Genes polymorphism as risk factor of recurrent urolithiasis: a systematic review and meta-analysis.

INTRODUCTION: Urolithiasis is one of the most prevalent diseases worldwide. Its prevalence is rising, both in developing and developed countries. It is known that genetic factors play big roles in the development of urolithiasis. One of the suspected factors is gene polymorphism. This study aims to find an accurate estimate of the association between genetic polymorphism and the risk of recurrent urolithiasis. METHODS: A systematic review and meta-analysis were performed on 12 studies from 3 databases that investigated gene polymorphism as an risk factor of urolithiasis. The review was done using Review Manager® version 5.3. RESULTS: Insignificant heterogenicity was found in this study. Populations from Asia and the Middle East are more likely to experience recurrent urolithiasis. Additionally, variation in the VDR and urokinase genes, particularly in the Asian population, increases the risk of developing recurrent urolithiasis. CONCLUSIONS: Gene polymorphisms have significant roles in the development of urolithiasis, especially in the Middle Eastern region.

Comparison of the Effectiveness of Pre-urodynamic Single-dose Levofloxacin with Post-urodynamic Levofloxacin for Three Days Related to the Incidence of Urinary Tract Infection: A Randomized Control Trial.

PURPOSE: The current study aims to compare the effectiveness of pre-urodynamic single-dose levofloxacin and post-urodynamic levofloxacin for three days related to the incidence of urinary tract infections post-urodynamic examination. MATERIALS AND METHODS: This is a single-blind randomized clinical trial conducted in three outpatient urology centers in Jakarta: Cipto Mangunkusumo General Hospital, Siloam Asri Hospital, and Persahabatan General Hospital using a consecutive sampling method between July 2019 - February 2022. The outcome of the study is the incidence of urinary tract infections in both treatment groups. Urinary tract infection was defined as a patient with one or more clinical symptoms of lower urinary tract infection and one or more urinalysis parameters positive for urinary tract infections. Chi-square was used to evaluate the association where p < 0.05 was used to determine statistical significance. RESULTS: A total of 126 patients (63 patients in each arm) were included in the evaluation and analysis. Overall, urinary tract infections were detected in 25 cases (19.8%), 12 patients from the pre-urodynamic antibiotic group (9.5%) and 13 patients from the post-urodynamic antibiotic group (10.3%) (P = .823). E.coli was the most common bacteria found in the urine culture. CONCLUSION: There is no significant difference between a single dose of 500 mg of Levofloxacin administered one hour before the urodynamic study and a once-daily dose of 500 mg of Levofloxacin for three days following the urodynamic study related to urinary tract infections prevention post-urodynamic examination.

Endoscopic-guided percutaneous nephrolithotomy (EPSL) with prone split-leg position for complex kidney stone: A case report.

INTRODUCTION: The optimal patient positioning for percutaneous nephrolithotomy (PCNL) based on the complexity of stone burden is not yet defined in the literature This report elaborated left complex kidney stones case underwent endoscopic-guided PCNL with a prone split-leg position (ePSL). PRESENTATION OF CASE: Forty-three years old women were referred with a history of failed left open kidney surgery because of frozen kidney. A renal biopsy examination confirmed xanthogranulomatous tissue. Standard prone PCNL was performed. There were so many debris in pelviocalyceal system, so we used ultrasound guidance to puncture instead of fluoroscopy. There was residual stone in superior calyx that nephroscope couldn't reach. ePSL method was used in the second procedure. The stone was fragmented with pneumatic lithotripter. Evaluation using C-arm and nephroscope illustrated no residual stones, infundibulum laceration, and active bleeding. DISCUSSION: This technique's main objectives are to remove urinary tract stones along the whole tract with a one-step and one-access approach with optimal utilization of full array endourologic equipment. The prone split-leg position was chosen for multiple reasons such as operator preference, the familiarity of a specific position, and inability to perform direct puncture in the upper pole. The main limitation is no long-term follow-up for patients to see the effectiveness and safety of this technique. CONCLUSION: To conclude, ePSL with a prone split-leg position is a safe procedure with a relatively low rate of complications and can be used for complex kidney stone.