Introduction. Urolithiasis is a polyetiological, polypathognomonic metabolic disease characterized by the formation of kidney stones. The study of trends in the urolithiasis prevalence is of fundamental importance in practical medicine. The study of endemic territories allows us to analyze all possible risk factors for the development of urolithiasis from genetic to nutritional. The aim of our study is a comparative analysis of the urolithiasis prevalence in the Russian Federation for different periods. Materials and methods. We analyzed urolithiasis prevalence and incidence in the entire population of Russia from 2005 to 2020. The work is based on official statistics of the Ministry of Health of the Russian Federation. Statistical analysis of the data was carried out using the SPSS Statistics 21 software package. Results and discussion. Urolithiasis prevalence in the Russian Federation is considered in detail from 2005 to 2020. We did a comparative analysis of the data on the general urolithiasis prevalence, the incidence of urolithiasis, urolithiasis prevalence separately in the adult and children's population of Russia in the period from 2005 to 2020 out. We gave the leading regions in the Russian Federation in terms of the number of urolithiasis cases. We spent correlation analysis of the urolithiasis incidence with the number of cases of diabetes mellitus type 2, obesity and the level of meat consumption in the Russian population. Conclusion. Urolithiasis incidence and prevalence among the adult population is steadily growing in all regions of the Russian Federation, while the incidence among children remains stable. The relationship between the prevalence of urolithiasis and incidence of diabetes mellitus type 2 and obesity was noted.
Purpose: To assess the 30-day stone-free rate and peri-operative outcomes of flexible ureteroscopy (FURS) with flexible and navigable suction ureteral access sheaths (FANS) in adults undergoing same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS). Methods: Prospectively data of 115 adult patients with bilateral kidney stone disease undergoing SSB-RIRS across 14 global centers between July 2023 and March 2024 were analyzed. Patient demographics, stone characteristics and operative outcomes were recorded. A low-dose non contrast CT scan was performed at 30 days to assess the stone-free rate and clinical outcomes. Results: Overall bilateral zero residual fragment(ZRF) was 42.6%; unilateral ZRF was 75.7%. Only two patients were noted to have residual fragments > 4 mm. 1.7% experienced Traxer-Thomas grade 1 ureteric injury which was managed with a ureteral stent for four weeks. No pelvicalyceal injury occured. Postoperative mean loin pain score was 1.7 ± 1.0. None had sepsis nor required blood transfusion. 4.3% required readmission within 30 days of surgery. Multivariate analysis indicated longer total operation time correlated with lower odds of achieving a 100% bilateral stone-free (ZRF) (OR 0.978, 95%CI = 0.959–0.994, p = 0.013). Conclusion: To our knowledge, this is the first multicenter study demonstrating the use of FANS in SSB-RIRS can achieve bilateral ZRF with low complication and re-intervention rates. However, prolonged surgical time may negatively impact outcomes. The indications of bilateral renal stones management with FURS can be expanded in appropriate chosen patients.
Мочекаменная болезнь (МКБ) является одним из наиболее распространенныx заболеваний во всем мире. По данным нескольких популяционных исследований, распространенность мочекаменной болезни в мире составл
The essence of Urolithiasis - one of the oldest diseases known by the mankind - is still not understood completely. For a long time the comprehension of Urolithiasis was based on matrix, colloid, ionic, inhibitory and precipitation theories. In these cases it was impossible to single out separate pathogenetic patterns. Besides, in spite of the absence of in vivo proofs the fact that new concrement nucleus forming (de novo nucleation) is only possible outside of the stone-forming metastability range should be taken into consideration for metaphilactic purposes. Fortunately, certain progress in understanding Urolithiasis started with the onset of studies devoted to detailed scrutiny of stone-forming patients’ metabolic peculiarities as well as with the introduction into clinical practice of the up-to-date digital endoscopes. Based on existing publications one may classify pathogenesis of stone-forming into 4 major groups: growth of calcium-oxalic stones on Randall’s plaques in patients with hypercalciumuria; excrescences on the of Belliny’s ducts’ “gags”; microlites forming within the internal medullar layer discharging tubules’ lumen in patients with cystineuria; stones forming in free solution. There is no doubt this classification is not the final one, neither does it exclude mixed variants, however better understanding of the aforementioned pathogenic variants would facilitate a novel view at Urolithiasis and in patients with kidney stones would increase anti-relapse measures’ effectiveness.