{"id":3564,"date":"2024-08-20T14:52:59","date_gmt":"2024-08-20T14:52:59","guid":{"rendered":"https:\/\/www.medinik.de\/med-fachbereich\/"},"modified":"2026-04-01T10:15:33","modified_gmt":"2026-04-01T10:15:33","slug":"med-speciality","status":"publish","type":"page","link":"https:\/\/www.medinik.de\/en\/med-speciality\/","title":{"rendered":"Med. speciality"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;off|desktop&#8221; module_class=&#8221;fade-out-section&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00012f68-7d00-4818-b649-20d75de3265b&#8221; background_image=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2024\/08\/header_med_fachbereich_desk.jpg&#8221; height_tablet=&#8221;&#8221; height_phone=&#8221;&#8221; height_last_edited=&#8221;on|tablet&#8221; custom_margin=&#8221;||||false&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; background_last_edited=&#8221;on|desktop&#8221; background_image_tablet=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2024\/08\/header_med_fachbereich_medinik_tab.jpg&#8221; background_image_phone=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2024\/08\/header_med_fachbereich_medinik_mob.jpg&#8221; background_enable_image_tablet=&#8221;on&#8221; background_enable_image_phone=&#8221;on&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;1_2,1_2&#8243; make_equal=&#8221;on&#8221; module_class=&#8221;custom_row row-1440&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;fc0747b4-478d-48f4-8b1f-e468d1419db6&#8243; width_tablet=&#8221;&#8221; width_phone=&#8221;&#8221; width_last_edited=&#8221;on|desktop&#8221; min_height=&#8221;544px&#8221; min_height_tablet=&#8221;756px&#8221; min_height_phone=&#8221;722px&#8221; min_height_last_edited=&#8221;on|desktop&#8221; height=&#8221;30vw&#8221; max_height=&#8221;722px&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_2&#8243; module_class=&#8221;second-on-mobile header-row&#8221; _builder_version=&#8221;4.23.4&#8243; _module_preset=&#8221;default&#8221; custom_css_main_element=&#8221;margin: auto;&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;on|phone&#8221; custom_css_main_element_tablet=&#8221;margin: auto auto 0;&#8221; custom_css_main_element_phone=&#8221;margin: auto auto 0;&#8221;][et_pb_text _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;_initial&#8221; text_font=&#8221;|600|||||||&#8221; text_letter_spacing=&#8221;0.5px&#8221; background_layout=&#8221;dark&#8221; custom_margin=&#8221;|-28px|||false|false&#8221; text_line_height_tablet=&#8221;&#8221; text_line_height_phone=&#8221;&#8221; text_line_height_last_edited=&#8221;on|desktop&#8221; custom_css_main_element=&#8221;hyphens: auto !important;&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Medical speciality \u2014<\/p>\n<h1>Procedure and publications.<\/h1>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; module_class=&#8221;first-on-mobile&#8221; _builder_version=&#8221;4.23.4&#8243; _module_preset=&#8221;default&#8221; custom_css_main_element=&#8221;margin: auto;&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;100px||100px||false|false&#8221; custom_padding_tablet=&#8221;50px||50px||false|false&#8221; custom_padding_phone=&#8221;50px||50px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||33px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||30px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2 style=\"text-align: left;\">Application steps of mediNiK\u00ae<\/h2>\n<p>[\/et_pb_text][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<style>#sp-ea-3810 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-3810.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon {margin-right: 0;}<\/style><div id=\"sp_easy_accordion-1724401577\"><div id=\"sp-ea-3810\" class=\"sp-ea-one sp-easy-accordion\" data-ea-active=\"ea-click\" data-ea-mode=\"vertical\" data-preloader=\"\" data-scroll-active-item=\"\" data-offset-to-scroll=\"0\"><div class=\"ea-card ea-expand sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38100\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38100\" aria-controls=\"collapse38100\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">Before using mediNiK\u00ae<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse38100\" data-parent=\"#sp-ea-3810\" role=\"region\" aria-labelledby=\"ea-header-38100\"> <div class=\"ea-body\"><p><strong>A.<\/strong> Make sure that there is no contrast medium, blood or other substances in the kidney that could affect vision and\/or hydrogel formation.<br \/><strong>B.<\/strong> Before removing the syringe cap, the pressure point should be released by pressing in the plunger rod. This ensures that the syringes are emptied easily and evenly.<br \/><strong>C.<\/strong> For optimum results, the kidney stones should be collected at the lowest point of a kidney calyx.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38101\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38101\" aria-controls=\"collapse38101\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">Administration of mediNiK\u00ae<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38101\" data-parent=\"#sp-ea-3810\" role=\"region\" aria-labelledby=\"ea-header-38101\"> <div class=\"ea-body\"><p><strong>1. <\/strong>Use the endoscope <strong>to navigate<\/strong> within vision to the kidney stone fragments. Irrigate with physiological sterile saline solution (0.9 % NaCI) to ensure good visibility.<br \/><strong>2. Stop<\/strong> irrigation. Slowly inject the blue base substance K1 in pulses through the working channel of the endoscope until the fragments to be removed are completely surrounded by blue K1. If more than one renal calyx is affected, repeat this step for each calyx individually.<br \/><u>Tip:<\/u> Only use as much of the blue base substance K1 as necessary. This is then turned into a hydrogel by adding the second component, the yellow activator K2.<br \/><strong>3. <\/strong>Carefully <strong>flush<\/strong> the working channel of the endoscope with 0.9 % NaCI.<br \/><u>Caution:<\/u> Avoid turbulence\/dilution of the blue K1 by flushing the working channel too intensively. Pull the endoscope back slightly.<br \/><strong>4. Inject<\/strong> the yellow K2 carefully and slowly through the previously flushed working channel. Move the endoscope slowly in the direction of the affected renal calyx(es).<br \/><u>Caution:<\/u> Avoid turbulence in the blue K1 by injecting too quickly. Irrespective of the amount of blue base substance K1 used, the entire content of the yellow activator K2 syringe (11 ml) should be injected.<br \/><strong>5. Insert<\/strong> the stone retrieval basket (e.g., Dormia or tipless basket) into the working channel of the endoscope.<br \/><strong>6. Carefully grasp and remove<\/strong> the hydrogel clot with the stone retrieval basket. Flushing can now be restarted at low intensity.<br \/><u>Caution:<\/u> The grasper can cut the hydrogel if it is closed too tightly.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38102\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38102\" aria-controls=\"collapse38102\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">Following administration<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38102\" data-parent=\"#sp-ea-3810\" role=\"region\" aria-labelledby=\"ea-header-38102\"> <div class=\"ea-body\"><p>Ensure that all hydrogel clots have been removed. However, if hydrogel clots remain, these are \u2013 as a rule \u2013 dissolved by diuresis. The hydrogel can also be actively dissolved by adding a chelating agent (e.g. EDTA).<\/p><p><strong>Repeating the procedure:<\/strong> If the procedure is repeated, all of the previously used yellow K2 must be completely flushed out of the kidney.<br \/><strong>Single use:<\/strong> mediNiK\u00ae is intended for single use and must not be resterilized.<br \/><strong>Disposal:<\/strong> The syringes filled with blue K1 and yellow K2 can be disposed of in accordance with the lowest internal hospital disposal standards. The hydrogel must be disposed of separately as it has come into contact with mucous membranes and\/or urine.<\/p><\/div><\/div><\/div><\/div><\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#309F52&#8243; max_width=&#8221;1120px&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;19px|20px|22px|20px|false|false&#8221; border_radii=&#8221;on|16px|16px|16px|16px&#8221; border_color_all=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;69a0e13c-1630-45aa-b27d-7a6ca54e8478&#8243; link_font=&#8221;||||on|||#FFFFFF|&#8221; link_text_color=&#8221;#FFFFFF&#8221; header_6_font=&#8221;|600|||||||&#8221; header_6_font_size=&#8221;20px&#8221; header_6_line_height=&#8221;0.5em&#8221; background_layout=&#8221;dark&#8221; custom_margin=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h6><span style=\"font-size: 16px;\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.medinik.de\/wp-content\/uploads\/2024\/08\/circle_exclamation_mark_63x63@3x.svg\" width=\"62\" height=\"62\" alt=\"\" class=\"wp-image-924 alignleft size-full\" \/>Note:<\/span><\/h6>\n<p>All serious incidents occurring in connection with the device must be reported to the manufacturer and the competent authority of the Member State in which the user and\/or patient is located (<a href=\"mailto:vigilanz@purenum.com\">vigilanz@purenum.com<\/a>).[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|phone&#8221; module_id=&#8221;FAQ_Fachbereich&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;0px||90px||false|false&#8221; custom_padding_tablet=&#8221;||45px||false|false&#8221; custom_padding_phone=&#8221;||45px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||30px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2 style=\"text-align: left;\">Frequently asked questions about the use of mediNiK\u00ae<\/h2>\n<p>[\/et_pb_text][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<style>#sp-ea-3814 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-3814.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon {margin-right: 0;}<\/style><div id=\"sp_easy_accordion-1724401577\"><div id=\"sp-ea-3814\" class=\"sp-ea-one sp-easy-accordion\" data-ea-active=\"ea-click\" data-ea-mode=\"vertical\" data-preloader=\"\" data-scroll-active-item=\"\" data-offset-to-scroll=\"0\"><div class=\"ea-card ea-expand sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38140\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38140\" aria-controls=\"collapse38140\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">1. Do I need a special ureterorenoscope?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse38140\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38140\"> <div class=\"ea-body\"><p>No. You can use your existing ureterorenoscope without any problem.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38141\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38141\" aria-controls=\"collapse38141\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">2. How many syringes do I need per patient\/administration?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38141\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38141\"> <div class=\"ea-body\"><p>1 administration = 2 syringes (1 of component K1 + 1 of component K2)<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38142\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38142\" aria-controls=\"collapse38142\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">3. How can you tell that a sufficient amount of the base substance K1 has been injected?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38142\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38142\"> <div class=\"ea-body\"><p>K1 is blue in color and transparent, creating a good color contrast on the monitor and ensuring that the stone fragments are visible. When all stone fragments are completely coated with the blue component, a sufficient amount has been administered.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38143\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38143\" aria-controls=\"collapse38143\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">4. How can I be sure that a sufficient amount of the activator K2 has been administered?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38143\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38143\"> <div class=\"ea-body\"><p>There is no need to ensure a precise mixing ratio. At least two to three times the amount of K2 should be injected compared to the previously introduced base substance K1. As overdose of the K2 activator is not possible, the entire contents of the syringe can be injected slowly (without turbulence).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38144\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38144\" aria-controls=\"collapse38144\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">5. Is it possible to administer too much mediNiK\u00ae (K1 or K2)?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38144\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38144\"> <div class=\"ea-body\"><p>With regard to the quantity of base substance K1, it makes sense to inject only enough to completely enclose all fragments according to the principle of as much as necessary, as little as possible. About 0.3 to 0.5 ml of K1 should be sufficient for one calyx, although several calices can be filled in succession before K2 is added. On the other hand, it is not possible to inject too much of the activator K2.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38145\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38145\" aria-controls=\"collapse38145\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">6. After adding component K2, no solid hydrogel is formed, or only a small amount. Why is that?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38145\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38145\"> <div class=\"ea-body\"><p>a. The flushing was not stopped before the administation of K1 and K1 was therefore \"flushed out\".<br \/>b. Component K2 was administered so quickly that component K1 was \"flushed out\" by the resulting turbulence.<br \/>c. Component K2 was administered too close to component K1, so that component K1 was \"flushed out\".<br \/>d. Too little of component K2 was used, and there was no visible yellowing of the total fluid in the kidney.<br \/>e. If it is not the first administration: Inadequate flushing, residual component K2 was still present in the kidney.<br \/>f. Not waiting long enough for the gel to form.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38146\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38146\" aria-controls=\"collapse38146\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">7. What happens if flushing is NOT turned off before injecting mediNiK\u00ae?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38146\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38146\"> <div class=\"ea-body\"><p>The base substance K1 is \"flushed away\" or diluted by the flow caused by flushing. The residual fragments to be retrieved are therefore insufficiently coated.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38147\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38147\" aria-controls=\"collapse38147\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">8. What happens if I do not administer a component?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38147\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38147\"> <div class=\"ea-body\"><p>If only one of the two components is administered, no gel formation will occur. Consequently, the residual fragments cannot be retrieved as expected.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38148\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38148\" aria-controls=\"collapse38148\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">9. What happens if I reverse the order of use?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38148\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38148\"> <div class=\"ea-body\"><p>If the activator K2 is administered first, K1 gel formation will occur instantaneously during the subsequent injection of base substance K1. The residual fragments will therefore be bound weakly or not at all by the hydrogel.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38149\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38149\" aria-controls=\"collapse38149\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">10. Do I need to apply pressure to the syringes to force the components out of the syringes?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38149\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38149\"> <div class=\"ea-body\"><p>The higher viscosity component K1 (base substance) requires slightly more force than component K2 (activator), especially if it is delivered through a catheter (which can be useful when using a reusable scope, for example). When administered directly via the working channel as we recommend, both components can be easily dosed. If it is not possible to administer the components K1 or K2, it may be because:<\/p><p>1) the selected catheter is too narrow.<br \/>2) there is a blockage in the catheter caused by residues of the other component that have not been flushed away.<br \/>3) the Tuohy Borst at the entrance to the working channel is tightened too much so that the cross-section of the catheter is reduced.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-381410\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse381410\" aria-controls=\"collapse381410\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">11. It is difficult to plunge the syringes when they are first pressed, is this normal?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse381410\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-381410\"> <div class=\"ea-body\"><p>Yes, the technical pressure point must be released first. This is done by briefly pressing in the plunger rod with the cap fixed in place, e.g. by placing the syringe on a solid surface, similar to other syringes from FARCO-PHARMA (e.g. Instillagel and Endosgel).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-381411\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse381411\" aria-controls=\"collapse381411\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">12. Can mediNiK\u00ae be administered a second time during surgery?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse381411\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-381411\"> <div class=\"ea-body\"><p>Yes, mediNiK\u00ae can even be administered several times to one patient. This requires the kidney to be well flushed with physiological saline solution so that no residues of component K2 are present. Residual K2 would lead to immediate gel formation upon readministration of K1 without the stone fragments being sufficiently coated.<\/p><\/div><\/div><\/div><\/div><\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;0px||90px||false|false&#8221; custom_padding_tablet=&#8221;||45px||false|false&#8221; custom_padding_phone=&#8221;||45px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||30px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2 style=\"text-align: left;\">Retrieval of renal stone fragments<\/h2>\n<p>[\/et_pb_text][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<style>#sp-ea-3817 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-3817.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon {margin-right: 0;}<\/style><div id=\"sp_easy_accordion-1724401577\"><div id=\"sp-ea-3817\" class=\"sp-ea-one sp-easy-accordion\" data-ea-active=\"ea-click\" data-ea-mode=\"vertical\" data-preloader=\"\" data-scroll-active-item=\"\" data-offset-to-scroll=\"0\"><div class=\"ea-card ea-expand sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38170\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38170\" aria-controls=\"collapse38170\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">13. Grasping the hydrogel with the grasper is difficult or causes the hydrogel to tear. Why is that?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse38170\" data-parent=\"#sp-ea-3817\" role=\"region\" aria-labelledby=\"ea-header-38170\"> <div class=\"ea-body\"><p>It is essential to wait at least 3 minutes after injecting K2, as the gel will be too soft to grip if you do not wait long enough. Complete closure of the extraction basket cuts through the hydrogel. Grasping the hydrogel differs fundamentally from conventional grasping of stone fragments. To allow for the retrieval of larger amounts of the hydrogel (containing the bound residual fragments), it is designed to be soft. This means it can mold to the urinary tract or ureteral sheath. Therefore, the extraction basket should be closed only slightly. Grasping the hydrogel is fundamental to the procedure and can be practiced in advance on a model of the kidney.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38171\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38171\" aria-controls=\"collapse38171\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">14. Why does the hydrogel clot have to be pulled out \"carefully\"? What if I \"lose\" half of it?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38171\" data-parent=\"#sp-ea-3817\" role=\"region\" aria-labelledby=\"ea-header-38171\"> <div class=\"ea-body\"><p>The hydrogel is designed to be soft so that it can mold to the urinary tract or ureteral sheath. There is a constriction at the junction between the renal pelvis and the ureteral sheath. If the hydrogel is pulled through too quickly at this point, the part protruding from the extraction basket may be sheared off. This part must be retrieved in a further step. As the gel is located directly inside the renal pelvis, it is easy to grasp and subsequently retrieve the fragments.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38172\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38172\" aria-controls=\"collapse38172\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">15. What happens if residues of mediNiK\u00ae remain in the kidney after the procedure?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38172\" data-parent=\"#sp-ea-3817\" role=\"region\" aria-labelledby=\"ea-header-38172\"> <div class=\"ea-body\"><p>Residues of mediNiK\u00ae remaining in the kidney do not pose a risk to the patient. Natural diuresis reverses gel formation. Initially, the gel becomes softer and softer until it turns completely back into a liquid and is excreted by the patient in the urine.<\/p><\/div><\/div><\/div><\/div><\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;0px||90px||false|false&#8221; custom_padding_tablet=&#8221;||45px||false|false&#8221; custom_padding_phone=&#8221;||45px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||30px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2 style=\"text-align: left;\">Following administration<\/h2>\n<p>[\/et_pb_text][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<style>#sp-ea-3820 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-3820.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon {margin-right: 0;}<\/style><div id=\"sp_easy_accordion-1724401577\"><div id=\"sp-ea-3820\" class=\"sp-ea-one sp-easy-accordion\" data-ea-active=\"ea-click\" data-ea-mode=\"vertical\" data-preloader=\"\" data-scroll-active-item=\"\" data-offset-to-scroll=\"0\"><div class=\"ea-card ea-expand sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38200\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38200\" aria-controls=\"collapse38200\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">16. How do I dispose of the hydrogel and syringe residues?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse38200\" data-parent=\"#sp-ea-3820\" role=\"region\" aria-labelledby=\"ea-header-38200\"> <div class=\"ea-body\"><p>Component K1 and component K2 do not pose any risk to humans. Syringes can be disposed of in accordance with the hospital's internal disposal standards for the lowest waste safety level. The catheters and the hydrogel must be disposed of separately as they come into contact with mucous membranes and\/or urine and the renal stone fragments.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38201\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38201\" aria-controls=\"collapse38201\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">17. Can leftover mediNiK\u00ae be used for another operation?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38201\" data-parent=\"#sp-ea-3820\" role=\"region\" aria-labelledby=\"ea-header-38201\"> <div class=\"ea-body\"><p>No. The principle is that opened and used syringes may only be used in one patient for a single operation.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38202\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38202\" aria-controls=\"collapse38202\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">18. How can I isolate the retrieved stone fragments from the hydrogel for analysis?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38202\" data-parent=\"#sp-ea-3820\" role=\"region\" aria-labelledby=\"ea-header-38202\"> <div class=\"ea-body\"><p>There are two possibilities, in principle:<br \/>1) The stones can be mechanically removed from the hydrogel and rinsed with sufficient water.<br \/>2) The hydrogel is dissolved by placing it in a chelating agent (e.g. EDTA) so that isolated stone fragments can be sent for analysis.<\/p><\/div><\/div><\/div><\/div><\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|phone&#8221; admin_label=&#8221;Unsere Produkte&#8221; module_id=&#8221;trainingsvideo_en&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;_initial&#8221; background_color=&#8221;#FFFFFF&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;0px||100px||false|false&#8221; custom_padding_tablet=&#8221;||50px||false|false&#8221; custom_padding_phone=&#8221;0px||50px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||30px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2 style=\"text-align: left;\">Hydrogel method in OR<\/h2>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;1_3,1_3,1_3&#8243; use_custom_gutter=&#8221;on&#8221; module_class=&#8221;video-cards&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;_initial&#8221; width=&#8221;100%&#8221; width_tablet=&#8221;&#8221; width_phone=&#8221;90%&#8221; width_last_edited=&#8221;on|phone&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_video src=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2025\/12\/Purenum-mediNiK-Schulungsfilm-2025-EN-small.mp4&#8243; src_webm=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2025\/12\/Purenum-mediNiK-Schulungsfilm-2025-EN-small.webm&#8221; image_src=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2025\/12\/Screen_Video-MediNiK-Schulung_2025.jpg&#8221; font_icon=&#8221;&#xe04e;||divi||400&#8243; use_icon_font_size=&#8221;on&#8221; icon_font_size=&#8221;80px&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; border_radii=&#8221;on|8px|8px|8px|8px&#8221; border_width_all=&#8221;0.5px&#8221; border_color_all=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_video][et_pb_text ul_type=&#8221;none&#8221; ul_item_indent=&#8221;20px&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;_initial&#8221; text_font=&#8221;|600|||||||&#8221; text_text_color=&#8221;#309F52&#8243; text_line_height=&#8221;2em&#8221; ul_font_size=&#8221;16px&#8221; ul_line_height=&#8221;1.5em&#8221; header_font_size=&#8221;80px&#8221; header_2_font=&#8221;|600|||||||&#8221; header_3_font=&#8221;|600|||||||&#8221; header_4_font=&#8221;|600|||||||&#8221; header_4_letter_spacing=&#8221;-0.5px&#8221; header_6_font=&#8221;|600|||||||&#8221; header_6_font_size=&#8221;12px&#8221; header_6_letter_spacing=&#8221;1px&#8221; header_6_line_height=&#8221;1.6em&#8221; text_orientation=&#8221;center&#8221; width=&#8221;100%&#8221; width_tablet=&#8221;&#8221; width_phone=&#8221;&#8221; width_last_edited=&#8221;on|phone&#8221; max_width=&#8221;700px&#8221; module_alignment=&#8221;left&#8221; custom_margin=&#8221;||40px||false|false&#8221; text_line_height_tablet=&#8221;1.5em&#8221; text_line_height_phone=&#8221;1.5em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_font_size_tablet=&#8221;55px&#8221; global_colors_info=&#8221;{}&#8221; custom_margin__hover_enabled=&#8221;on|desktop&#8221; custom_margin__hover=&#8221;||40px||false|false&#8221;]<\/p>\n<h6 style=\"text-align: left;\">VIDEO \u2014<\/h6>\n<h4 style=\"text-align: left;\"><span>Training video on the use of mediNiK\u00ae<\/span><\/h4>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_video src=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2026\/01\/yt-d3-2911-0830-case-va-amiel.mp4&#8243; src_webm=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2026\/01\/YT_D3_2911_0830_Case_VA_Amiel.webm&#8221; image_src=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2026\/01\/Screen_Video_Live-Session_ICE25_Rom.jpg&#8221; font_icon=&#8221;&#xe04e;||divi||400&#8243; use_icon_font_size=&#8221;on&#8221; icon_font_size=&#8221;80px&#8221; module_id=&#8221;video-semi-live-ice25-rom&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; border_radii=&#8221;on|8px|8px|8px|8px&#8221; border_width_all=&#8221;0.5px&#8221; border_color_all=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_video][et_pb_text ul_type=&#8221;none&#8221; ul_item_indent=&#8221;20px&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;_initial&#8221; text_font=&#8221;|600|||||||&#8221; text_text_color=&#8221;#309F52&#8243; text_line_height=&#8221;2em&#8221; ul_font_size=&#8221;16px&#8221; ul_line_height=&#8221;1.5em&#8221; header_font_size=&#8221;80px&#8221; header_2_font=&#8221;|600|||||||&#8221; header_3_font=&#8221;|600|||||||&#8221; header_4_font=&#8221;|600|||||||&#8221; header_4_letter_spacing=&#8221;-0.5px&#8221; header_6_font=&#8221;|600|||||||&#8221; header_6_font_size=&#8221;12px&#8221; header_6_letter_spacing=&#8221;1px&#8221; header_6_line_height=&#8221;1.6em&#8221; text_orientation=&#8221;center&#8221; width=&#8221;100%&#8221; width_tablet=&#8221;&#8221; width_phone=&#8221;&#8221; width_last_edited=&#8221;on|phone&#8221; max_width=&#8221;800px&#8221; module_alignment=&#8221;left&#8221; custom_margin=&#8221;||40px||false|false&#8221; text_line_height_tablet=&#8221;1.5em&#8221; text_line_height_phone=&#8221;1.5em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_font_size_tablet=&#8221;55px&#8221; global_colors_info=&#8221;{}&#8221; custom_margin__hover_enabled=&#8221;on|desktop&#8221; custom_margin__hover=&#8221;||40px||false|false&#8221;]<\/p>\n<h6 style=\"text-align: left;\">VIDEO \u2014<\/h6>\n<h4 style=\"text-align: left;\">Semi Live ICE25 Rom 2025<\/h4>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_video src=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2026\/04\/SemiLive_2026_Amiel.mp4&#8243; image_src=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2026\/04\/Screen_Video_Live-Session_EAU_London2026.jpg&#8221; font_icon=&#8221;&#xe04e;||divi||400&#8243; use_icon_font_size=&#8221;on&#8221; icon_font_size=&#8221;80px&#8221; module_id=&#8221;video-semi-live-eau-madrid-2025&#8243; _builder_version=&#8221;4.27.6&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; border_radii=&#8221;on|8px|8px|8px|8px&#8221; border_width_all=&#8221;0.5px&#8221; border_color_all=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221; title_text=&#8221;Screenshot&#8221; src_webm=&#8221;https:\/\/www.medinik.de\/wp-content\/uploads\/2026\/04\/SemiLive_2026_Amiel.webm&#8221; sticky_enabled=&#8221;0&#8243;][\/et_pb_video][et_pb_text ul_type=&#8221;none&#8221; ul_item_indent=&#8221;20px&#8221; _builder_version=&#8221;4.27.6&#8243; _module_preset=&#8221;_initial&#8221; text_font=&#8221;|600|||||||&#8221; text_text_color=&#8221;#309F52&#8243; text_line_height=&#8221;2em&#8221; ul_font_size=&#8221;16px&#8221; ul_line_height=&#8221;1.5em&#8221; header_font_size=&#8221;80px&#8221; header_2_font=&#8221;|600|||||||&#8221; header_3_font=&#8221;|600|||||||&#8221; header_4_font=&#8221;|600|||||||&#8221; header_4_letter_spacing=&#8221;-0.5px&#8221; header_6_font=&#8221;|600|||||||&#8221; header_6_font_size=&#8221;12px&#8221; header_6_letter_spacing=&#8221;1px&#8221; header_6_line_height=&#8221;1.6em&#8221; text_orientation=&#8221;center&#8221; width=&#8221;100%&#8221; width_tablet=&#8221;&#8221; width_phone=&#8221;&#8221; width_last_edited=&#8221;on|phone&#8221; max_width=&#8221;800px&#8221; module_alignment=&#8221;left&#8221; custom_margin=&#8221;||40px||false|false&#8221; hover_enabled=&#8221;0&#8243; text_line_height_tablet=&#8221;1.5em&#8221; text_line_height_phone=&#8221;1.5em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_font_size_tablet=&#8221;55px&#8221; global_colors_info=&#8221;{}&#8221; custom_margin__hover_enabled=&#8221;on|desktop&#8221; custom_margin__hover=&#8221;||40px||false|false&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<h6 style=\"text-align: left;\">VIDEO \u2014<\/h6>\n<h4 style=\"text-align: left;\">Semi Live EAU London 2026<\/h4>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|desktop&#8221; module_class=&#8221;sec-publikationen&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;0px||80px||false|false&#8221; custom_padding_tablet=&#8221;||40px||false|false&#8221; custom_padding_phone=&#8221;||40px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||30px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2 style=\"text-align: left;\">Publications<\/h2>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; header_3_font=&#8221;||||||||&#8221; header_3_letter_spacing=&#8221;1.6px&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h3 style=\"text-align: left;\">ABOUT mediNiK\u00ae<\/h3>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; module_class=&#8221;row-leistungsfaehigkeit&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Stone extraction during flexible ureterorenoscopy with or without the hydrogel method: a randomized, multicenter safety and feasibility study<br \/>\n<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-leistungsfaehigkeit&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; link_font=&#8221;||||on||||&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Amiel T, Neisius A, Netsch C, Secker A, Fisang C, Grunwald I, Lunger L, Straub M. Stone extraction during flexible ureterorenoscopy with or without the hydrogel method: a randomized, multicenter safety and feasibility study. World J Urol. 2025 Oct 31;43(1):655. doi: 10.1007\/s00345-025-06011-7 PMID: 41171315 <\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; module_alignment=&#8221;left&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-leistungsfaehigkeit\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/drks.de\/search\/de\/trial\/DRKS00030532\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->    jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->        \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->        if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->            \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->            $(\".aufklapptext-leistungsfaehigkeit\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->            $(\"#btn-leistungsfaehigkeit\").click(function () {<!-- [et_pb_line_break_holder] -->                var $this = $(this);<!-- [et_pb_line_break_holder] -->                var $aufklapptextRemaining = $(\".aufklapptext-leistungsfaehigkeit\");<!-- [et_pb_line_break_holder] -->                var $aufklapptextEinleitung = $(\".aufklapptext-preview-leistungsfaehigkeit\");<!-- [et_pb_line_break_holder] -->                var $rowLeistungsfaehigkeit = $(\".row-leistungsfaehigkeit\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->                $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->                $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                \/\/ Toggle the active class on .row-leistungsfaehigkeit<!-- [et_pb_line_break_holder] -->                $rowLeistungsfaehigkeit.toggleClass('row-leistungsfaehigkeit-active');<!-- [et_pb_line_break_holder] -->            });<!-- [et_pb_line_break_holder] -->        }<!-- [et_pb_line_break_holder] -->    });<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row module_class=&#8221;row-leistungsfaehigkeit&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-leistungsfaehigkeit&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Purpose<\/strong><br \/>Achieving the highest possible stone-free rate is the primary goal of kidney stone surgery, yet standard flexible ureterorenoscopy often leaves small residual fragments that predispose to recurrence. The hydrogel method using mediNiK\u00ae\u00a0was developed to embed and extract even the smallest fragments with conventional baskets. This study aimed to evaluate the safety and feasibility-defined as the ability to extract fragments < 1 mm-of stone extraction during flexible ureterorenoscopy with or without the hydrogel method.<\/p>\n<p><strong>Materials and methods<\/strong><br \/>This prospective, randomized, multicenter proof-of-concept trial included patients > 18 years with kidney stones > 8 mm and no anatomical abnormalities. Patients were randomized to flexible ureterorenoscopy + hydrogel (Group 1) or flexible ureterorenoscopy (Group 2) alone. After laser lithotripsy, fragments were retrieved either embedded in hydrogel or individually, and categorized by size (< 0.5 mm, 0.5-1.0 mm, > 1.0 mm). Explorative statistical analyses included Mann-Whitney U, Student&#8217;s t-test, and Chi-square test. Adverse events were monitored intraoperatively and during a 6-week follow-up.<\/p>\n<p><strong>Results\u00a0<\/strong><br \/>Of 65 screened patients, 40 were analysed (Group 1: n = 23; Group 2: n = 17). The hydrogel method significantly retrieved more fragments < 1 mm (1716 vs. 209) and > 1 mm (310 vs. 118). On a per-patient level, more < 1 mm fragments were removed in Group 1 (median 7 [IQR 21] vs. 0 [2], p < 0.003). Surgery duration was longer in Group 1 (80 [28] vs. 62 [20] minutes, p = 0.02). No serious adverse events were reported.<\/p>\n<p><strong>Conclusions<\/strong><br \/>The hydrogel method was a safe and feasible addition to fURS, allowing improved retrieval of even the smallest fragments without added risk. The main limitations are the small sample size and absence of long-term stone-free and recurrence data, underscoring the need for larger confirmatory studies.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; module_class=&#8221;row-steinstaub&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Novel Biocompatible Adhesive to Remove Stone Dust: <br \/>Usability Trial in a Kidney Model<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-steinstaub&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Hausmann T, Becker B, Gross AJ, Netsch C, Rosenbaum CM. Novel Biocompatible Adhesive to Remove Stone Dust: Usability Trial in a Kidney Model. J Endourol. 2021 Aug;35(8):1223-1228. doi: 10.1089\/end.2020.0748. Epub 2021 Apr 15. PMID: 33559523.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-steinstaub\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/www.liebertpub.com\/doi\/10.1089\/end.2020.0748\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-steinstaub\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-steinstaub\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-steinstaub\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-steinstaub\");<!-- [et_pb_line_break_holder] -->            var $rowsteinstaub = $(\".row-steinstaub\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-steinstaub<!-- [et_pb_line_break_holder] -->            $rowsteinstaub.toggleClass('row-steinstaub-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row module_class=&#8221;row-steinstaub&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-steinstaub&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Introduction and Objective<br \/><\/strong>\u201cClinically insignificant residual fragments\u201d are an independent predictive factor for recurrence of nephrolithiasis. To improve the stone-free rates (SFR), we tested the viability of a novel bioadhesive system for intrarenal embedding and retrieval of residual fragments &lt;1\u2009mm in a kidney model.<\/p>\n<p><strong>Materials and Methods<br \/><\/strong>All procedures were performed in a standardized setting, including a kidney model (Kidney module right, Samed GmbH, Dresden) in a plastic basin filled with water. We used a Viper URF flexible ureterorenoscope (fURS) (6.6\/8F, Richard Wolf, Knittlingen). A mean amount of 138\u2009mg (standard deviation [SD] \u00b132.2\u2009mg) of sand grains (range, 0.2\u20130.8\u2009mm) was inserted in renal calices of the kidney model. We assessed the extraction efficacy of fURS using the bioadhesive system. In total, eight different surgeons performed each one trial, respectively. The endoscopic and macroscopic SFR, the level of the surgeons&#8217; experience, and the overall time of stone retrieval were evaluated. Additionally, a survey of the participants was conducted, to assess the contentment with this novel system.<\/p>\n<p><strong>Results<br \/><\/strong>The extraction of the sand grains was only possible using the bioadhesive system, otherwise they were too small sized to grab with a retrieval basket. The total SFR was 84% (SD \u00b111.7%). The operation time (p\u2009=\u20090.052) and the percentage of extracted sand grains (p\u2009=\u20090.194) were not significantly different between experienced and less experienced surgeons. All participants stated that it was a promising technique, which they could imagine using on a daily basis.<\/p>\n<p><strong>Conclusions<br \/><\/strong>The bioadhesive system improves the SFR with fragments from 0.2 to 0.8\u2009mm (0% vs 84%). Also, the performance of this operation is not dependent on the surgeon&#8217;s experience level. This method might improve the SFR in difficult anatomic conditions, that is, lower calices or anomalous kidneys.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; module_class=&#8221;row-testdiar&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Viability and biocompatibility of an adhesive system for intrarenal embedding and endoscopic removal of small residual fragments in minimally-invasive stone treatment in an in vivo pig model<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-testdiar&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Hein S, Schoeb DS, Grunwald I, Richter K, Haberstroh J, Seidl M, Bronsert P, Wetterauer U, Schoenthaler M, Miernik A. Viability and biocompatibility of an adhesive system for intrarenal embedding and endoscopic removal of small residual fragments in minimally-invasive stone treatment in an in vivo pig model. World J Urol. 2018 Apr;36(4):673-680. doi: 10.1007\/s00345-018-2188-8. Epub 2018 Jan 24. PMID: 29368229.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-testdiar\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/link.springer.com\/article\/10.1007\/s00345-018-2188-8\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-testdiar\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-testdiar\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-testdiar\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-testdiar\");<!-- [et_pb_line_break_holder] -->            var $rowtestdiar = $(\".row-testdiar\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-testdiar<!-- [et_pb_line_break_holder] -->            $rowtestdiar.toggleClass('row-testdiar-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row module_class=&#8221;row-testdiar&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-testdiar&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Purpose<\/strong><br \/>To evaluate the viability and biocompatibility of a novel, patented bioadhesive system for intrarenal embedding and retrieval of residual fragments after endoscopic lithotripsy. Complete stone clearance via active removal of residual fragments (RF) after intracorporeal laser lithotripsy may be time-consuming and fail in many cases. Therefore, the novel adhesive has been developed and evaluated for the first time in an in vivo pig model in the present work.<\/p>\n<p><strong>Methods<\/strong><br \/>Four female domestic pigs underwent flexible ureteroscopy (RIRS) or percutaneous nephrolithotomy (PNL) under general anesthesia (8 kidneys, 4 \u00d7 RIRS, 4 \u00d7 PNL) evaluating the bioadhesive system. Interventions: RIRS without adhesive system (sham procedure, kidney I); 3 \u00d7 RIRS using the bioadhesive system (kidneys II\u2013IV); and 4 \u00d7 PNL using the bioadhesive system (V\u2013VIII). We endoscopically inserted standardized human stone probes followed by comminution using Ho:YAG lithotripsy. The bioadhesive (kidney II\u2013VIII) was then applied and the adhesive-stone fragment complex extracted. After nephrectomy, all kidneys were evaluated by two independent, blinded pathologists. Endpoints were the procedure\u2019s safety and adhesive system\u2019s biocompatibility.<\/p>\n<p><strong>Results<\/strong><br \/>We observed no substantial toxic effects. We were able to embed and remove 80\u201390% of fragments. However, because of the pig\u2019s hampering pyelocaliceal anatomy, a quantified, proportional assessment of the embedded fragments was compromised.<\/p>\n<p><strong>Conclusions<\/strong><br \/>For the first time, we demonstrated the proven feasibility and safety of this novel bioadhesive system for embedding and endoscopically removing small RF in conjunction with a lack of organ toxicity in vivo.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; module_class=&#8221;row-lithotomy&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>New for Old\u2013Coagulum Lithotomy vs a Novel Bioadhesive for Complete Removal of Stone Fragments in a Comparative Study in an Ex Vivo Porcine Model<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-testdiar&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Schoeb DS, Schoenthaler M, Schlager D, Petzold R, Richter K, Grunwald I, Wetterauer U, Miernik A, Hein S. New for Old-Coagulum Lithotomy vs a Novel Bioadhesive for Complete Removal of Stone Fragments in a Comparative Study in an Ex Vivo Porcine Model. J Endourol. 2017 Jun;31(6):611-616. doi: 10.1089\/end.2017.0125. Epub 2017 May 8. PMID: 28385037.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-lithotomy\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/www.liebertpub.com\/doi\/10.1089\/end.2017.0125\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-lithotomy\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-lithotomy\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-lithotomy\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-lithotomy\");<!-- [et_pb_line_break_holder] -->            var $rowlithotomy = $(\".row-lithotomy\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-lithotomy<!-- [et_pb_line_break_holder] -->            $rowlithotomy.toggleClass('row-lithotomy-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row module_class=&#8221;row-lithotomy&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-lithotomy&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Objectives<br \/><\/strong>To evaluate a recently reported new bioadhesive system for the retrieval of small residual fragments (RFs) after intracorporeal lithotripsy, we systematically compared this system with coagulum lithotomy in retrograde intrarenal surgery.<\/p>\n<p><strong>Materials and Methods<br \/><\/strong>We extracted 30 human stone fragments (\u22641\u2009mm) in an ex vivo porcine kidney model using a flexible ureteroscope for three groups: (1) the novel bioadhesive, (2) autologous blood as a natural adhesive, and (3) (control group) a conventional retrieval basket. Each group consisted of 15 test runs. Outcomes were evaluated regarding the macroscopic stone-free rate (SFR), retrieval time, and number of ureteral passages.<\/p>\n<p><strong>Results<br \/><\/strong>For groups 1 and 2, a significant advantage in stone clearance, mean retrieval time, and number of retrievals was detected compared to the control group (p\u2009=\u20090.001). The time and number of retrievals were significantly lower in group 1 (10:36 minutes, p\u2009=\u20090.001) than in group 2 (26:12 minutes, p\u2009=\u20090.001), with shorter clotting time and better visibility.<\/p>\n<p><strong>Conclusions<br \/><\/strong>These data show the general feasibility of intrarenal RF embedding to improve the SFR. Our data furthermore suggest the superiority of the artificial bioadhesive embedding agent over the application of native blood. Further in vivo studies and other research are necessary to confirm the adhesive&#8217;s effect in patients.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; module_class=&#8221;row-biocompatible&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Novel Biocompatible Adhesive for Intrarenal Embedding and Endoscopic Removal of Small Residual Fragments after Minimally Invasive Stone Treatment in an Ex Vivo Porcine Kidney Model: Initial Evaluation of a Prototype<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-biocompatible&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Hein S, Schoenthaler M, Wilhelm K, Schlager D, Thiel K, Brandmann M, Richter K, Grunwald I, Wetterauer U, Miernik A. Novel Biocompatible Adhesive for Intrarenal Embedding and Endoscopic Removal of Small Residual Fragments after Minimally Invasive Stone Treatment in an Ex Vivo Porcine Kidney Model: Initial Evaluation of a Prototype. J Urol. 2016 Dec;196(6):1772-1777. doi: 10.1016\/j.juro.2016.05.094. Epub 2016 May 30. PMID: 27256206.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-biocompatible\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/www.auajournals.org\/doi\/10.1016\/j.juro.2016.05.094\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-biocompatible\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-biocompatible\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-biocompatible\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-biocompatible\");<!-- [et_pb_line_break_holder] -->            var $rowbiocompatible = $(\".row-biocompatible\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-biocompatible<!-- [et_pb_line_break_holder] -->            $rowbiocompatible.toggleClass('row-biocompatible-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row module_class=&#8221;row-biocompatible&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-biocompatible&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Purpose<\/strong><br \/>Residual fragments related to endoscopic intracorporeal lithotripsy are a challenging problem. The impact of residual fragments remains a subject of discussion and growing evidence highlights that they have a central role in recurrent stone formation. Therefore, we developed a novel bioadhesive system for intrarenal embedding and retrieval of residual fragments after endoscopic lithotripsy in an ex vivo porcine kidney model.<\/p>\n<p><strong>Materials and Methods<\/strong><br \/>In a standardized setting 30 human stone fragments 1 mm or less were inserted in the lower pole of an ex vivo porcine kidney model. We assessed the extraction efficacy of flexible ureteroscopy using the bioadhesive system in 15 preparations and a conventional retrieval basket in 15. Outcomes were compared regarding the endoscopic and macroscopic stone-free rate, and overall time of retrieval.<\/p>\n<p><strong>Results<\/strong><br \/>Embedding and retrieving the residual fragment-bioadhesive complex were feasible in all trial runs. We observed no adverse effects such as adhesions between the adhesive and the renal collecting system or the instruments used. The stone-free rate was 100% and 60% in the bioadhesive and conventional retrieval groups, respectively (p = 0.017). Mean retrieval time was significantly shorter at 10 minutes 33 seconds vs 36 minutes 56 seconds in the bioadhesive group vs the conventional group (p = 0.001).<\/p>\n<p><strong>Conclusions<\/strong><br \/>This novel method involving adhesive based complete removal of residual fragments from the collecting system has proved to be feasible. Our evaluation in a porcine kidney model revealed that this technology performed well. Further tests, including inpatient studies, are required to thoroughly evaluate the benefit and potential drawbacks of bioadhesive based extraction of residual fragments after intracorporeal lithotripsy.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; header_3_font=&#8221;|||on|||||&#8221; header_3_letter_spacing=&#8221;1.6px&#8221; custom_padding=&#8221;35px||||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h3 style=\"text-align: left;\"><span 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(\/figma)--&gt;\" style=\"font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration: none; caret-color: #000000; color: #000000;\"><\/span><span>About medical need<\/span><\/h3>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; admin_label=&#8221;Zeile&#8221; module_class=&#8221;row-stone-event-free&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Stone-event-free survival after retrograde intrarenal surgery: is the stone-free-status so relevant for the future outcomes?<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-endoscopically&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Mesquita S, Mendes G, Marques-Monteiro M, Rocha MA, Madanelo M, Fraga A, Cavadas V. Stone-event-free survival after retrograde intrarenal surgery: is the stone-free-status so relevant for the future outcomes? Int Urol Nephrol. 2025 May;57(5):1473-1480. doi: 10.1007\/s11255-024-04343-8. Epub 2024 Dec 28. PMID: 39731646 <\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-stone-event-free\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/www.liebertpub.com\/doi\/10.1089\/end.2016.0101\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-stone-event-free\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-stone-event-free\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-stone-event-free\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-stone-event-free\");<!-- [et_pb_line_break_holder] -->            var $rowendoscopically = $(\".row-stone-event-free\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-endoscopically<!-- [et_pb_line_break_holder] -->            $rowendoscopically.toggleClass('row-endoscopically-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=&#8221;Zeile&#8221; module_class=&#8221;row-stone-event-free&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-stone-event-free&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Introduction<\/strong><br \/>The primary aim of stone treatment is to achieve stone-free status. Residual fragments can cause stone growth, recurrence, urinary tract infections, and ureteric obstruction. Our goal was to describe the natural history of stone burden after retrograde intrarenal surgery (RIRS) based on stone-free status (SFS), evaluating stone growth and stone-events.<\/p>\n<p><strong>Methods<\/strong><br \/>We retrospectively reviewed data from patients who underwent RIRS at a tertiary care center between October 2014 and September 2019. The stone burden was assessed by measuring the maximum diameter (mm) and volume (mm3). Patients were divided into four groups according to SFS-(A) absolute stone-free, no stones on non-contrast-enhanced computed tomography (NCCT); (B) relative stone-free with \u2264 2 mm fragments, (C) relative stone-free with 2.1-4 mm fragments, and (D) residual fragments > 4 mm. Our main outcomes were stone growth over time (defined as an increase in diameter compared to first postoperative measurement) and incidence of stone-related events (pain or additional intervention to treat symptoms, obstruction, or removing fragments).<\/p>\n<p><strong>Results<\/strong><br \/>A total of 98 patients were included in the study-42 were classified as absolute stone-free (Group A), 20 were categorized as relatively stone-free (Groups B and C), and 36 had a residual stone burden with fragments larger than 4 mm (Group D) on postoperative NCCT. There was a significant difference in the number of stones among the groups (p < 0.001). The pre-operative stone volume differed significantly among the groups (p = 0.003). Group A had the lowest median total stone volume (551.3 mm3). Twenty patients (20.4%) developed stone-events during a mean follow-up period of 62.3 months (\u00b1 26.0). Stone-event-free survival differed significantly between the groups (p = 0.028), with Group D demonstrating a higher incidence of stone-related events post-RIRS compared to the other groups. Sixteen patients (16.3%) had renal colic requiring a hospital visit across all groups. Thirteen patients (13.3%) required re-intervention (3 patients belonged to Group A, 1 to Group B, 2 to Group C, and 7 to Group D).<\/p>\n<p><strong>Conclusions<\/strong><br \/>Group D shows a higher rate of stone-related events post-RIRS. Ensuring complete stone-free status after RIRS is crucial for treatment success. Other factors should be considered in the management, including ensuring compliance with general preventive measures and stone-specific pharmacological treatments to prevent recurrence.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; admin_label=&#8221;Zeile&#8221; module_class=&#8221;row-kidney&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Kidney stones and the risk of renal cell carcinoma and upper tract urothelial carcinoma: the Netherlands Cohort Study<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-endoscopically&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>van de Pol JAA, van den Brandt PA, Schouten LJ. Kidney stones and the risk of renal cell carcinoma and upper tract urothelial carcinoma: the Netherlands Cohort Study. Br J Cancer. 2019 Feb;120(3):368-374. doi: 10.1038\/s41416-018-0356-7. Epub 2018 Dec 19. PMID: 30563989<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-kidney\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/www.nature.com\/articles\/s41416-018-0356-7\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-kidney\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-kidney\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-kidney\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-kidney\");<!-- [et_pb_line_break_holder] -->            var $rowendoscopically = $(\".row-kidney\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-endoscopically<!-- [et_pb_line_break_holder] -->            $rowendoscopically.toggleClass('row-endoscopically-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=&#8221;Zeile&#8221; module_class=&#8221;row-kidney&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-kidney&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Abstract:<\/h4>\n<p><strong>Background<\/strong><br \/>We examined the association between kidney stones and renal cell carcinoma (RCC) and upper tract urothelial carcinoma (UTUC) risk in the Netherlands Cohort Study on diet and cancer.<\/p>\n<p><strong>Methods<\/strong><br \/>In total, 120,852 participants aged 55-69 completed a self-administered questionnaire on diet, medical conditions and other risk factors for cancer at baseline (1986). After 20.3 years of cancer follow-up 4352 subcohort members, 544 RCC cases and 140 UTUC cases were eligible for case-cohort analysis. Hazard ratios (HR) and 95% confidence intervals (CIs) were estimated by multivariable-adjusted proportional hazards models.<\/p>\n<p><strong>Results<\/strong><br \/>Kidney stones were associated with an increased RCC risk (HR: 1.39, 95% CI 1.05-1.84), vs. no kidney stones. Kidney stones were associated with an increased risk of papillary RCC (HR: 3.08, 95% CI 1.55-6.11), but not clear-cell RCC (HR: 1.14, 95% CI 0.79-1.65). UTUC risk was increased for participants with kidney stones (HR: 1.66, 95% CI 1.03-2.68). No heterogeneity of associations was found for UTUC in the ureter and renal pelvis. An early kidney stone diagnosis (\u226440 years) was associated with an increased RCC and UTUC risk, compared to later diagnosis.<\/p>\n<p><strong>Conclusion<\/strong><br \/>Kidney stones were associated with increased papillary RCC risk, but not clear-cell RCC risk. No heterogeneity was found for UTUC subtypes.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; admin_label=&#8221;Zeile&#8221; module_class=&#8221;row-endoscopically&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Endoscopically Determined Stone Clearance Predicts Disease Recurrence Within 5 Years After Retrograde Intrarenal Surgery<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-endoscopically&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Hein S, Miernik A, Wilhelm K, Schlager D, Schoeb DS, Adams F, Vach W, Schoenthaler M. Endoscopically Determined Stone Clearance Predicts Disease Recurrence Within 5 Years After Retrograde Intrarenal Surgery. J Endourol. 2016 Jun;30(6):644-9. doi: 10.1089\/end.2016.0101. Epub 2016 Apr 22. PMID: 27021947.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-endoscopically\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/www.liebertpub.com\/doi\/10.1089\/end.2016.0101\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-endoscopically\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-endoscopically\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-endoscopically\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-endoscopically\");<!-- [et_pb_line_break_holder] -->            var $rowendoscopically = $(\".row-endoscopically\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-endoscopically<!-- [et_pb_line_break_holder] -->            $rowendoscopically.toggleClass('row-endoscopically-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=&#8221;Zeile&#8221; module_class=&#8221;row-endoscopically&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-endoscopically&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Objective<\/strong><br \/>To assess stone-related events (SREs) requiring retreatment in a series of 100 consecutive patients treated by retrograde intrarenal surgery (RIRS) for renal stones and to evaluate potential risk factors thereof.<\/p>\n<p><strong>Patients and Methods<\/strong><br \/>The primary outcome was incidence of SRE (medical or surgical treatment). Secondary outcomes included side of SRE, time to SRE, and late complications. Analysis of potential risk factors included high-risk stone formers (HRSFs), obesity, high stone burden, and lower pole stones. In addition, we evaluated endoscopically determined small residual fragments (SRF) of &lt;1\u2009mm (i.e., fragments too small for retrieval) as an independent risk factor.<\/p>\n<p><strong>Results<\/strong><br \/>Eighty-five of the 99 patients were followed up for a mean of 59 months (31\u201369), among whom 26 (30.1%) had SRE. Thirty-four of the 85 (40%) patients were HRSFs, 22 of whom experienced SRE (both sides) during follow-up (64.7%, p\u2009&lt;\u20090.001). Eight of the 17 patients (47.1%) with SRF experienced ipsilateral side SRE compared with 13 (19.1%) of the 68 without SRF (p\u2009=\u20090.022, hazard ratio 2.823, 95% confidence interval [95% CI] 1.16, 6.85). Risk for ipsilateral SRE was unaffected by the presence of SRF among HRSFs (p\u2009=\u20090.561). Of low-risk patients with SRF, 33.3% experienced ipsilateral SRE, while those without SRF experienced no ipsilateral SRE (p\u2009&lt;\u20090.001).<\/p>\n<p><strong>Conclusion<\/strong><br \/>Endoscopically determined stone clearance predicts disease recurrence within 5 years after RIRS. Even SRF are an important risk factor for future stone-related (ipsilateral) events; therefore, patients with residual fragments of any size should not be labeled \u201cstone free\u201d and endoscopic stone treatment should aim at complete stone clearance.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; admin_label=&#8221;Zeile&#8221; module_class=&#8221;row-naturalhistory&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Natural History of Post-Treatment Kidney Stone Fragments: A Systematic Review and Meta-Analysis<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-naturalhistory&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Brain E, Geraghty RM, Lovegrove CE, Yang B, Somani BK. Natural History of Post-Treatment Kidney Stone Fragments: A Systematic Review and Meta-Analysis. J Urol. 2021 Sep;206(3):526-538. doi: 10.1097\/JU.0000000000001836. Epub 2021 Apr 27. PMID: 33904756.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-naturalhistory\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/www.auajournals.org\/doi\/10.1097\/JU.0000000000001836\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-naturalhistory\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-naturalhistory\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-naturalhistory\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-naturalhistory\");<!-- [et_pb_line_break_holder] -->            var $rownaturalhistory = $(\".row-naturalhistory\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-naturalhistory<!-- [et_pb_line_break_holder] -->            $rownaturalhistory.toggleClass('row-naturalhistory-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row module_class=&#8221;row-naturalhistory&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-naturalhistory&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Purpose<\/strong><br \/>We assessed the literature around post-treatment asymptomatic residual stone fragments and performed a meta-analysis. The main outcomes were intervention rate and disease progression.<\/p>\n<p><strong>Materials and Methods<\/strong><br \/>We searched Ovid\u00ae, MEDLINE\u00ae, Embase\u2122, the Cochrane Library and ClinicalTrials.gov using search terms: \u201casymptomatic\u201d, \u201cnephrolithiasis\u201d, \u201cESWL\u201d, \u201cPCNL\u201d, \u201cURS\u201d and \u201cintervention.\u201d Inclusion criteria were all studies with residual renal fragments following treatment (shock wave lithotripsy, ureteroscopy or percutaneous nephrolithotomy). Analysis was performed using \u2018metafor\u2019 in R and bias determined using Newcastle\u2013Ottawa scale.<\/p>\n<p><strong>Results<\/strong><br \/>From 273 articles, 18 papers (2,096 patients) had details of intervention rate for residual fragments. Aggregate intervention rates for \u22644 mm fragments rose from 19% (20 months) to 22% (50 months), while &gt;4 mm fragments rose from 22% to 47%. Aggregate disease progression rates for \u22644 mm rose from 25% to 47% and &gt;4 mm rose from 26% to 88%. However, there was substantial difference in definition of \u201cdisease progression.\u201d Meta-analysis comparing &gt;4 mm against \u22644 mm fragments: intervention rate for &gt;4 mm (vs \u22644 mm): OR=1.50 (95% CI 0.70\u20132.30), p &lt;0.001, I2=67.6%, tau2=0.48, Cochran&#8217;s Q=11.4 (p=0.02) and Egger&#8217;s regression: z=3.11, p=0.002. Disease progression rate for &gt;4 mm: OR=0.06 (95% CI \u22120.98\u20131.10), p=0.91, I2=53.0%, tau2=0.57, Cochran&#8217;s Q=7.11 (p=0.07) and Egger&#8217;s regression: z=\u22120.75, p=0.45. Bias analysis demonstrated a moderate risk.<\/p>\n<p><strong>Conclusions<\/strong><br \/>Larger post-treatment residual fragments are significantly more likely to require further intervention especially in the long term. Smaller fragments, although less likely to require further intervention, still carry that risk. Notably, there is no significant difference in disease progression between fragment sizes. Patients with residual fragments should be appropriately counselled and informed decision-making regarding further management should be done.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; module_class=&#8221;row-clearance&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Clearance rates of residual stone fragments and dusts after endoscopic lithotripsy procedures using a holmium laser: 2-year follow-up results<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-clearance&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Kang M, Son H, Jeong H, Cho MC, Cho SY. Clearance rates of residual stone fragments and dusts after endoscopic lithotripsy procedures using a holmium laser: 2-year follow-up results. World J Urol. 2016 Nov;34(11):1591-1597. doi: 10.1007\/s00345-016-1807-5. Epub 2016 Mar 21. PMID: 27000560.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-clearance\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/link.springer.com\/article\/10.1007\/s00345-016-1807-5\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-clearance\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-clearance\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-clearance\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-clearance\");<!-- [et_pb_line_break_holder] -->            var $rowclearance = $(\".row-clearance\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-clearance<!-- [et_pb_line_break_holder] -->            $rowclearance.toggleClass('row-clearance-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row module_class=&#8221;row-clearance&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-clearance&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Purpose<\/strong><br \/>To investigate the spontaneous clearance rates of remnant particles following miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS).<\/p>\n<p><strong>Methods<\/strong><br \/>Among 624 patients who underwent mini-PCNL or RIRS at our institution from 2011 to 2015, we collected data of 247 patients with 2 years of follow-up. Of these, we included 148 patients with unilateral renal stones between 10 and 30 mm, as well as remnant particles after surgery. The size criteria of dusts and residual fragments (RFs) were, respectively, &lt;1 and &lt;3 mm.<\/p>\n<p><strong>Results<\/strong><br \/>After excluding 22 patients, 126 patients (RFs = 21, dusts = 98, and both RFs and dusts = 7) were analyzed. Mean age was 56.5 (\u00b114.4) years, and mean stone size was 19.5 (\u00b112.5) mm. The mean follow-up period was 18.5 (\u00b1 12.9) months. In patients whose remnant particles were naturally eliminated following lithotripsy, the mean stone passage time was 9.0 (\u00b19.3) months in the dusts and 13.9 (\u00b111.1) months in the RFs groups (P = 0.135). Remnant particles disappeared in 42 out of 105 patients (40.0 %) in dusts and 7 out of 28 patients (25.0 %) in RFs groups (P = 0.187). The size of dusts and RFs increased, respectively, in 18.1 % (19\/105) and 28.6 % (8\/28) of patients with remnant particles during the follow-up period.<\/p>\n<p><strong>Conclusions<\/strong><br \/>The presence of dusts and RFs was poor prognostic factors in patients underwent renal stone surgery using a holmium laser. Complete residual stone removal by using a basket or dusts eradication by irrigation for an adequate time during surgery can be a good surgical strategy.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; module_class=&#8221;row-removal&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Removal of Small, Asymptomatic Kidney Stones and Incidence of Relapse<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-removal&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Sorensen MD, Harper JD, Borofsky MS, Hameed TA, Smoot KJ, Burke BH, Levchak BJ, Williams JC Jr, Bailey MR, Liu Z, Lingeman JE. Removal of Small, Asymptomatic Kidney Stones and Incidence of Relapse. N Engl J Med. 2022 Aug 11;387(6):506-513. doi: 10.1056\/NEJMoa2204253. PMID: 35947709; PMCID: PMC9741871.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-removal\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/www.nejm.org\/doi\/10.1056\/NEJMoa2204253\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-removal\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-removal\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-removal\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-removal\");<!-- [et_pb_line_break_holder] -->            var $rowremoval = $(\".row-removal\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-removal<!-- [et_pb_line_break_holder] -->            $rowremoval.toggleClass('row-removal-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row module_class=&#8221;row-removal&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-removal&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Background<\/strong><br \/>The benefits of removing small (\u22646 mm), asymptomatic kidney stones endoscopically is unknown. Current guidelines leave such decisions to the urologist and the patient. A prospective study involving older, nonendoscopic technology and some retrospective studies favor observation. However, published data indicate that about half of small renal stones left in place at the time that larger stones were removed caused other symptomatic events within 5 years after surgery.<\/p>\n<p><strong>Methods<\/strong><br \/>We conducted a multicenter, randomized, controlled trial in which, during the endoscopic removal of ureteral or contralateral kidney stones, remaining small, asymptomatic stones were removed in 38 patients (treatment group) and were not removed in 35 patients (control group). The primary outcome was relapse as measured by future emergency department visits, surgeries, or growth of secondary stones.<\/p>\n<p><strong>Results<\/strong><br \/>After a mean follow-up of 4.2 years, the treatment group had a longer time to relapse than the control group (P&lt;0.001 by log-rank test). The restricted mean (\u00b1SE) time to relapse was 75% longer in the treatment group than in the control group (1631.6\u00b172.8 days vs. 934.2\u00b1121.8 days). The risk of relapse was 82% lower in the treatment group than the control group (hazard ratio, 0.18; 95% confidence interval, 0.07 to 0.44), with 16% of patients in the treatment group having a relapse as compared with 63% of those in the control group. Treatment added a median of 25.6 minutes (interquartile range, 18.5 to 35.2) to the surgery time. Five patients in the treatment group and four in the control group had emergency department visits within 2 weeks after surgery. Eight patients in the treatment group and 10 in the control group reported passing kidney stones.<\/p>\n<p><strong>Conclusions<\/strong><br \/>The removal of small, asymptomatic kidney stones during surgery to remove ureteral or contralateral kidney stones resulted in a lower incidence of relapse than nonremoval and in a similar number of emergency department visits related to the surgery. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the Veterans Affairs Puget Sound Health Care System; ClinicalTrials.gov number, NCT02210650.)<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;3_4,1_4&#8243; module_class=&#8221;row-predictive&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=&#8221;none&#8221; max_width=&#8221;1120px&#8221; module_alignment=&#8221;center&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#309F52&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_text content_tablet=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_phone=&#8221;<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>&#8221; content_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_font_size=&#8221;24px&#8221; link_font=&#8221;|600||on|||||&#8221; link_text_color=&#8221;#4a5965&#8243; custom_margin=&#8221;|0px|0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_font_size_phone=&#8221;16px&#8221; text_font_size_last_edited=&#8221;off|phone&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; header_4_font_size_tablet=&#8221;24px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; header_4_line_height_tablet=&#8221;&#8221; header_4_line_height_phone=&#8221;&#8221; header_4_line_height_last_edited=&#8221;on|tablet&#8221; custom_css_main_element=&#8221;h4{||  hyphens: auto;||}&#8221; border_color_top=&#8221;#253746&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>The Predictive Factors for Readmission and Rehospitalization After Retrograde Intrarenal Surgery: The Results of RIRSearch Study Group<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=&#8221;aufklapptext-preview-predictive&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; custom_margin=&#8221;||||false|false&#8221; border_color_top=&#8221;#A6ADB3&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Dogan C, Yazici CM, Akgul HM, Ozman O, Basatac C, Cinar O, Siddikoglu D, Cakir H, Elmaagac B, Sancak EB, Onal B, Akpinar H. The Predictive Factors for Readmission and Rehospitalization After Retrograde Intrarenal Surgery: The Results of RIRSearch Study Group. J Endourol. 2022 Jan;36(1):56-64. doi: 10.1089\/end.2021.0327. Epub 2021 Dec 9. PMID: 34235975.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221; custom_css_main_element_last_edited=&#8221;off|tablet&#8221; custom_css_main_element_tablet=&#8221;width: 44% !important;&#8221; custom_css_main_element_phone=&#8221;width: 100% !important;||margin-bottom: 0px !important;&#8221;][et_pb_code admin_label=&#8221;Code&#8221; _builder_version=&#8221;4.27.5&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;|0px||0px|false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;|||0px|false|false&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"publikation-button-box\"><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div id=\"btn-predictive\" class=\"btn-accordion-open\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/arrow-right-sharp-light.svg\" alt=\"Pfeil\"><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] -->  <\/p>\n<div class=\"btn-accordion-extern-link\"> <!-- Das leere id wurde entfernt --><!-- [et_pb_line_break_holder] -->    <a target=\"_blank\" href=\"https:\/\/www.liebertpub.com\/doi\/10.1089\/end.2021.0327\" rel=\"noopener\"><!-- [et_pb_line_break_holder] -->      <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/09\/icon-extern-link.svg\" alt=\"\"><!-- [et_pb_line_break_holder] -->    <\/a><!-- [et_pb_line_break_holder] -->  <\/div>\n<p><!-- [et_pb_line_break_holder] -->  <!-- [et_pb_line_break_holder] --><\/div>\n<p><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!--    \/\/ Accordion - Mehr anzeigen text--><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] -->jQuery(document).ready(function ($) {<!-- [et_pb_line_break_holder] -->    \/\/ Check if we are in the Visual Builder<!-- [et_pb_line_break_holder] -->    if (!$('body').hasClass('et-fb')) {<!-- [et_pb_line_break_holder] -->        \/\/ Initial hiding of the text in the frontend<!-- [et_pb_line_break_holder] -->        $(\".aufklapptext-predictive\").css(\"display\", \"none\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Click event handler for the icon within the button<!-- [et_pb_line_break_holder] -->        $(\"#btn-predictive\").click(function () {<!-- [et_pb_line_break_holder] -->            var $this = $(this);<!-- [et_pb_line_break_holder] -->            var $aufklapptextRemaining = $(\".aufklapptext-predictive\");<!-- [et_pb_line_break_holder] -->            var $aufklapptextEinleitung = $(\".aufklapptext-preview-predictive\");<!-- [et_pb_line_break_holder] -->            var $rowpredictive = $(\".row-predictive\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the text display<!-- [et_pb_line_break_holder] -->            $aufklapptextRemaining.slideToggle(300);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the icon rotation<!-- [et_pb_line_break_holder] -->            $this.toggleClass('btn-accordion-open-rotated');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            \/\/ Toggle the active class on .row-predictive<!-- [et_pb_line_break_holder] -->            $rowpredictive.toggleClass('row-predictive-active');<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->    }<!-- [et_pb_line_break_holder] -->});<!-- [et_pb_line_break_holder] --><\/script>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row module_class=&#8221;row-predictive&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;1120px&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;aufklapptext-predictive&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;3a211a91-220a-4ac6-9b17-f218862bdc1f&#8221; text_line_height=&#8221;1.5em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; text_line_height_last_edited=&#8221;off|desktop&#8221; custom_css_main_element=&#8221;#text-display-fade {||  position: relative;||  background: linear-gradient(to bottom, rgba(0, 0, 0, 1) 0%, rgba(0, 0, 0, 0.5) 50%, rgba(0, 0, 0, 0) 100%);||  -webkit-background-clip: text;||  -webkit-text-fill-color: transparent;||}||&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#bfbfbf&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h4>Brief summary of results:<\/h4>\n<p><strong>Purpose<\/strong><br \/>Retrograde intrarenal surgery (RIRS) is a safe and effective treatment option for upper urinary tract stones smaller than 2\u2009cm. Although several studies have documented perioperative and postoperative complications related to RIRS, there exists limited data regarding the readmission and rehospitalization of patients after RIRS. The aims of the study were to document the rates of readmission and rehospitalization after RIRS and to determine the predictive factors for readmission and rehospitalization.<\/p>\n<p><strong>Materials and Methods<\/strong><br \/>In this study, we retrospectively analyzed patients who underwent RIRS for the treatment of renal stone disease and were unexpectedly readmitted to the hospital within 30 days after discharge. The hospital admission systems were used to determine readmissions and rehospitalizations. Readmission and rehospitalization rates, causes, and treatment procedures were evaluated. Univariate and multivariate analyses of clinicodemographic properties were performed to evaluate possible predictive factors for readmission and rehospitalization after RIRS.<\/p>\n<p><strong>Results<\/strong><br \/>A total of 1036 patients were included in the study. Of these patients, 103 (9.9%) were readmitted to the hospital. Among these readmissions, 35 patients (33.9%) were rehospitalized and 14 (13.6%) underwent surgical intervention. The most common reasons for readmission were renal colic and fever. The presence of preoperative pyuria (odds ratio [OR] 1.86), stone volume (OR 1.54), postoperative complications (OR 3.66), and stone-free status (OR 0.46) were predictive factors for readmission, whereas hospitalization time (OR 1.32), postoperative complications (OR 9.70), and stone-free status (OR 0.06) were predictive factors for rehospitalization after RIRS.<\/p>\n<p><strong>Conclusion<\/strong><br \/>Nearly 10% of patients who underwent RIRS were readmitted to the hospital within the first month after discharge, and some were rehospitalized. Preoperative pyuria, high stone volume, presence of postoperative complications, and low stone-free status predicted this readmission and rehospitalization. Clinicians must recognize these predictive factors and inform their patients about this possibility.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Medical speciality \u2014 Procedure and publications.Application steps of mediNiK\u00ae<style>#sp-ea-3810 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-3810.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-3810.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon {margin-right: 0;}<\/style><div id=\"sp_easy_accordion-1724401577\"><div id=\"sp-ea-3810\" class=\"sp-ea-one sp-easy-accordion\" data-ea-active=\"ea-click\" data-ea-mode=\"vertical\" data-preloader=\"\" data-scroll-active-item=\"\" data-offset-to-scroll=\"0\"><div class=\"ea-card ea-expand sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38100\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38100\" aria-controls=\"collapse38100\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">Before using mediNiK\u00ae<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse38100\" data-parent=\"#sp-ea-3810\" role=\"region\" aria-labelledby=\"ea-header-38100\"> <div class=\"ea-body\"><p><strong>A.<\/strong> Make sure that there is no contrast medium, blood or other substances in the kidney that could affect vision and\/or hydrogel formation.<br \/><strong>B.<\/strong> Before removing the syringe cap, the pressure point should be released by pressing in the plunger rod. This ensures that the syringes are emptied easily and evenly.<br \/><strong>C.<\/strong> For optimum results, the kidney stones should be collected at the lowest point of a kidney calyx.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38101\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38101\" aria-controls=\"collapse38101\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">Administration of mediNiK\u00ae<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38101\" data-parent=\"#sp-ea-3810\" role=\"region\" aria-labelledby=\"ea-header-38101\"> <div class=\"ea-body\"><p><strong>1. <\/strong>Use the endoscope <strong>to navigate<\/strong> within vision to the kidney stone fragments. Irrigate with physiological sterile saline solution (0.9 % NaCI) to ensure good visibility.<br \/><strong>2. Stop<\/strong> irrigation. Slowly inject the blue base substance K1 in pulses through the working channel of the endoscope until the fragments to be removed are completely surrounded by blue K1. If more than one renal calyx is affected, repeat this step for each calyx individually.<br \/><u>Tip:<\/u> Only use as much of the blue base substance K1 as necessary. This is then turned into a hydrogel by adding the second component, the yellow activator K2.<br \/><strong>3. <\/strong>Carefully <strong>flush<\/strong> the working channel of the endoscope with 0.9 % NaCI.<br \/><u>Caution:<\/u> Avoid turbulence\/dilution of the blue K1 by flushing the working channel too intensively. Pull the endoscope back slightly.<br \/><strong>4. Inject<\/strong> the yellow K2 carefully and slowly through the previously flushed working channel. Move the endoscope slowly in the direction of the affected renal calyx(es).<br \/><u>Caution:<\/u> Avoid turbulence in the blue K1 by injecting too quickly. Irrespective of the amount of blue base substance K1 used, the entire content of the yellow activator K2 syringe (11 ml) should be injected.<br \/><strong>5. Insert<\/strong> the stone retrieval basket (e.g., Dormia or tipless basket) into the working channel of the endoscope.<br \/><strong>6. Carefully grasp and remove<\/strong> the hydrogel clot with the stone retrieval basket. Flushing can now be restarted at low intensity.<br \/><u>Caution:<\/u> The grasper can cut the hydrogel if it is closed too tightly.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38102\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38102\" aria-controls=\"collapse38102\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">Following administration<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38102\" data-parent=\"#sp-ea-3810\" role=\"region\" aria-labelledby=\"ea-header-38102\"> <div class=\"ea-body\"><p>Ensure that all hydrogel clots have been removed. However, if hydrogel clots remain, these are \u2013 as a rule \u2013 dissolved by diuresis. The hydrogel can also be actively dissolved by adding a chelating agent (e.g. EDTA).<\/p><p><strong>Repeating the procedure:<\/strong> If the procedure is repeated, all of the previously used yellow K2 must be completely flushed out of the kidney.<br \/><strong>Single use:<\/strong> mediNiK\u00ae is intended for single use and must not be resterilized.<br \/><strong>Disposal:<\/strong> The syringes filled with blue K1 and yellow K2 can be disposed of in accordance with the lowest internal hospital disposal standards. The hydrogel must be disposed of separately as it has come into contact with mucous membranes and\/or urine.<\/p><\/div><\/div><\/div><\/div><\/div>Note: All serious incidents occurring in connection with the device must be reported to the manufacturer and the competent authority of the Member State in which the user and\/or patient is located (vigilanz@purenum.com).Frequently asked questions about the use of mediNiK\u00ae<style>#sp-ea-3814 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-3814.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-3814.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon {margin-right: 0;}<\/style><div id=\"sp_easy_accordion-1724401577\"><div id=\"sp-ea-3814\" class=\"sp-ea-one sp-easy-accordion\" data-ea-active=\"ea-click\" data-ea-mode=\"vertical\" data-preloader=\"\" data-scroll-active-item=\"\" data-offset-to-scroll=\"0\"><div class=\"ea-card ea-expand sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38140\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38140\" aria-controls=\"collapse38140\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">1. Do I need a special ureterorenoscope?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse38140\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38140\"> <div class=\"ea-body\"><p>No. You can use your existing ureterorenoscope without any problem.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38141\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38141\" aria-controls=\"collapse38141\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">2. How many syringes do I need per patient\/administration?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38141\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38141\"> <div class=\"ea-body\"><p>1 administration = 2 syringes (1 of component K1 + 1 of component K2)<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38142\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38142\" aria-controls=\"collapse38142\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">3. How can you tell that a sufficient amount of the base substance K1 has been injected?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38142\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38142\"> <div class=\"ea-body\"><p>K1 is blue in color and transparent, creating a good color contrast on the monitor and ensuring that the stone fragments are visible. When all stone fragments are completely coated with the blue component, a sufficient amount has been administered.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38143\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38143\" aria-controls=\"collapse38143\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">4. How can I be sure that a sufficient amount of the activator K2 has been administered?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38143\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38143\"> <div class=\"ea-body\"><p>There is no need to ensure a precise mixing ratio. At least two to three times the amount of K2 should be injected compared to the previously introduced base substance K1. As overdose of the K2 activator is not possible, the entire contents of the syringe can be injected slowly (without turbulence).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38144\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38144\" aria-controls=\"collapse38144\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">5. Is it possible to administer too much mediNiK\u00ae (K1 or K2)?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38144\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38144\"> <div class=\"ea-body\"><p>With regard to the quantity of base substance K1, it makes sense to inject only enough to completely enclose all fragments according to the principle of as much as necessary, as little as possible. About 0.3 to 0.5 ml of K1 should be sufficient for one calyx, although several calices can be filled in succession before K2 is added. On the other hand, it is not possible to inject too much of the activator K2.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38145\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38145\" aria-controls=\"collapse38145\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">6. After adding component K2, no solid hydrogel is formed, or only a small amount. Why is that?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38145\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38145\"> <div class=\"ea-body\"><p>a. The flushing was not stopped before the administation of K1 and K1 was therefore \"flushed out\".<br \/>b. Component K2 was administered so quickly that component K1 was \"flushed out\" by the resulting turbulence.<br \/>c. Component K2 was administered too close to component K1, so that component K1 was \"flushed out\".<br \/>d. Too little of component K2 was used, and there was no visible yellowing of the total fluid in the kidney.<br \/>e. If it is not the first administration: Inadequate flushing, residual component K2 was still present in the kidney.<br \/>f. Not waiting long enough for the gel to form.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38146\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38146\" aria-controls=\"collapse38146\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">7. What happens if flushing is NOT turned off before injecting mediNiK\u00ae?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38146\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38146\"> <div class=\"ea-body\"><p>The base substance K1 is \"flushed away\" or diluted by the flow caused by flushing. The residual fragments to be retrieved are therefore insufficiently coated.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38147\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38147\" aria-controls=\"collapse38147\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">8. What happens if I do not administer a component?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38147\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38147\"> <div class=\"ea-body\"><p>If only one of the two components is administered, no gel formation will occur. Consequently, the residual fragments cannot be retrieved as expected.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38148\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38148\" aria-controls=\"collapse38148\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">9. What happens if I reverse the order of use?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38148\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38148\"> <div class=\"ea-body\"><p>If the activator K2 is administered first, K1 gel formation will occur instantaneously during the subsequent injection of base substance K1. The residual fragments will therefore be bound weakly or not at all by the hydrogel.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38149\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38149\" aria-controls=\"collapse38149\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">10. Do I need to apply pressure to the syringes to force the components out of the syringes?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38149\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-38149\"> <div class=\"ea-body\"><p>The higher viscosity component K1 (base substance) requires slightly more force than component K2 (activator), especially if it is delivered through a catheter (which can be useful when using a reusable scope, for example). When administered directly via the working channel as we recommend, both components can be easily dosed. If it is not possible to administer the components K1 or K2, it may be because:<\/p><p>1) the selected catheter is too narrow.<br \/>2) there is a blockage in the catheter caused by residues of the other component that have not been flushed away.<br \/>3) the Tuohy Borst at the entrance to the working channel is tightened too much so that the cross-section of the catheter is reduced.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-381410\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse381410\" aria-controls=\"collapse381410\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">11. It is difficult to plunge the syringes when they are first pressed, is this normal?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse381410\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-381410\"> <div class=\"ea-body\"><p>Yes, the technical pressure point must be released first. This is done by briefly pressing in the plunger rod with the cap fixed in place, e.g. by placing the syringe on a solid surface, similar to other syringes from FARCO-PHARMA (e.g. Instillagel and Endosgel).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-381411\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse381411\" aria-controls=\"collapse381411\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">12. Can mediNiK\u00ae be administered a second time during surgery?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse381411\" data-parent=\"#sp-ea-3814\" role=\"region\" aria-labelledby=\"ea-header-381411\"> <div class=\"ea-body\"><p>Yes, mediNiK\u00ae can even be administered several times to one patient. This requires the kidney to be well flushed with physiological saline solution so that no residues of component K2 are present. Residual K2 would lead to immediate gel formation upon readministration of K1 without the stone fragments being sufficiently coated.<\/p><\/div><\/div><\/div><\/div><\/div>Retrieval of renal stone fragments<style>#sp-ea-3817 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-3817.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-3817.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon {margin-right: 0;}<\/style><div id=\"sp_easy_accordion-1724401577\"><div id=\"sp-ea-3817\" class=\"sp-ea-one sp-easy-accordion\" data-ea-active=\"ea-click\" data-ea-mode=\"vertical\" data-preloader=\"\" data-scroll-active-item=\"\" data-offset-to-scroll=\"0\"><div class=\"ea-card ea-expand sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38170\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38170\" aria-controls=\"collapse38170\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">13. Grasping the hydrogel with the grasper is difficult or causes the hydrogel to tear. Why is that?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse38170\" data-parent=\"#sp-ea-3817\" role=\"region\" aria-labelledby=\"ea-header-38170\"> <div class=\"ea-body\"><p>It is essential to wait at least 3 minutes after injecting K2, as the gel will be too soft to grip if you do not wait long enough. Complete closure of the extraction basket cuts through the hydrogel. Grasping the hydrogel differs fundamentally from conventional grasping of stone fragments. To allow for the retrieval of larger amounts of the hydrogel (containing the bound residual fragments), it is designed to be soft. This means it can mold to the urinary tract or ureteral sheath. Therefore, the extraction basket should be closed only slightly. Grasping the hydrogel is fundamental to the procedure and can be practiced in advance on a model of the kidney.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38171\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38171\" aria-controls=\"collapse38171\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">14. Why does the hydrogel clot have to be pulled out \"carefully\"? What if I \"lose\" half of it?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38171\" data-parent=\"#sp-ea-3817\" role=\"region\" aria-labelledby=\"ea-header-38171\"> <div class=\"ea-body\"><p>The hydrogel is designed to be soft so that it can mold to the urinary tract or ureteral sheath. There is a constriction at the junction between the renal pelvis and the ureteral sheath. If the hydrogel is pulled through too quickly at this point, the part protruding from the extraction basket may be sheared off. This part must be retrieved in a further step. As the gel is located directly inside the renal pelvis, it is easy to grasp and subsequently retrieve the fragments.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38172\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38172\" aria-controls=\"collapse38172\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">15. What happens if residues of mediNiK\u00ae remain in the kidney after the procedure?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38172\" data-parent=\"#sp-ea-3817\" role=\"region\" aria-labelledby=\"ea-header-38172\"> <div class=\"ea-body\"><p>Residues of mediNiK\u00ae remaining in the kidney do not pose a risk to the patient. Natural diuresis reverses gel formation. Initially, the gel becomes softer and softer until it turns completely back into a liquid and is excreted by the patient in the urine.<\/p><\/div><\/div><\/div><\/div><\/div>Following administration<style>#sp-ea-3820 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-3820.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-3820.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon {margin-right: 0;}<\/style><div id=\"sp_easy_accordion-1724401577\"><div id=\"sp-ea-3820\" class=\"sp-ea-one sp-easy-accordion\" data-ea-active=\"ea-click\" data-ea-mode=\"vertical\" data-preloader=\"\" data-scroll-active-item=\"\" data-offset-to-scroll=\"0\"><div class=\"ea-card ea-expand sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38200\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38200\" aria-controls=\"collapse38200\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">16. How do I dispose of the hydrogel and syringe residues?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse38200\" data-parent=\"#sp-ea-3820\" role=\"region\" aria-labelledby=\"ea-header-38200\"> <div class=\"ea-body\"><p>Component K1 and component K2 do not pose any risk to humans. Syringes can be disposed of in accordance with the hospital's internal disposal standards for the lowest waste safety level. The catheters and the hydrogel must be disposed of separately as they come into contact with mucous membranes and\/or urine and the renal stone fragments.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38201\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38201\" aria-controls=\"collapse38201\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">17. Can leftover mediNiK\u00ae be used for another operation?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38201\" data-parent=\"#sp-ea-3820\" role=\"region\" aria-labelledby=\"ea-header-38201\"> <div class=\"ea-body\"><p>No. The principle is that opened and used syringes may only be used in one patient for a single operation.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-38202\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse38202\" aria-controls=\"collapse38202\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">18. How can I isolate the retrieved stone fragments from the hydrogel for analysis?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse38202\" data-parent=\"#sp-ea-3820\" role=\"region\" aria-labelledby=\"ea-header-38202\"> <div class=\"ea-body\"><p>There are two possibilities, in principle:<br \/>1) The stones can be mechanically removed from the hydrogel and rinsed with sufficient water.<br \/>2) The hydrogel is dissolved by placing it in a chelating agent (e.g. EDTA) so that isolated stone fragments can be sent for analysis.<\/p><\/div><\/div><\/div><\/div><\/div>Hydrogel method in ORVIDEO \u2014 Training video on the use of mediNiK\u00aeVIDEO \u2014 Semi Live ICE25 Rom 2025VIDEO \u2014 Semi Live EAU London 2026PublicationsABOUT mediNiK\u00aeStone extraction during flexible ureterorenoscopy with or without the hydrogel method: a randomized, multicenter safety and feasibility study Amiel T, Neisius A, Netsch C, Secker A, Fisang C, Grunwald I, Lunger L, Straub M. Stone extraction during flexible ureterorenoscopy with or without the hydrogel method: a randomized, multicenter safety and feasibility study. World J Urol. 2025 Oct 31;43(1):655. doi: 10.1007\/s00345-025-06011-7 PMID: 41171315 Brief summary of results: PurposeAchieving the highest possible stone-free rate is the primary goal of kidney stone surgery, yet standard flexible ureterorenoscopy often leaves small residual fragments that predispose to recurrence. The hydrogel method using mediNiK\u00ae\u00a0was developed to embed and extract even the smallest fragments with conventional baskets. This study aimed to evaluate the safety and feasibility-defined as [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","inline_featured_image":false,"footnotes":""},"class_list":["post-3564","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Med. speciality - mediNiK\u00ae<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.medinik.de\/en\/med-speciality\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Med. speciality - mediNiK\u00ae\" \/>\n<meta property=\"og:description\" content=\"Medical speciality \u2014 Procedure and publications.Application steps of mediNiK\u00aeNote: All serious incidents occurring in connection with the device must be reported to the manufacturer and the competent authority of the Member State in which the user and\/or patient is located (vigilanz@purenum.com).Frequently asked questions about the use of mediNiK\u00aeRetrieval of renal stone fragmentsFollowing administrationHydrogel method in ORVIDEO \u2014 Training video on the use of mediNiK\u00aeVIDEO \u2014 Semi Live ICE25 Rom 2025VIDEO \u2014 Semi Live EAU London 2026PublicationsABOUT mediNiK\u00aeStone extraction during flexible ureterorenoscopy with or without the hydrogel method: a randomized, multicenter safety and feasibility study Amiel T, Neisius A, Netsch C, Secker A, Fisang C, Grunwald I, Lunger L, Straub M. Stone extraction during flexible ureterorenoscopy with or without the hydrogel method: a randomized, multicenter safety and feasibility study. World J Urol. 2025 Oct 31;43(1):655. doi: 10.1007\/s00345-025-06011-7 PMID: 41171315 Brief summary of results: PurposeAchieving the highest possible stone-free rate is the primary goal of kidney stone surgery, yet standard flexible ureterorenoscopy often leaves small residual fragments that predispose to recurrence. The hydrogel method using mediNiK\u00ae\u00a0was developed to embed and extract even the smallest fragments with conventional baskets. This study aimed to evaluate the safety and feasibility-defined as [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.medinik.de\/en\/med-speciality\/\" \/>\n<meta property=\"og:site_name\" content=\"mediNiK\u00ae\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-01T10:15:33+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"32 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/med-speciality\\\/\",\"url\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/med-speciality\\\/\",\"name\":\"Med. speciality - mediNiK\u00ae\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/med-speciality\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/med-speciality\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.medinik.de\\\/wp-content\\\/uploads\\\/2024\\\/08\\\/circle_exclamation_mark_63x63@3x.svg\",\"datePublished\":\"2024-08-20T14:52:59+00:00\",\"dateModified\":\"2026-04-01T10:15:33+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/med-speciality\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.medinik.de\\\/en\\\/med-speciality\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/med-speciality\\\/#primaryimage\",\"url\":\"https:\\\/\\\/www.medinik.de\\\/wp-content\\\/uploads\\\/2024\\\/08\\\/circle_exclamation_mark_63x63@3x.svg\",\"contentUrl\":\"https:\\\/\\\/www.medinik.de\\\/wp-content\\\/uploads\\\/2024\\\/08\\\/circle_exclamation_mark_63x63@3x.svg\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/med-speciality\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Startseite\",\"item\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Med. speciality\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/#website\",\"url\":\"https:\\\/\\\/www.medinik.de\\\/en\\\/\",\"name\":\"mediNiK\u00ae\",\"description\":\"Der neue Standard. 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Stone extraction during flexible ureterorenoscopy with or without the hydrogel method: a randomized, multicenter safety and feasibility study. World J Urol. 2025 Oct 31;43(1):655. doi: 10.1007\/s00345-025-06011-7 PMID: 41171315 Brief summary of results: PurposeAchieving the highest possible stone-free rate is the primary goal of kidney stone surgery, yet standard flexible ureterorenoscopy often leaves small residual fragments that predispose to recurrence. The hydrogel method using mediNiK\u00ae\u00a0was developed to embed and extract even the smallest fragments with conventional baskets. 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