laser lithotripter in dusting mode (0 ... Full text Link to item Cite

Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.

Journal Article Ann Clin Transl Neurol · February 2022 OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ... Full text Open Access Link to item Cite

Evolution of Single-Use Urologic Endoscopy: Benchtop and Initial Clinical Assessment of a New Single-Use Flexible Cystoscope.

Journal Article J Endourol · January 2022 Introduction: Office cystoscopy is one of the most frequently performed procedures by a urologist. However, single-use cystoscopes remain quite undeveloped. Ambu® has developed single-use broncoscopes, rhinolaryngoscopes, and duodenoscopes. Recently, they ... Full text Link to item Cite

Comparison of Different Pulse Modulation Modes for Holmium:Yttrium-Aluminum-Garnet Laser Lithotripsy Ablation in a Benchtop Model.

Journal Article J Endourol · January 2022 Introduction: Manipulation of Holmium:Yttrium-Aluminum-Garnet laser parameters such as pulse energy (PE), frequency, and duration can impact laser lithotripsy ablation efficiency. In 2017, Lumenis introduced Mosesâ„¢ Technology, which uses pulse modulation t ... Full text Link to item Cite

Investigating Risk Factors for Urine Culture Contamination in Outpatient Clinics: A New Avenue for Diagnostic Stewardship.

Journal Article Antimicrob Steward Healthc Epidemiol · 2022 Mixed flora in urine cultures usually occur due to pre-analytic contamination. In our outpatient urology clinic, we found a high prevalence of mixed flora (46.2%), which was associated with female sex and older age. Patient education did not impact the rat ... Full text Link to item Cite

Evaluation of a Novel Single-Use Flexible Ureteroscope.

Journal Article J Endourol · June 2021 Introduction: A novel single-use flexible ureteroscope promises the optical characteristics and maneuverability of a reusable fourth-generation flexible ureteroscope. In this study, the LithoVue Single-Use Digital flexible ureteroscope was directly compare ... Full text Link to item Cite

Benchtop Assessment of a New Single-Use Flexible Ureteroscope.

Journal Article J Endourol · June 2021 Introduction: Single-use flexible ureteroscopes are an increasingly popular alternative to reusable ureteroscopes. In this study, we performed a benchtop examination of the physical and optical properties of the new Dornier Axisâ„¢ (Webling, Germany) single- ... Full text Link to item Cite

The Role of Cavitation in Energy Delivery and Stone Damage During Laser Lithotripsy.

Journal Article J Endourol · June 2021 Purpose: Although cavitation during laser lithotripsy (LL) contributes to the Moses effect, the impact of cavitation on stone damage is less clear. Using different laser settings, we investigate the role of cavitation bubbles in energy delivery and stone d ... Full text Link to item Cite

Rising occurrence of hypocitraturia and hyperoxaluria associated with increasing prevalence of stone disease in calcium kidney stone formers.

Journal Article Scand J Urol · October 2020 OBJECTIVE: To evaluate metabolic risk factors in calcium kidney stone formers from two different decades, comparing changes in metabolic profiles over time. METHODS: A retrospective analysis was performed of calcium kidney stone formers who underwent metab ... Full text Link to item Cite

No-Shows in Adult Urology Outpatient Clinics: Economic and Operational Implications.

Journal Article Urol Pract · September 2020 INTRODUCTION: We analyzed trends and explored implications of no-show rates in adult urology from provider related characteristics at an academic program. METHODS: No-show rates were determined from electronic health records of appointments in adult urolog ... Full text Link to item Cite

Letter to the Editor-Reply.

Journal Article Urology · September 2020 Full text Link to item Cite

The Impact of Alternative Alkalinizing Agents on 24-Hour Urine Parameters.

Conference Urology · August 2020 OBJECTIVES: To determine if alternative alkalinizing agents lead to similar changes in 24-hour urine pH and citrate compared to potassium citrate (KCIT). Many stone formers cannot tolerate KCIT due to side effects or cost. In these patients, we have prescr ... Full text Link to item Cite

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

Journal Article J Neurol · July 2020 OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ... Full text Link to item Cite

Assessment of conservative dietary management as a method for normalization of 24-h urine pH in stone formers.

Journal Article Urolithiasis · April 2020 Low urine pH is a metabolic risk factor for stone formation. While medical therapy is typically prescribed (as urinary alkalinization), patients typically prefer dietary modifications. We aimed to assess capacity to alter urine pH with dietary management a ... Full text Link to item Cite

Roadmap for Transforming Preoperative Assessment to Preoperative Optimization.

Journal Article Anesth Analg · April 2020 Preoperative assessment typically equates to evaluating and accepting the presenting condition of the patient (unless extreme) and commonly occurs only a few days before the planned surgery. While this timing enables a preoperative history and examination ... Full text Link to item Cite

New devices for kidney stone management.

Journal Article Curr Opin Urol · March 2020 PURPOSE OF REVIEW: The purpose of this review is to summarize recent developments in the array of devices which are commonly used by urologists in the surgical management of kidney stones. To accomplish this goal, an extensive review of recent endourology ... Full text Link to item Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

Holmium:Yttrium-Aluminum-Garnet Laser Pulse Type Affects Irrigation Temperatures in a Benchtop Ureteral Model.

Journal Article J Endourol · November 2019 Introduction: MOSESâ„¢ technology is a holmium:yttrium-aluminum-garnet laser pulse mode shown to minimize stone retropulsion. This may facilitate lithotripsy at higher power settings. However, power and heat production are proportional, and temperatures capa ... Full text Link to item Cite

The Rise and Fall of High Temperatures During Ureteroscopic Holmium Laser Lithotripsy.

Journal Article Journal of endourology · October 2019 Introduction: Temperatures over 43°C-the threshold for cellular injury-may be achieved during ureteroscopic holmium laser lithotripsy. The time to reach and subsequently clear high temperatures at variable laser power settings and irrigation ... Full text Cite

Nationwide Readmission Rates Following Percutaneous Nephrolithotomy: Does Age Matter?

Journal Article J Endourol · September 2019 Introduction/Objectives: Despite minimal evidence that evaluates the effect of age on percutaneous nephrolithotomy (PCNL) morbidity, pediatric and elderly patients are considered high-risk groups. Our objective was to assess the effect of the extremes of a ... Full text Link to item Cite

A decision analysis of observation vs immediate reintervention for asymptomatic residual fragments less than 4 mm following ureteroscopic lithotripsy

Journal Article Urology Practice · September 1, 2019 Introduction: We performed a decision analysis model of the cost-effectiveness of observation vs intervention for asymptomatic residual fragments less than 4 mm in diameter following ureteroscopic holmium laser lithotripsy. Methods: Outcomes data from a re ... Full text Cite

An in vitro evaluation of laser settings and location in the efficiency of the popcorn effect.

Journal Article Urolithiasis · August 2019 To examine different locations and laser settings' effects on the efficiency of the "popcorn" method of laser lithotripsy, which consists of placing the laser in a group of small stones and firing continuously to break them into smaller particles. Pre-frag ... Full text Link to item Cite

EDITORIAL COMMENT.

Journal Article Urology · August 2019 Full text Link to item Cite

Low Dose Fluoroscopy During Ureteroscopy Does Not Compromise Surgical Outcomes.

Journal Article J Endourol · July 2019 Objective: To evaluate whether reducing the dose of fluoroscopy to ¼ of standard dose during unilateral ureteroscopy for ureteral stone treatment would impact in a reduction of total radiation emitted and whether this strategy would impact operation time, ... Full text Link to item Cite

Emerging Technologies in Ultrasonic and Pneumatic Lithotripsy.

Journal Article Urol Clin North Am · May 2019 Percutaneous nephrolithotomy is the treatment of choice for large renal stones. Larger, straight access tracts allow for use of rigid pneumatic and ultrasonic lithotripsy devices. Through advanced technologies, more efficient fragmentation has become possi ... Full text Link to item Cite

The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction.

Journal Article J Am Geriatr Soc · April 2019 BACKGROUND/OBJECTIVES: Every year, up to 40% of the more than 16 million older Americans who undergo anesthesia/surgery develop postoperative cognitive dysfunction (POCD) or delirium. Each of these distinct syndromes is associated with decreased quality of ... Full text Open Access Link to item Cite

Psychiatric Diagnoses and Other Factors Associated with Emergency Department Return within 30 Days of Ureteroscopy.

Journal Article J Urol · March 2019 PURPOSE: Emergency department visits after ureteroscopy are costly and inconvenient. To better understand those at risk we aimed to identify patient demographic, medical and surgical factors associated with 30-day emergency department presentation followin ... Full text Link to item Cite

Avoiding a Lemon: Performance Consistency of Single-Use Ureteroscopes.

Journal Article J Endourol · February 2019 INTRODUCTION AND OBJECTIVES: Single-use flexible ureteroscopes are increasingly popular because of high repair costs of reusable ureteroscopes. As new single-use ureteroscopes enter the market, the consistency of performance of these devices has been quest ... Full text Link to item Cite

Let's Get to the Point: Comparing Insertion Characteristics and Scope Damage of Flat-Tip and Ball-Tip Holmium Laser Fibers.

Journal Article J Endourol · January 2019 INTRODUCTION: A ball-tip holmium laser fiber (TracTip; Boston Scientific) has been developed to theoretically reduce damaging friction forces generated within a ureteroscope working channel. We compared the insertional forces and damage with a ureteroscope ... Full text Link to item Cite

Dusting Efficiency of the Moses Holmium Laser: An Automated In Vitro Assessment.

Journal Article J Endourol · December 2018 INTRODUCTION: Moses technology is a novel Holmium:YAG laser system designed to minimize stone retropulsion and improve stone ablation when the laser is not in direct contact with the stone. Our aim was to assess the efficiency of Moses technology relative ... Full text Link to item Cite

Disproportionate Use of Inpatient Care by Older Adults With Kidney Stones.

Journal Article Urology · October 2018 OBJECTIVE: To describe variation in utilization and costs of inpatient care for patients with kidney stones, examining associations with older age. MATERIALS AND METHODS: Using the Nationwide Inpatient Sample we examined inpatient discharges with stone dia ... Full text Link to item Cite

Abdominal Radiography With Digital Tomosynthesis: An Alternative to Computed Tomography for Identification of Urinary Calculi?

Journal Article Urology · October 2018 OBJECTIVE: To compare the accuracy of plain abdominal radiography (kidneys, ureter, and bladder [KUB]) with digital tomosynthesis (DT) to noncontrast computed tomography (NCCT), the gold standard imaging modality for urinary stones. Due to radiation and co ... Full text Link to item Cite

Antibiotic Utilization Before Endourological Surgery for Urolithiasis: Endourological Society Survey Results.

Journal Article J Endourol · October 2018 INTRODUCTION: Ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) are common procedures performed to treat kidney stones. Despite advances in technology/technique, serious infectious complications can occur. To better understand the preoperative ant ... Full text Link to item Cite

Analgesic Prescribing Patterns for Acute Symptomatic Kidney Stones in Emergency Departments

Conference Journal of the American College of Surgeons · October 2018 Full text Cite

In Vitro Comparison of a Novel Single Probe Dual-Energy Lithotripter to Current Devices.

Journal Article J Endourol · June 2018 PURPOSE: The LithoClast Trilogy is a novel single probe, dual-energy lithotripter with ultrasonic (US) vibration and electromagnetic impact forces. ShockPulse and LithoClast Select are existing lithotripters that also use a combination of US and mechanical ... Full text Link to item Cite

Effect of Laser Settings and Irrigation Rates on Ureteral Temperature During Holmium Laser Lithotripsy, an In Vitro Model.

Journal Article Journal of endourology · January 2018 PurposeUreteroscopic laser lithotripsy requires irrigation for adequate visualization and temperature control during treatment of ureteral stones. However, there are little data on how different irrigation and laser settings affect the ureteral wa ... Full text Cite

Ureteroscopic Laser Lithotripsy: A Review of Dusting vs Fragmentation with Extraction.

Journal Article J Endourol · January 2018 INTRODUCTION: Ureteroscopic laser lithotripsy is becoming the most commonly utilized treatment for patients with urinary calculi. The Holmium:YAG (yttrium aluminum garnet) laser is integral to the operation and is the preferred flexible intracorporeal lith ... Full text Link to item Cite

Enhanced Endoscopic Imaging

Chapter · January 1, 2018 Video imaging and documentation technologies have become commonplace in urologic practice. Improvements in video imaging technology have allowed significant advancements in endourology and minimally invasive urologic surgery. Digital endoscopes, 3D video i ... Full text Cite

Next-Generation Single-Use Ureteroscopes: An In Vitro Comparison.

Journal Article J Endourol · December 2017 INTRODUCTION: Single-use ureteroscopes have been gaining popularity in recent years. We compare the optics, deflection, and irrigation flow of two novel single-use flexible ureteroscopes-the YC-FR-A and the NeoFlex-with contemporary reusable and single-use ... Full text Link to item Cite

The economics of stone disease.

Journal Article World J Urol · September 2017 The rising prevalence of kidney stone disease is associated with significant costs to healthcare systems worldwide. This is in part due to direct procedural and medical management costs, as well as indirect costs to health systems, patients, and families. ... Full text Link to item Cite

Comparison of Radiation Exposure from Fixed Table Fluoroscopy to a Portable C-Arm During Ureteroscopy.

Journal Article J Endourol · September 2017 INTRODUCTION: Current treatment practices within the field of endourology require the routine use of radiation exposure to provide adequate imaging during urologic procedures. One such procedure requiring repeated radiation exposure during treatment is ure ... Full text Link to item Cite

Imaging Advances in Urolithiasis.

Journal Article J Endourol · July 2017 The prevalence of urinary stones in the United States has been described as 1 in 11 persons reporting a history of stones. Imaging plays a crucial role in diagnosis, management, and follow-up for these patients and imaging technology over the last 100 year ... Full text Link to item Cite

Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model.

Journal Article Urology · May 2017 OBJECTIVE: To more clearly define the efficiency and potential benefits of variable pulse-width laser technology for ureteroscopic lithotripsy, we performed comparative in vitro evaluations assessing stone comminution, laser fiber tip degradation, and ston ... Full text Link to item Cite

Comparison of Broad vs Narrow Focal Width Lithotripter Fields.

Journal Article J Endourol · May 2017 OBJECTIVE: To investigate the impact of lithotripter focal width on stone fragmentation. MATERIALS AND METHODS: A modified reflector was used to reduce -6 dB beam size of the HM3 lithotripter, while increasing concomitantly peak pressure. Fragmentation in ... Full text Link to item Cite

Should metabolic evaluation be performed in patients with struvite stones?

Journal Article Urolithiasis · April 2017 Previous studies suggested that patients with pure struvite calculi rarely have underlying metabolic abnormalities. Therefore, most of these patients do not undergo metabolic studies. We report our experience with these patients and their response to direc ... Full text Link to item Cite

Benchtop and Initial Clinical Evaluation of the ShockPulse Stone Eliminator in Percutaneous Nephrolithotomy.

Journal Article J Endourol · February 2017 PURPOSE: Standardized bench testing of the new ShockPulseâ„¢ intracorporeal lithotripter was performed against three commercially available lithotripsy systems to determine differences and nuances in performance. MATERIALS AND METHODS: The ShockPulse intraco ... Full text Link to item Cite

Outcomes of ureteroscopy.

Journal Article Minerva Urol Nefrol · December 2016 Over the past 2 decades, ureteroscopy has changed from a procedure considered second-line to shockwave lithotripsy to a commonly performed procedure for renal and ureteral stones. The increase in the use of ureteroscopy is due largely to improvements in te ... Link to item Cite

Comparison of the Nanopulse Lithotripter to the Holmium Laser: Stone Fragmentation Efficiency and Impact on Flexible Ureteroscope Deflection and Flow.

Journal Article J Endourol · November 2016 INTRODUCTION: The Nanopulse Lithotripter (NPL; Lithotech Medical, Israel) is a novel intracorporeal device that uses a nanosecond duration electrical discharge through a reusable flexible coaxial probe to endoscopically fragment urinary stones. This device ... Full text Link to item Cite

Contemporary Management of Struvite Stones Using Combined Endourologic and Medical Treatment: Predictors of Unfavorable Clinical Outcome.

Journal Article J Endourol · July 2016 BACKGROUND AND PURPOSE: Struvite stones have been associated with significant morbidity and mortality, yet there has not been a report on the medical management of struvite stones in almost 20 years. We report on the contemporary outcomes of the surgical a ... Full text Link to item Cite

C-arm technique with distance driven for nephrolithiasis and kidney stones detection: Preliminary study

Conference 3rd IEEE EMBS International Conference on Biomedical and Health Informatics, BHI 2016 · April 18, 2016 Kidney stone is among the common painful disorders of the urinary system. The presence of stones in the kidney refers to Nephrolithiasis. For nephrolithiasis and kidney stones detection, a C-arm tomographic technique was investigated in this paper to gener ... Full text Cite

Prevalence of Hyperoxaluria in Urinary Stone Formers: Chronological and Geographical Trends and a Literature Review.

Journal Article Journal of endourology · April 2016 PurposeTo report chronological trends and geographical distributions related to the prevalence of hyperoxaluria in stone-forming patients.Materials and methodsWe systematically reviewed the existing literature between 1982 and 2013 seekin ... Full text Cite

Digital Tomosynthesis: A Viable Alternative to Noncontrast Computed Tomography for the Follow-Up of Nephrolithiasis?

Journal Article J Endourol · April 2016 OBJECTIVE: Digital tomosynthesis (DT) is a new X-ray-based imaging technique that allows image enhancement with minimal increase in radiation exposure. The purpose of this study was to compare DT with noncontrast computed tomography (NCCT) and to evaluate ... Full text Link to item Cite

Treatment Response in Patients with Stones, and Low Urinary pH and Hypocitraturia Stratified by Body Mass Index.

Journal Article J Urol · March 2016 PURPOSE: Obesity has been shown to be a risk factor for kidney stone formation. Obesity leads to insulin resistance which subsequently leads to low urinary pH. Low urinary pH is typically treated with potassium citrate. We determined if the response to pot ... Full text Link to item Cite

Use of ureteral access sheaths in ureteroscopy.

Journal Article Nat Rev Urol · March 2016 The ureteral access sheath (UAS) facilitates the use of flexible ureteroscopy, enabling improved minimally invasive management of complex upper urinary tract diseases. The UAS, which comes in a variety of diameters and lengths, is passed in a retrograde fa ... Full text Link to item Cite

Evaluation of Novel Ball-Tip Holmium Laser Fiber: Impact on Ureteroscope Performance and Fragmentation Efficiency.

Journal Article J Endourol · February 2016 PURPOSE: A novel ball tip (BT) holmium laser fiber has recently been developed, which features a modified rounded tip. The modification is purported to aid in insertion and minimize damage to the ureteroscope working channel. We evaluated this laser fiber ... Full text Link to item Cite

Radiation Dosimetry for Ureteroscopy Patients: A Phantom Study Comparing the Standard and Obese Patient Models.

Journal Article J Endourol · January 2016 PURPOSE: To determine the effect of obesity on radiation exposure during simulated ureteroscopy. METHODS: A validated anthropomorphic adult male phantom with a body mass index (BMI) of approximately 24 kg/m(2), was positioned to simulate ureteroscopy. Padd ... Full text Link to item Cite

C-arm technique using distance driven method for nephrolithiasis and kidney stones detection

Conference Progress in Biomedical Optics and Imaging - Proceedings of SPIE · January 1, 2016 Distance driven represents a state of art method that used for reconstruction for x-ray techniques. C-arm tomography is an x-ray imaging technique that provides three dimensional information of the object by moving the C-shaped gantry around the patient. W ... Full text Cite

Imaging for urolithiasis: standards, trends, and radiation exposure.

Journal Article Curr Opin Urol · January 2016 PURPOSE OF REVIEW: To discuss current trends in imaging for urolithiasis and review the recent scientific literature surrounding this topic. Specifically, to address the efforts urologist should be making to reduce the use of ionizing radiation and to exam ... Full text Link to item Cite

How do I set up a stone clinic?

Chapter · January 1, 2016 A comprehensive stone center can effectively manage complex urinary stone disease with the right tools. A collaborative team that includes a Urologist, a Nephrologist, a Dietician and a mid-level practitioner is optimal. The center should coordinate with a ... Full text Cite

Preliminary study on C-arm technique for nephrolithiasis and kidney stones detection

Conference Proceedings - 2015 IEEE International Conference on Bioinformatics and Biomedicine, BIBM 2015 · December 16, 2015 Nephrolithiasis can be a painful problem due to presence of kidney stones. In this paper, we investigated a C-arm tomographic technique with digital detector for nephrolithiasis and kidney stones detection. The studies were based on a C-arm system to provi ... Full text Cite

Medical expulsive therapy for pediatric urolithiasis: Systematic review and meta-analysis.

Journal Article J Pediatr Urol · December 2015 OBJECTIVE: Kidney stone disease has become more common among children and young adults. Despite its well-documented success in adults, published success rates of medical expulsive therapy (MET) for pediatric urolithiasis vary widely. Our objective was to d ... Full text Link to item Cite

Minimizing radiation exposure during percutaneous nephrolithotomy.

Journal Article Minerva Urol Nefrol · December 2015 Given the recent trends in growing per capita radiation dose from medical sources, there have been increasing concerns over patient radiation exposure. Patients with kidney stones undergoing percutaneous nephrolithotomy (PNL) are at particular risk for hig ... Link to item Cite

Radiation Exposure during the Evaluation and Management of Nephrolithiasis.

Journal Article J Urol · October 2015 PURPOSE: There is rising concern over the increasing amount of patient radiation exposure from diagnostic imaging and medical procedures. Patients with nephrolithiasis are at potentially significant risk for radiation exposure due to the need for imaging t ... Full text Link to item Cite

Estimating the nationwide, hospital based economic impact of pediatric urolithiasis.

Journal Article J Urol · May 2015 PURPOSE: The incidence of urolithiasis is increasing in children and adolescents but the economic impact of this problem is unclear. We examined 2 large databases to estimate the nationwide economic impact of pediatric urolithiasis. MATERIALS AND METHODS: ... Full text Link to item Cite

Shock wave lithotripsy: the new phoenix?

Journal Article World J Urol · February 2015 INTRODUCTION: Following its introduction in 1980, shock wave lithotripsy (SWL) rapidly emerged as the first-line treatment for the majority of patients with urolithiasis. Millions of SWL therapies have since been performed worldwide, and nowadays, SWL stil ... Full text Link to item Cite

A prospective, multi-institutional study of flexible ureteroscopy for proximal ureteral stones smaller than 2 cm.

Journal Article J Urol · January 2015 PURPOSE: Flexible ureteroscopy is rapidly becoming a first line therapy for many patients with renal and ureteral stones. However, current understanding of treatment outcomes in patients with isolated proximal ureteral stones is limited. Therefore, we perf ... Full text Link to item Cite

Radiation exposure to the patient and the urologist

Chapter · January 1, 2015 Patients with ureteral stones are at significant risk for radiation from both diagnostic imaging and fluoroscopy used in the operating room at the time of surgery. Surgeons and operating room staff are also at risk for exposure from fluoroscopy. Non-contra ... Full text Cite

Combined Endoscopic and Percutaneous Retrieval of a Retained 4-Wire Ureteral Stone Basket.

Journal Article J Endourol Case Rep · 2015 Complex endourologic procedures may require the use of a combined ureteroscopic and percutaneous approach. Endoscopic removal of a retained 4-wire ureteral stone basket is particularly complex, as broken tines can potentially injure the ureter if the baske ... Full text Open Access Link to item Cite

Clinical outcomes after ureteroscopic lithotripsy in patients who initially presented with urosepsis: matched pair comparison with elective ureteroscopy.

Journal Article J Endourol · December 2014 BACKGROUND AND PURPOSE: The outcomes of ureteroscopy (URS) after urgent decompression and antibiotics for patients who initially present with urosepsis because of obstructive urolithiasis have not been previously evaluated. The aim of this study was to com ... Full text Link to item Cite

Potassium citrate and calcium stones: Benefit or risk?

Chapter · November 1, 2014 Nephrolithiasis is a common urological disease that will affect 5-10∈% of adults during their lifetime. The natural history of nephrolithiasis is characterized by recurrence, with almost 50∈% of patients recurring within 5 years of their initial stone even ... Full text Cite

Imaging (Cost, radiation)

Chapter · November 1, 2014 Periodic imaging of the recurrent stone former is an important component of their management. Imaging can help monitor for stone activity and the effectiveness of preventative strategies. There are a number of factors to take into consideration when choosi ... Full text Cite

Does body mass index impact the outcomes of tubeless percutaneous nephrolithotomy?

Journal Article BJU Int · September 2014 OBJECTIVE: To evaluate whether body mass index (BMI) has an impact on the outcomes of tubeless percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: We retrospectively reviewed patients who underwent tubeless PCNL at our institution from 2006 to 2011. ... Full text Link to item Cite

Accuracy of endoscopic intraoperative assessment of urologic stone size.

Journal Article J Endourol · May 2014 INTRODUCTION: Endoscopic treatment of renal calculi relies on surgeon assessment of residual stone fragment size for either basket removal or for the passage of fragments postoperatively. We therefore sought to determine the accuracy of endoscopic assessme ... Full text Link to item Cite

Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter.

Journal Article Proc Natl Acad Sci U S A · April 1, 2014 The efficiency of shock wave lithotripsy (SWL), a noninvasive first-line therapy for millions of nephrolithiasis patients, has not improved substantially in the past two decades, especially in regard to stone clearance. Here, we report a new acoustic lens ... Full text Open Access Link to item Cite

As low as reasonably achievable: Methods for reducing radiation exposure during the management of renal and ureteral stones.

Journal Article Indian J Urol · January 2014 Imaging for urolithiasis has evolved over the past 30 years. Currently, non-contrast computed tomography (NCCT) remains the first line imaging modality for the evaluation of patients with suspected urolithiasis. NCCT is a dominant source of ionizing radiat ... Full text Link to item Cite

Urolithiasis

Chapter · January 1, 2014 Stone disease is a common and costly health problem, and its prevalence in on the rise. In the United States between 2007 and 2010, the overall prevalence was reported to be 8.8 % [ 1 ]. This increase is likely due to similar trends in the obesity epidemic ... Full text Cite

Effect of supine vs prone position on outcomes of percutaneous nephrolithotomy in staghorn calculi: results from the Clinical Research Office of the Endourology Society Study.

Journal Article Urology · December 2013 OBJECTIVE: To analyze the effect of patient positioning on outcomes of percutaneous nephrolithotomy (PNL) among patients with staghorn stones. The choice of optimal position for these patients undergoing PNL remains challenging. No previous studies exclusi ... Full text Link to item Cite

Instrumentation and Surgical Technique: Step-by-Step Percutaneous Nephrolithotomy: Tube or Tubeless Percutaneous Nephrolithotomy

Chapter · October 28, 2013 Percutaneous nephrolithotomy has become the preferred treatment for large and/or complex renal and proximal ureteral calculi. The objective of this chapter is to evaluate the efficacy and safety of tubeless percutaneous nephrolithotomy. We analyzed publish ... Full text Cite

Radiation exposure in the follow-up of patients with urolithiasis comparing digital tomosynthesis, non-contrast CT, standard KUB, and IVU.

Journal Article J Endourol · October 2013 OBJECTIVE: To compare the effective doses (EDs) associated with imaging modalities for follow-up of patients with urolithiasis, including stone protocol non-contrast computed tomography (NCCT), kidney, ureter, and bladder radiograph (KUB), intravenous urog ... Full text Link to item Cite

Radiation exposure associated with dedicated renal mass computed tomography protocol: impact of patient characteristics.

Journal Article J Endourol · September 2013 BACKGROUND AND PURPOSE: Renal mass protocol CT (RMP-CT) using multiphase abdomen and pelvis CT imaging is the mainstay for diagnosis, characterization, and follow-up for renal masses; however, it is associated with ionizing radiation to the patient. We sou ... Full text Link to item Cite

Emergent ureteric stent vs percutaneous nephrostomy for obstructive urolithiasis with sepsis: patterns of use and outcomes from a 15-year experience.

Journal Article BJU Int · July 2013 OBJECTIVES: To characterize the use of emergent JJ ureteric stent placement and percutaneous nephrostomy (PCN) for patients with obstructive urolithiasis with sepsis, and to determine whether outcomes differ between the two treatment methods. PATIENTS AND ... Full text Link to item Cite

Imaging techniques for stone disease and methods for reducing radiation exposure.

Journal Article Urol Clin North Am · February 2013 Imaging plays a critical role in the evaluation of patients with urolithiasis. It is essential for the diagnosis of stones and provides important information to aide in determining the appropriate treatment of renal or ureteral calculi. Imaging for urolith ... Full text Link to item Cite

Percutaneous stone removal: Case discussion on stones in a horseshoe kidney

Chapter · January 1, 2013 Percutaneous nephrolithotomy (PNL) occupies a central place in the management of kidney as well as large proximal ureteral stones. Advances in equipment and technology with utilization of balloon dilatation, newer digital rigid and flexible nephroscopes, i ... Full text Cite

Imaging

Chapter · January 1, 2013 Imaging is a key component in the evaluation of patients with urolithiasis, as it is essential for the diagnosis and for determining the appropriate treatment of renal and ureteral stone disease. The ideal imaging study would be rapidly performed, have hig ... Full text Cite

Lithotrites and postoperative fever: does lithotrite type matter? Results from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study.

Conference Urol Int · 2013 OBJECTIVE: To compare the risks of fever from different lithotrites after percutaneous nephrolithotomy (PNL). MATERIALS AND METHODS: The Clinical Research Office of the Endourological Society (CROES) PNL database is a prospective, multi-institutional, inte ... Full text Link to item Cite

In-vitro assessment of a new portable ballistic lithotripter with percutaneous and ureteroscopic models.

Journal Article J Endourol · November 2012 BACKGROUND AND PURPOSE: The EMS Swiss LithoBreaker is a new, portable, electrokinetic lithotripter. We compared its tip velocity and displacement characteristics with a handheld, pneumatic lithotripter LMA StoneBreaker.â„¢ We also evaluated fragmentation eff ... Full text Link to item Cite

Optical performance comparison of deflectable laparoscopes for laparoendoscopic single-site surgery.

Journal Article J Endourol · October 2012 Featured Publication BACKGROUND AND PURPOSE: Flexible working angles and fine optical visualization are major requisite factors in performing laparoendoscopic single-site (LESS) urologic procedures. Multiple mechanical design approaches have been used to develop deflectable la ... Full text Link to item Cite

IMPACT OF NEPHROSTOMY TRACT LENGTH ON PNL OUTCOMES

Conference JOURNAL OF ENDOUROLOGY · September 1, 2012 Link to item Cite

EFFECTS OF HOLMIUM: YAG LASER ENERGY SETTINGS ON FIBER TIP DEGRADATION

Conference JOURNAL OF ENDOUROLOGY · September 1, 2012 Link to item Cite

DOES THE MODALITY OF PREOPERATIVE IMAGING AFFECT THE OUTCOME OF PNL?

Conference JOURNAL OF ENDOUROLOGY · September 1, 2012 Link to item Cite

OBESITY TRIPLES THE RADIATION EXPOSURE OF STONE PROTOCOL CT

Conference JOURNAL OF ENDOUROLOGY · September 1, 2012 Link to item Cite

EFFECTS OF SODIUM AND FRUCTOSE INTAKE ON PEDIATRIC STONE FORMATION

Conference JOURNAL OF ENDOUROLOGY · September 1, 2012 Link to item Cite

Organ-specific radiation dose rates and effective dose rates during percutaneous nephrolithotomy.

Journal Article J Endourol · May 2012 Featured Publication BACKGROUND AND PURPOSE: Radiation exposure during medical procedures continues to be an increasing concern for physicians and patients. We determined organ-specific dose rates and calculated effective dose rates during right and left percutaneous nephrolit ... Full text Link to item Cite

When (and how) to surgically treat asymptomatic renal stones.

Journal Article Nat Rev Urol · March 27, 2012 Featured Publication Asymptomatic renal stones are identified in 8-10% of screened populations. With the increasing utilization of CT, the number of patients seeking urologic care for incidentally diagnosed renal calculi is likely to increase. Such patients present an importan ... Full text Link to item Cite

Risk reduction strategy for radiation exposure during percutaneous nephrolithotomy.

Journal Article Curr Opin Urol · March 2012 Featured Publication PURPOSE OF REVIEW: To discuss the risk of radiation exposure to patients with nephrolithiasis. To review the risk factors for increased radiation exposure to patients during percutaneous nephrolithotomy (PNL) from fluoroscopy. To review the techniques to r ... Full text Link to item Cite

Determination of patient radiation dose during ureteroscopic treatment of urolithiasis using a validated model.

Journal Article J Urol · March 2012 Featured Publication PURPOSE: We measured organ specific radiation dose rates and determined effective dose rates during simulated ureteroscopy using a validated model. To calculate the effective dose, patients were exposed to ureteroscopic management of stones at our institut ... Full text Link to item Cite

Video Imaging and Documentation

Chapter · January 5, 2012 Video imaging and documentation technologies have become commonplace in urologic practice. Improvements in video imaging technology have allowed significant advancements in endourology and minimally invasive urologic surgery. Digital endoscopes, 3D video i ... Full text Cite

Shock wave lithotripsy: Present indications and future prospects

Chapter · January 1, 2012 This chapter describes the fundamentals of shock wave lithotripsy (SWL), the instrumentation for SWL, shock wave generation, rate of delivery and focusing, coupling of the shock wave, and stone localization. The process of fragmentation through spallation, ... Full text Cite

LESS PYELOPLASTY: A COMBINED LAPAROSCOPIC AND ROBOTIC APPROACH

Conference JOURNAL OF ENDOUROLOGY · November 1, 2011 Link to item Cite

Optimization of treatment strategy used during shockwave lithotripsy to maximize stone fragmentation efficiency.

Journal Article J Endourol · September 2011 Featured Publication BACKGROUND AND PURPOSE: Previous studies have demonstrated that treatment strategy plays a critical role in ensuring maximum stone fragmentation during shockwave lithotripsy (SWL). We aimed to develop an optimal treatment strategy in SWL to produce maximum ... Full text Open Access Link to item Cite

Pathologic evaluation of hemostatic agents in percutaneous nephrolithotomy tracts in a porcine model.

Journal Article J Endourol · August 2011 Featured Publication BACKGROUND AND PURPOSE: Hemostatic agents have been suggested as an adjunct for tubeless percutaneous nephrolithotomy (PCNL). We pathologically evaluated the percutaneous tracts injected with the fibrin sealant (FS) Evicel and hemostatic gelatin matrix (HG ... Full text Link to item Cite

Reduced radiation exposure with the use of an air retrograde pyelogram during fluoroscopic access for percutaneous nephrolithotomy.

Journal Article J Endourol · April 2011 Featured Publication INTRODUCTION: Fluoroscopy with retrograde pyelogram is commonly used to obtain access for percutaneous nephrolithotomy (PNL). Our practice uses room air for retrograde identification of calyceal anatomy. Herein we explore whether an air pyelogram was assoc ... Full text Link to item Cite

Third prize: the role of endoscopic nephron-sparing surgery in the management of upper tract urothelial carcinoma.

Journal Article J Endourol · March 2011 Featured Publication INTRODUCTION: Upper tract urothelial carcinoma (UT-UC) is an uncommon disease with pronounced difference in 5-year survival for noninvasive (96%) versus invasive (17%) disease. High survival rate of early disease questioned the accepted norm of using radic ... Full text Link to item Cite

Low dose computerized tomography for detection of urolithiasis--its effectiveness in the setting of the urology clinic.

Journal Article J Urol · March 2011 Featured Publication PURPOSE: Low dose noncontrast computerized tomography is becoming a common imaging tool to diagnose urolithiasis. We investigated its usefulness as a diagnostic tool in the outpatient setting. MATERIALS AND METHODS: A total of 62 patients with suspected ur ... Full text Link to item Cite

The digital flexible ureteroscope: in vitro assessment of optical characteristics.

Journal Article J Endourol · March 2011 Featured Publication INTRODUCTION: Recent advances in endoscope design have placed the charged coupled device chip on the tip of the endoscope. The image is instantly digitalized and converted into an electrical signal for transmission. Digital technology was first introduced ... Full text Link to item Cite

Demystifying the medical management of nephrolithiasis.

Journal Article Rev Urol · 2011 Featured Publication Nephrolithiasis is a common problem associated with significant costs to the health care system. Its prevalence continues to increase, particularly in women, which is attributed to changes in diet and lifestyle. The costs associated with the evaluation and ... Link to item Cite

Factors affecting patient radiation exposure during percutaneous nephrolithotomy.

Journal Article J Urol · December 2010 PURPOSE: We identified patient and stone characteristics that may contribute to increased radiation exposure during percutaneous nephrolithotomy and offer technique modifications to limit the radiation dose. MATERIAL AND METHODS: We reviewed the records of ... Full text Link to item Cite

In vivo determination of urinary stone composition using dual energy computerized tomography with advanced post-acquisition processing.

Journal Article J Urol · December 2010 Featured Publication PURPOSE: We assessed whether dual energy computerized tomography with advanced post-image processing can accurately differentiate urinary calculi composition in vivo. MATERIALS AND METHODS: A total of 25 patients scheduled to undergo ureteroscopic/percutan ... Full text Link to item Cite

Tubeless percutaneous nephrolithotomy--the new standard of care?

Journal Article J Urol · October 2010 Featured Publication PURPOSE: Traditionally the placement of a nephrostomy tube at the conclusion of percutaneous nephrolithotomy is considered the standard of care. However, the need for nephrostomy tube placement has been questioned by numerous authors. We evaluated the lite ... Full text Link to item Cite

Heterogeneity in the reporting of disease characteristics and treatment outcomes in studies evaluating treatments for nephrolithiasis.

Journal Article J Endourol · September 2010 BACKGROUND AND PURPOSE: There is no standardization in the nephrolithiasis literature regarding preoperative or postoperative evaluation of patients who are undergoing treatment for stone disease. This may hinder comparisons of efficacy of different treatm ... Full text Link to item Cite

FACTORS AFFECTING RADIATION EXPOSURE DURING URETEROSCOPY

Conference JOURNAL OF ENDOUROLOGY · September 1, 2010 Link to item Cite

ORGAN SPECIFIC RADIATION DOSE DURING PERCUTANEOUS NEPHROLITHOTOMY

Conference JOURNAL OF ENDOUROLOGY · September 1, 2010 Link to item Cite

The preoperative use of erythropoietin stimulating proteins prior to radical prostatectomy is not associated with increased cardiovascular or thromboembolic morbidity or mortality.

Journal Article Urology · June 2010 OBJECTIVES: To critically examine the cardiovascular and thromboembolic risks associated with erythropoietin stimulating proteins (ESPs) in men with normal hemoglobin levels undergoing open radical retropubic prostatectomy. METHODS: Between October 1, 2000 ... Full text Link to item Cite

Robot assisted partial nephrectomy versus laparoscopic partial nephrectomy for renal tumors: a multi-institutional analysis of perioperative outcomes.

Journal Article J Urol · September 2009 PURPOSE: Robot assisted partial nephrectomy is rapidly emerging as an alternative to laparoscopic partial nephrectomy for the treatment of renal malignancy. We present the largest multi-institution comparison of the 2 approaches to date, describing outcome ... Full text Link to item Cite

Medical therapy of stone disease: from prevention to promotion of passage options.

Journal Article Curr Urol Rep · January 2009 Medical therapy has been used for many years in the prevention of urinary stones. Medications directed at correcting urinary metabolic abnormalities responsible for promoting stone formation include thiazide diuretics, citrate salts, and allopurinol. All h ... Full text Link to item Cite

Robot-assisted ureterolysis, retroperitoneal biopsy, and omental wrap: pilot series for the treatment of idiopathic retroperitoneal fibrosis.

Journal Article J Endourol · August 2008 BACKGROUND AND PURPOSE: Retroperitoneal fibrosis (RPF) is an uncommon disease of vague cause distinguished by a chronic inflammatory response. Traditionally, RPF with ureteral involvement has been managed with open ureterolysis and transposition, with exce ... Full text Link to item Cite

ROBOTIC RECONSTRUCTION OF THE URINARY TRACT

Conference Journal of Urology · April 2008 Full text Cite

Minimally invasive management of retroperitoneal fibrosis.

Journal Article Urology · February 2008 OBJECTIVES: Ureteral obstruction is a common finding in retroperitoneal fibrosis (RPF). The management of ureteral obstruction in patients with RPF is challenging and controversial. To our knowledge we are the first to report on laparoscopic ureterolysis ( ... Full text Link to item Cite

The impact of obstructive interval and sperm granuloma on outcome of vasectomy reversal.

Journal Article J Urol · January 2004 PURPOSE: We studied the impact of the interval from vasectomy to reversal and presence of sperm granuloma on outcomes of reversal. MATERIALS AND METHODS: A total of 213 microsurgical vasectomy reversals performed by a single surgeon were stratified accordi ... Full text Link to item Cite