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01-06-2016 | Invited Review

Clinical significance of residual fragments in 2015: impact, detection, and how to avoid them

Authors: Simon Hein, Arkadiusz Miernik, Konrad Wilhelm, Fabian Adams, Daniel Schlager, Thomas R. W. Herrmann, Jens J. Rassweiler, Martin Schoenthaler

Published in: World Journal of Urology | Issue 6/2016

Abstract

Purpose

Residual fragments are common after stone treatment. Little is known about clinical outcomes relevant to the patient. This comprehensive review of the literature highlights the impact of residual fragments, modes of detection, and treatment strategies to avoid residual fragments in shock wave therapy, ureteroscopy, and percutaneous nephrolithotomy.

Methods

A comprehensive review of current literature was performed using PubMed^®, MEDLINE^®, Embase™, Ovid^®, Google Scholar™, and the Cochrane Library. Publications relevant to the subject were retrieved and critically appraised.

Results

Residual fragments after treatment for urinary stones have a significant impact on a patient’s well-being and future course. (Ultra-) low-dose non-contrast computed tomography detects small residuals most reliably. In shock wave lithotripsy, adherence to basic principles helps to improve results. Various techniques and devices facilitate complete stone clearance in conventional and miniaturized percutaneous nephrolithotomy and (flexible) ureteroscopy. Promising new technologies in shock waves, lasers, and robotics (and potentially microrobotics) are on the horizon.

Conclusions

Residual fragments are relevant to patients. Contemporary treatment of urolithiasis should aim at complete stone clearance.

Available only for authorised users

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Title: Clinical significance of residual fragments in 2015: impact, detection, and how to avoid them
Authors: Simon Hein
Arkadiusz Miernik
Konrad Wilhelm
Fabian Adams
Daniel Schlager
Thomas R. W. Herrmann
Jens J. Rassweiler
Martin Schoenthaler
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 6/2016
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-015-1713-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Clinical significance of residual fragments in 2015: impact, detection, and how to avoid them

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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