{"id":3565,"date":"2024-08-20T14:52:59","date_gmt":"2024-08-20T14:52:59","guid":{"rendered":"https:\/\/www.medinik.de\/med-fachbereich\/"},"modified":"2026-04-01T10:16:54","modified_gmt":"2026-04-01T10:16:54","slug":"especialidad-medica","status":"publish","type":"page","link":"https:\/\/www.medinik.de\/es\/especialidad-medica\/","title":{"rendered":"Especialidad m\u00e9dica"},"content":{"rendered":"<p>[et_pb_section fb_built=\u00bb1&#8243; custom_padding_last_edited=\u00bboff|desktop\u00bb module_class=\u00bbfade-out-section\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00012f68-7d00-4818-b649-20d75de3265b\u00bb background_image=\u00bbhttps:\/\/www.medinik.de\/wp-content\/uploads\/2024\/08\/header_med_fachbereich_desk.jpg\u00bb height_tablet=\u00bb\u00bb height_phone=\u00bb\u00bb height_last_edited=\u00bbon|tablet\u00bb custom_margin=\u00bb||||false\u00bb custom_padding=\u00bb0px||0px||true|false\u00bb background_last_edited=\u00bbon|desktop\u00bb background_image_tablet=\u00bbhttps:\/\/www.medinik.de\/wp-content\/uploads\/2024\/08\/header_med_fachbereich_medinik_tab.jpg\u00bb background_image_phone=\u00bbhttps:\/\/www.medinik.de\/wp-content\/uploads\/2024\/08\/header_med_fachbereich_medinik_mob.jpg\u00bb background_enable_image_tablet=\u00bbon\u00bb background_enable_image_phone=\u00bbon\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row column_structure=\u00bb1_2,1_2&#8243; make_equal=\u00bbon\u00bb module_class=\u00bbcustom_row row-1440&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbfc0747b4-478d-48f4-8b1f-e468d1419db6&#8243; width_tablet=\u00bb\u00bb width_phone=\u00bb\u00bb width_last_edited=\u00bbon|desktop\u00bb min_height=\u00bb544px\u00bb min_height_tablet=\u00bb756px\u00bb min_height_phone=\u00bb722px\u00bb min_height_last_edited=\u00bbon|desktop\u00bb height=\u00bb30vw\u00bb max_height=\u00bb722px\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb1_2&#8243; module_class=\u00bbsecond-on-mobile header-row\u00bb _builder_version=\u00bb4.23.4&#8243; _module_preset=\u00bbdefault\u00bb custom_css_main_element=\u00bbmargin: auto;\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bbon|phone\u00bb custom_css_main_element_tablet=\u00bbmargin: auto auto 0;\u00bb custom_css_main_element_phone=\u00bbmargin: auto auto 0;\u00bb][et_pb_text _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb_initial\u00bb text_font=\u00bb|600|||||||\u00bb text_letter_spacing=\u00bb0.5px\u00bb background_layout=\u00bbdark\u00bb max_width=\u00bb530px\u00bb custom_margin=\u00bb|-28px|||false|false\u00bb text_line_height_tablet=\u00bb\u00bb text_line_height_phone=\u00bb\u00bb text_line_height_last_edited=\u00bbon|desktop\u00bb custom_css_main_element=\u00bbhyphens: auto !important;\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<p>Especialidad m\u00e9dica  \u2014<\/p>\n<h1>Aplicaci\u00f3n y publicaciones.<\/h1>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=\u00bb1_2&#8243; module_class=\u00bbfirst-on-mobile\u00bb _builder_version=\u00bb4.23.4&#8243; _module_preset=\u00bbdefault\u00bb custom_css_main_element=\u00bbmargin: auto;\u00bb global_colors_info=\u00bb{}\u00bb][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1&#8243; custom_padding_last_edited=\u00bbon|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb100px||100px||false|false\u00bb custom_padding_tablet=\u00bb50px||50px||false|false\u00bb custom_padding_phone=\u00bb50px||50px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||33px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb||30px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h2 style=\"text-align: left;\">Pasos de aplicaci\u00f3n de mediNiK\u00ae<\/h2>\n<p>[\/et_pb_text][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb]<style>#sp-ea-4057 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-4057.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-4057.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-4057.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-4057.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-4057.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-4057.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-4057\" 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-40570\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40570\" aria-controls=\"collapse40570\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">Antes de utilizar mediNiK\u00ae<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse40570\" data-parent=\"#sp-ea-4057\" role=\"region\" aria-labelledby=\"ea-header-40570\"> <div class=\"ea-body\"><p><strong>A.<\/strong> Aseg\u00farese de que no hay medio de contraste, sangre u otras sustancias en el ri\u00f1\u00f3n que puedan afectar a la visualizaci\u00f3n y\/o a la formaci\u00f3n del hidrogel.<br \/><strong>B.<\/strong> Antes de retirar el capuch\u00f3n de la jeringa, se debe aflojar el punto de presi\u00f3n presionando el v\u00e1stago del \u00e9mbolo. Esto permite un vaciado f\u00e1cil y uniforme de la jeringa.<br \/><strong>C.<\/strong> Para obtener un resultads \u00f3ptimo, los c\u00e1lculos renales deben recogerse en el punto m\u00e1s bajo de un c\u00e1liz renal.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40571\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40571\" aria-controls=\"collapse40571\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">Aplicaci\u00f3n de mediNiK\u00ae<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40571\" data-parent=\"#sp-ea-4057\" role=\"region\" aria-labelledby=\"ea-header-40571\"> <div class=\"ea-body\"><p><strong>1. Utilice<\/strong> el endoscopio para navegar hasta que los fragmentos de c\u00e1lculos renales est\u00e9n a la vista. Irrigue con soluci\u00f3n salina fisiol\u00f3gica est\u00e9ril (NaCI al 0,9\u00a0%) para garantizar una buena visibilidad.<br \/><strong>2. \u00a1Detenga<\/strong> la irrigaci\u00f3n! Aplique la sustancia base azul K1 lentamente y de forma pulsada a trav\u00e9s del canal de trabajo del endoscopio hasta que los fragmentos que se van a eliminar est\u00e9n completamente rodeados por el K1 azul. Si hay m\u00e1s de un c\u00e1liz renal afectado, repita este paso para cada c\u00e1liz individualmente.<br \/><u>Consejo:<\/u> Utilice s\u00f3lo la cantidad necesaria de la sustancia base azul K1. A continuaci\u00f3n, esta se convertir\u00e1 en hidrogel mediante la administraci\u00f3n del activador amarillo K2, el segundo componente.<br \/><strong>3. Enjuague<\/strong> cuidadosamente el canal de trabajo del endoscopio con NaCI al 0,9 %.<br \/><u>\u00a1Atenci\u00f3n!<\/u> Evite la turbulencia o diluci\u00f3n del K1 azul debido a una irrigaci\u00f3n demasiado intensa del canal de trabajo. Tire ligeramente del endoscopio hacia atr\u00e1s.<br \/><strong>4. Aplique<\/strong> el K2 amarillo con cuidado y lentamente a trav\u00e9s del canal de trabajo previamente irrigado. Desplace el endoscopio lentamente en direcci\u00f3n al c\u00e1liz o c\u00e1lices renales afectados.<br \/><u>\u00a1Atenci\u00f3n!<\/u> Evite la turbulencia del K1 azul debido a una administraci\u00f3n demasiado r\u00e1pida. Independientemente de la cantidad de sustancia base azul K1 utilizada, debe aplicarse todo el contenido de la jeringa del activador amarillo K2 (11\u00a0ml).<br \/><strong>5. Inserte<\/strong> la cesta de extracci\u00f3n de c\u00e1lculos (p. ej., cesta tipo Dormia o sin punta) a trav\u00e9s del canal de trabajo del endoscopio.<br \/><strong>6. Agarre y retire<\/strong> con cuidado el co\u00e1gulo de hidrogel con el instrumento de agarre. La irrigaci\u00f3n puede reanudarse ahora con baja intensidad.<br \/><u>\u00a1Atenci\u00f3n!<\/u> La pinza puede cortar el hidrogel si se cierra con demasiada fuerza.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40572\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40572\" aria-controls=\"collapse40572\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">Tras la aplicaci\u00f3n<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40572\" data-parent=\"#sp-ea-4057\" role=\"region\" aria-labelledby=\"ea-header-40572\"> <div class=\"ea-body\"><p>Aseg\u00farese de que se han eliminado todos los co\u00e1gulos de hidrogel. Sin embargo, si quedaran co\u00e1gulos de hidrogel, \u00e9stos se disuelven -por regla general- con la diuresis. El hidrogel tambi\u00e9n puede disolverse activamente a\u00f1adiendo un quelante (p.\u00a0ej., EDTA).<\/p><p><strong>Repetici\u00f3n del procedimiento:<\/strong> Si se repite el procedimiento, debe eliminarse completamente del ri\u00f1\u00f3n todo el K2 amarillo utilizado anteriormente.<br \/><strong>Un solo uso:<\/strong> mediNiK\u00ae\u2013 est\u00e1 destinado a un solo uso y no se debe reesterilizar.<br \/><strong>Eliminaci\u00f3n de residuos:<\/strong> Las jeringas llenas de K1 azul y K2 amarillo pueden desecharse de acuerdo con las normas internas de desecho hospitalario menos estrictas. El hidrogel debe desecharse por separado, puesto que ha entrado en contacto con las mucosas y\/o la orina.<\/p><\/div><\/div><\/div><\/div><\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb background_color=\u00bb#309F52&#8243; max_width=\u00bb1120px\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb19px|20px|22px|20px|false|false\u00bb border_radii=\u00bbon|16px|16px|16px|16px\u00bb border_color_all=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb69a0e13c-1630-45aa-b27d-7a6ca54e8478&#8243; link_font=\u00bb||||on|||#FFFFFF|\u00bb link_text_color=\u00bb#FFFFFF\u00bb header_6_font=\u00bb|600|||||||\u00bb header_6_font_size=\u00bb20px\u00bb header_6_line_height=\u00bb0.5em\u00bb background_layout=\u00bbdark\u00bb custom_margin=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb]<\/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\" \/>Nota<\/span><\/h6>\n<p>Todos los incidentes graves relacionados con el producto deber\u00e1n comunicarse al fabricante y a la autoridad competente del Estado miembro donde se encuentre el usuario y\/o paciente (<a href=\"mailto:vigilanz@purenum.com\">vigilanz@purenum.com<\/a>).<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1&#8243; custom_padding_last_edited=\u00bbon|phone\u00bb module_id=\u00bbFAQ_Fachbereich\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb0px||90px||false|false\u00bb custom_padding_tablet=\u00bb||45px||false|false\u00bb custom_padding_phone=\u00bb||45px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb||30px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h2 style=\"text-align: left;\">Preguntas frecuentes sobre el uso de mediNiK\u00ae<\/h2>\n<p>[\/et_pb_text][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb]<style>#sp-ea-4058 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-4058.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-4058.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-4058.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-4058.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-4058.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-4058.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-4058\" 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-40580\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40580\" aria-controls=\"collapse40580\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">1. \u00bfNecesito un ureterorrenoscopio especial?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse40580\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40580\"> <div class=\"ea-body\"><p>No. Cualquier ureterorrenoscopio disponible en el mercado puede utilizarse sin problemas.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40581\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40581\" aria-controls=\"collapse40581\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">2. \u00bfCu\u00e1ntas jeringas necesito por paciente\/aplicaci\u00f3n?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40581\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40581\"> <div class=\"ea-body\"><p>1 aplicaci\u00f3n = 2 puntas (1 x componente K1 + componente K2).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40582\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40582\" aria-controls=\"collapse40582\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">3. \u00bfC\u00f3mo puede saber que se ha aplicado una cantidad suficiente de la sustancia b\u00e1sica K1?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40582\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40582\"> <div class=\"ea-body\"><p>K1 es de color azul y al mismo tiempo transparente, de modo que se crea un buen contraste de color en el monitor y al mismo tiempo los fragmentos de piedra son visibles. Cuando todos los fragmentos de piedra est\u00e9n completamente mojados con el componente azul, se habr\u00e1 aplicado una cantidad suficiente.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40583\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40583\" aria-controls=\"collapse40583\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">4. \u00bfC\u00f3mo puede saber si se ha aplicado una cantidad suficiente de activador K2?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40583\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40583\"> <div class=\"ea-body\"><p>No es necesario respetar una proporci\u00f3n de mezcla exacta. Debe aplic\u00bfC\u00f3mo puede saber si se ha aplicado una cantidad suficiente de activador K2?arse al menos dos o tres veces la cantidad de K2 en comparaci\u00f3n con la sustancia base K1 introducida anteriormente. Dado que no es posible sobredosificar el activador K2, tambi\u00e9n se puede aplicar lentamente todo el contenido de la jeringa (\u00a1sin causar turbulencias!).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40584\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40584\" aria-controls=\"collapse40584\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">5. \u00bfEs posible aplicar demasiado mediNiK\u00ae (K1 o K2)?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40584\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40584\"> <div class=\"ea-body\"><p>En cuanto a la cantidad de sustancia base K1, tiene sentido aplicar s\u00f3lo la suficiente para encerrar completamente todos los fragmentos seg\u00fan el principio de \u00abtanto como sea necesario, tan poco como sea posible\u00bb. Aproximadamente de 0,3 ml a 0,5 ml de K1 deber\u00edan ser suficientes para un c\u00e1liz, por lo que se pueden llenar varios c\u00e1lices sucesivamente antes de a\u00f1adir K2. Por otra parte, no es posible aplicar \u00abdemasiado\u00bb activador K2.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40585\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40585\" aria-controls=\"collapse40585\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">6. Tras a\u00f1adir el componente K2, no se forma hidrogel s\u00f3lido o s\u00f3lo se forma una peque\u00f1a cantidad de hidrogel. \u00bfA qu\u00e9 se debe esto?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40585\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40585\"> <div class=\"ea-body\"><p>a. No se detuvo la irrigaci\u00f3n antes de la aplicaci\u00f3n de K1, lo que dio como resultado que K1 se eliminara o se diluyera.<br \/>b. El componente K2 se aplic\u00f3 tan r\u00e1pidamente que el componente K1 fue \u00abarrastrado debido a la turbulencia resultante\u00bb.<br \/>c. El componente K2 se aplic\u00f3 demasiado cerca del componente K1,lo que provoc\u00f3 que el componente K1 se eliminara.<br \/>d. Se utiliz\u00f3 una cantidad insuficiente del componente K2, por lo que no se observ\u00f3 una coloraci\u00f3n amarilla en todo el l\u00edquido en el ri\u00f1\u00f3n.<br \/>e. Si no es la primera aplicaci\u00f3n: En caso de irrigaci\u00f3n insuficiente, los residuos del componente K2 segu\u00edan presentes en el ri\u00f1\u00f3n.<br \/>f. No se esper\u00f3 suficiente tiempo para que se forme el gel.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40586\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40586\" aria-controls=\"collapse40586\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">7. \u00bfQu\u00e9 ocurre si NO se detiene la irrigaci\u00f3n antes de la aplicaci\u00f3n de mediNiK\u00ae?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40586\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40586\"> <div class=\"ea-body\"><p>La sustancia base K1 se dispersa y se elimina o se diluye debido al flujo causado por la irrigaci\u00f3n.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40587\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40587\" aria-controls=\"collapse40587\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">8. \u00bfQu\u00e9 ocurre si no aplico un componente?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40587\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40587\"> <div class=\"ea-body\"><p>Si s\u00f3lo se aplica uno de los dos componentes, no tiene lugar la formaci\u00f3n de gel. En consecuencia, los fragmentos residuales no pueden recuperarse como se esperaba.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40588\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40588\" aria-controls=\"collapse40588\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">9. \u00bfQu\u00e9 ocurre si cambio el orden de aplicaci\u00f3n?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40588\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40588\"> <div class=\"ea-body\"><p>Si se aplica primero el activador K2, la formaci\u00f3n del gel ocurre instant\u00e1neamente al aplicar posteriormente la sustancia base K1. Por lo tanto, los fragmentos residuales s\u00f3lo pueden adherirse al hidrogel de forma insuficiente o no adherirse en absoluto .<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40589\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40589\" aria-controls=\"collapse40589\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">10. \u00bfDebo ejercer presi\u00f3n sobre las jeringas para que las componentes salgan de ellas?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40589\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40589\"> <div class=\"ea-body\"><p>El componente K1 (sustancia base), de mayor viscosidad, requiere algo m\u00e1s de fuerza que el componente K2 (activador), especialmente si la aplicaci\u00f3n se realiza a trav\u00e9s de un cat\u00e9ter (lo que puede ser \u00fatil al usar un endoscopio reutilizable, por ejemplo). Con la aplicaci\u00f3n recomendada por nosotros directamente a trav\u00e9s del canal de trabajo, ambos componentes se pueden dosificar f\u00e1cilmente. Si no es factible aplicar los componentes K1 o K2 (a trav\u00e9s de un cat\u00e9ter), es posible que:<\/p><p>1) el cat\u00e9ter seleccionado sea demasiado fino;<br \/>2) haya una obstrucci\u00f3n en el cat\u00e9ter causada por residuos del otro componente que no se eliminaron por lavado.<br \/>3) el adaptador Tuohy Borst a la entrada del canal de trabajo est\u00e9 demasiado apretado, de modo que se reduce la secci\u00f3n transversal del cat\u00e9ter.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-405810\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse405810\" aria-controls=\"collapse405810\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">11. \u00bfEs normal que las jeringas est\u00e9n m\u00e1s duras al presionarlas por primera vez?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse405810\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-405810\"> <div class=\"ea-body\"><p>S\u00ed, primero debe liberarse el punto de presi\u00f3n t\u00e9cnica. Esto se logra presionando brevemente el v\u00e1stago del \u00e9mbolo, con lo que la tapa de cierre queda fijada en su lugar, por ejemplo, colocando la jeringa sobre una superficie firme, de manera similar a otras jeringas de FARCO-PHARMA (por ejemplo, Instillagel y Endosgel).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-405811\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse405811\" aria-controls=\"collapse405811\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">12. \u00bfSe puede utilizar mediNiK\u00ae por segunda vez durante una operaci\u00f3n?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse405811\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-405811\"> <div class=\"ea-body\"><p>S\u00ed, mediNiK\u00ae puede utilizarse incluso varias veces en un mismo paciente. Para ello, el canal de trabajo del endoscopio y el ri\u00f1\u00f3n deben enjuagarse cuidadosamente con una soluci\u00f3n salina fisiol\u00f3gica para que no queden residuos del componente K2. Los residuos de K2 provocar\u00edan la formaci\u00f3n inmediata de gel cuando se volviera a aplicar K1, sin que se puedan humedecer suficientemente los fragmentos del c\u00e1lculo.<\/p><\/div><\/div><\/div><\/div><\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1&#8243; custom_padding_last_edited=\u00bbon|phone\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb0px||90px||false|false\u00bb custom_padding_tablet=\u00bb||45px||false|false\u00bb custom_padding_phone=\u00bb||45px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb||30px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h2 style=\"text-align: left;\">Recuperaci\u00f3n de los fragmentos del c\u00e1lculo renal<\/h2>\n<p>[\/et_pb_text][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb]<style>#sp-ea-4059 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-4059.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-4059.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-4059.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-4059.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-4059.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-4059.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-4059\" 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-40590\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40590\" aria-controls=\"collapse40590\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">13. El agarre del hidrogel con la pinza es dif\u00edcil o provoca el desgarro del hidrogel. \u00bfA qu\u00e9 se debe esto?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse40590\" data-parent=\"#sp-ea-4059\" role=\"region\" aria-labelledby=\"ea-header-40590\"> <div class=\"ea-body\"><p>Es esencial esperar al menos 3 minutos despu\u00e9s de aplicar el K2, ya que el gel estar\u00e1 demasiado blando para agarrarlo si se espera demasiado. Asimismo, cerrar completamente la cesta de captura provoca el corte del hidrogel. El agarre del hidrogel difiere fundamentalmente del agarre convencional de los fragmentos de piedra. Para poder recuperar mayores cantidades de hidrogel (con los fragmentos residuales incluidos), \u00e9ste se coloca reblandecido. De este modo, puede adaptarse a las v\u00edas urinarias o a la vaina ureteral. Por lo tanto, la cesta de recogida s\u00f3lo debe cerrarse ligeramente. El agarre del hidrogel es un punto central de la aplicaci\u00f3n y puede practicarse muy bien de antemano en un modelo de ri\u00f1\u00f3n.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40591\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40591\" aria-controls=\"collapse40591\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">14: \u00bfPor qu\u00e9 hay que extraer el co\u00e1gulo de hidrogel \u00abcon cuidado\u00bb? \u00bfY qu\u00e9 pasa si \u00abpierdo\u00bb la mitad?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40591\" data-parent=\"#sp-ea-4059\" role=\"region\" aria-labelledby=\"ea-header-40591\"> <div class=\"ea-body\"><p>El hidrogel se ajusta a una consistencia blanda para que pueda adaptarse a las v\u00edas urinarias o a la vaina ureteral. Hay una estrechamiento.justo en la transici\u00f3n de la pelvis renal al orificio ureteral. Si se tira del hidrogel con demasiada rapidez a trav\u00e9s de este punto, la parte que sobresale de la cesta de recogida puede cortarse. Esta parte debe recuperarse en un paso posterior. Gracias a la localizaci\u00f3n directa en la pelvis renal, el agarre y la posterior recuperaci\u00f3n son f\u00e1ciles de realizar.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40592\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40592\" aria-controls=\"collapse40592\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">15: \u00bfQu\u00e9 ocurre si quedan residuos de mediNiK\u00ae en el ri\u00f1\u00f3n despu\u00e9s del procedimiento?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40592\" data-parent=\"#sp-ea-4059\" role=\"region\" aria-labelledby=\"ea-header-40592\"> <div class=\"ea-body\"><p>Los residuos de mediNiK\u00ae que permanecen en el ri\u00f1\u00f3n no suponen un riesgo para el paciente. La diuresis natural invierte la formaci\u00f3n del gel. Ante todo, el gel se vuelve cada vez m\u00e1s blando hasta que vuelve a convertirse completamente en l\u00edquido y el paciente lo elimina con la orina.<\/p><\/div><\/div><\/div><\/div><\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1&#8243; custom_padding_last_edited=\u00bbon|phone\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb0px||90px||false|false\u00bb custom_padding_tablet=\u00bb||45px||false|false\u00bb custom_padding_phone=\u00bb||45px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb||30px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h2 style=\"text-align: left;\">Tras la aplicaci\u00f3n<\/h2>\n<p>[\/et_pb_text][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb]<style>#sp-ea-4145 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-4145.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-4145.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-4145.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-4145.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-4145.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-4145.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-4145\" 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-41450\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse41450\" aria-controls=\"collapse41450\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">16: \u00bfC\u00f3mo elimino el hidrogel y los residuos de la jeringa?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse41450\" data-parent=\"#sp-ea-4145\" role=\"region\" aria-labelledby=\"ea-header-41450\"> <div class=\"ea-body\"><p>El componente K1 y el componente K2 no suponen ning\u00fan riesgo para los seres humanos. Las jeringas pueden eliminarse de acuerdo con las normas internas de eliminaci\u00f3n del hospital del nivel de seguridad m\u00e1s bajo. Los cat\u00e9teres y el hidrogel deben eliminarse por separado debido al contacto con las membranas mucosas y\/o la orina y los fragmentos de c\u00e1lculos renales.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-41451\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse41451\" aria-controls=\"collapse41451\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">17: \u00bfPuede utilizarse mediNiK\u00ae sobrante para otra operaci\u00f3n?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse41451\" data-parent=\"#sp-ea-4145\" role=\"region\" aria-labelledby=\"ea-header-41451\"> <div class=\"ea-body\"><p>No. Se aplica el principio de que las jeringas abiertas y usadas s\u00f3lo pueden utilizarse en el mismo paciente y en el mismo quir\u00f3fano.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-41452\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse41452\" aria-controls=\"collapse41452\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">18: \u00bfC\u00f3mo puedo aislar del hidrogel los fragmentos de c\u00e1lculos recuperados para poder analizarlos?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse41452\" data-parent=\"#sp-ea-4145\" role=\"region\" aria-labelledby=\"ea-header-41452\"> <div class=\"ea-body\"><p>En principio, hay 2 posibilidades:<br \/>1) Los c\u00e1lculos pueden extraerse mec\u00e1nicamente del hidrogel y enjuagarse con agua suficiente.<br \/>2) El hidrogel se disuelve introduci\u00e9ndolo en un agente quelante (por ejemplo, EDTA), de modo que se disponga de fragmentos aislados del c\u00e1lculo para su an\u00e1lisis.<\/p><\/div><\/div><\/div><\/div><\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1&#8243; custom_padding_last_edited=\u00bbon|phone\u00bb admin_label=\u00bbUnsere Produkte\u00bb module_id=\u00bbtrainingsvideo_en\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb_initial\u00bb background_color=\u00bb#FFFFFF\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb0px||100px||false|false\u00bb custom_padding_tablet=\u00bb||50px||false|false\u00bb custom_padding_phone=\u00bb0px||50px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb||30px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h2 style=\"text-align: left;\">M\u00e9todo de hidrogel en quir\u00f3fano<\/h2>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=\u00bb1_3,1_3,1_3&#8243; 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text_line_height=\u00bb2em\u00bb ul_font_size=\u00bb16px\u00bb ul_line_height=\u00bb1.5em\u00bb header_font_size=\u00bb80px\u00bb header_2_font=\u00bb|600|||||||\u00bb header_3_font=\u00bb|600|||||||\u00bb header_4_font=\u00bb|600|||||||\u00bb header_4_letter_spacing=\u00bb-0.5px\u00bb header_6_font=\u00bb|600|||||||\u00bb header_6_font_size=\u00bb12px\u00bb header_6_letter_spacing=\u00bb1px\u00bb header_6_line_height=\u00bb1.6em\u00bb text_orientation=\u00bbcenter\u00bb width=\u00bb100%\u00bb width_tablet=\u00bb\u00bb width_phone=\u00bb\u00bb width_last_edited=\u00bbon|phone\u00bb max_width=\u00bb800px\u00bb module_alignment=\u00bbleft\u00bb custom_margin=\u00bb||40px||false|false\u00bb text_line_height_tablet=\u00bb1.5em\u00bb text_line_height_phone=\u00bb1.5em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb header_font_size_tablet=\u00bb55px\u00bb global_colors_info=\u00bb{}\u00bb custom_margin__hover_enabled=\u00bbon|desktop\u00bb custom_margin__hover=\u00bb||40px||false|false\u00bb]<\/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=\u00bb1_3&#8243; _builder_version=\u00bb4.23.4&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_video src=\u00bbhttps:\/\/www.medinik.de\/wp-content\/uploads\/2026\/04\/SemiLive_2026_Amiel.mp4&#8243; image_src=\u00bbhttps:\/\/www.medinik.de\/wp-content\/uploads\/2026\/04\/Screen_Video_Live-Session_EAU_London2026.jpg\u00bb font_icon=\u00bb&#xe04e;||divi||400&#8243; use_icon_font_size=\u00bbon\u00bb icon_font_size=\u00bb80px\u00bb module_id=\u00bbvideo-semi-live-eau-madrid-2025&#8243; _builder_version=\u00bb4.27.6&#8243; _module_preset=\u00bbdefault\u00bb hover_enabled=\u00bb0&#8243; border_radii=\u00bbon|8px|8px|8px|8px\u00bb border_width_all=\u00bb0.5px\u00bb border_color_all=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb title_text=\u00bbScreenshot\u00bb src_webm=\u00bbhttps:\/\/www.medinik.de\/wp-content\/uploads\/2026\/04\/SemiLive_2026_Amiel.webm\u00bb sticky_enabled=\u00bb0&#8243;][\/et_pb_video][et_pb_text ul_type=\u00bbnone\u00bb ul_item_indent=\u00bb20px\u00bb _builder_version=\u00bb4.27.6&#8243; _module_preset=\u00bb_initial\u00bb text_font=\u00bb|600|||||||\u00bb text_text_color=\u00bb#309F52&#8243; text_line_height=\u00bb2em\u00bb ul_font_size=\u00bb16px\u00bb ul_line_height=\u00bb1.5em\u00bb header_font_size=\u00bb80px\u00bb header_2_font=\u00bb|600|||||||\u00bb header_3_font=\u00bb|600|||||||\u00bb header_4_font=\u00bb|600|||||||\u00bb header_4_letter_spacing=\u00bb-0.5px\u00bb header_6_font=\u00bb|600|||||||\u00bb header_6_font_size=\u00bb12px\u00bb header_6_letter_spacing=\u00bb1px\u00bb header_6_line_height=\u00bb1.6em\u00bb text_orientation=\u00bbcenter\u00bb width=\u00bb100%\u00bb width_tablet=\u00bb\u00bb width_phone=\u00bb\u00bb width_last_edited=\u00bbon|phone\u00bb max_width=\u00bb800px\u00bb module_alignment=\u00bbleft\u00bb custom_margin=\u00bb||40px||false|false\u00bb hover_enabled=\u00bb0&#8243; text_line_height_tablet=\u00bb1.5em\u00bb text_line_height_phone=\u00bb1.5em\u00bb text_line_height_last_edited=\u00bbon|phone\u00bb header_font_size_tablet=\u00bb55px\u00bb global_colors_info=\u00bb{}\u00bb custom_margin__hover_enabled=\u00bbon|desktop\u00bb custom_margin__hover=\u00bb||40px||false|false\u00bb sticky_enabled=\u00bb0&#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=\u00bb1&#8243; custom_padding_last_edited=\u00bbon|desktop\u00bb module_class=\u00bbsec-publikationen\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb0px||80px||false|false\u00bb custom_padding_tablet=\u00bb||40px||false|false\u00bb custom_padding_phone=\u00bb||40px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb||30px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h2 style=\"text-align: left;\">Publicaciones<\/h2>\n<p>[\/et_pb_text][et_pb_text _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb header_3_font=\u00bb||||||||\u00bb header_3_letter_spacing=\u00bb1.6px\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h3 style=\"text-align: left;\">SOBRE mediNiK\u00ae<\/h3>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=\u00bb3_4,1_4&#8243; module_class=\u00bbrow-leistungsfaehigkeit\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-leistungsfaehigkeit\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb link_font=\u00bb||||on||||\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb module_alignment=\u00bbleft\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbrow-leistungsfaehigkeit\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-leistungsfaehigkeit\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; module_class=\u00bbrow-steinstaub\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-steinstaub\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbrow-steinstaub\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-steinstaub\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; module_class=\u00bbrow-testdiar\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-testdiar\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbrow-testdiar\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-testdiar\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; module_class=\u00bbrow-lithotomy\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-testdiar\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbrow-lithotomy\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-lithotomy\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; module_class=\u00bbrow-biocompatible\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-biocompatible\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbrow-biocompatible\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-biocompatible\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb header_3_font=\u00bb|||on|||||\u00bb header_3_letter_spacing=\u00bb1.6px\u00bb custom_padding=\u00bb35px||||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h3 style=\"text-align: left;\"><span 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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>Sobre medical need<\/span><\/h3>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=\u00bb3_4,1_4&#8243; admin_label=\u00bbZeile\u00bb module_class=\u00bbrow-stone-event-free\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-endoscopically\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbZeile\u00bb module_class=\u00bbrow-stone-event-free\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-stone-event-free\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; admin_label=\u00bbZeile\u00bb module_class=\u00bbrow-kidney\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-endoscopically\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbZeile\u00bb module_class=\u00bbrow-kidney\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-kidney\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; admin_label=\u00bbZeile\u00bb module_class=\u00bbrow-endoscopically\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-endoscopically\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbZeile\u00bb module_class=\u00bbrow-endoscopically\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-endoscopically\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; admin_label=\u00bbZeile\u00bb module_class=\u00bbrow-naturalhistory\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-naturalhistory\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbrow-naturalhistory\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-naturalhistory\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; module_class=\u00bbrow-clearance\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-clearance\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbrow-clearance\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-clearance\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; module_class=\u00bbrow-removal\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/p>\n<h4>Removal of Small, Asymptomatic Kidney Stones and Incidence of Relapse<\/h4>\n<p>[\/et_pb_text][et_pb_text module_class=\u00bbaufklapptext-preview-removal\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbrow-removal\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-removal\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb3_4,1_4&#8243; module_class=\u00bbrow-predictive\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb00f772c2-7f67-4a40-b736-1d5323efc8d4&#8243; positioning=\u00bbnone\u00bb max_width=\u00bb1120px\u00bb module_alignment=\u00bbcenter\u00bb custom_margin=\u00bb0px||0px||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#309F52&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb3_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_text content_tablet=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene Detrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_phone=\u00bb<\/p>\n<h4 style=%22margin-bottom: 18px;%22>Neurogene<br \/>\nDetrusor\u00fcberaktivit\u00e4t<\/h4>\n<p>\u00bb content_last_edited=\u00bboff|desktop\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_font_size=\u00bb24px\u00bb link_font=\u00bb|600||on|||||\u00bb link_text_color=\u00bb#4a5965&#8243; custom_margin=\u00bb|0px|0px||false|false\u00bb custom_padding=\u00bb||0px||false|false\u00bb text_font_size_phone=\u00bb16px\u00bb text_font_size_last_edited=\u00bboff|phone\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb header_4_font_size_tablet=\u00bb24px\u00bb header_4_font_size_phone=\u00bb24px\u00bb header_4_font_size_last_edited=\u00bbon|phone\u00bb header_4_line_height_tablet=\u00bb\u00bb header_4_line_height_phone=\u00bb\u00bb header_4_line_height_last_edited=\u00bbon|tablet\u00bb custom_css_main_element=\u00bbh4{||  hyphens: auto;||}\u00bb border_color_top=\u00bb#253746&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbaufklapptext-preview-predictive\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb custom_margin=\u00bb||||false|false\u00bb border_color_top=\u00bb#A6ADB3&#8243; locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bb1_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb||||false|false\u00bb global_colors_info=\u00bb{}\u00bb custom_css_main_element_last_edited=\u00bboff|tablet\u00bb custom_css_main_element_tablet=\u00bbwidth: 44% !important;\u00bb custom_css_main_element_phone=\u00bbwidth: 100% !important;||margin-bottom: 0px !important;\u00bb][et_pb_code admin_label=\u00bbCode\u00bb _builder_version=\u00bb4.27.5&#8243; _module_preset=\u00bbdefault\u00bb custom_margin=\u00bb|0px||0px|false|false\u00bb custom_margin_tablet=\u00bb||||false|false\u00bb custom_margin_phone=\u00bb|||0px|false|false\u00bb custom_margin_last_edited=\u00bbon|desktop\u00bb global_colors_info=\u00bb{}\u00bb]<\/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=\u00bbrow-predictive\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb max_width=\u00bb1120px\u00bb custom_padding=\u00bb0px||0px||false|false\u00bb locked=\u00bboff\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4&#8243; _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text module_class=\u00bbaufklapptext-predictive\u00bb _builder_version=\u00bb4.27.0&#8243; _module_preset=\u00bb3a211a91-220a-4ac6-9b17-f218862bdc1f\u00bb text_line_height=\u00bb1.5em\u00bb custom_margin=\u00bb||||false|false\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb text_line_height_last_edited=\u00bboff|desktop\u00bb custom_css_main_element=\u00bb#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;||}||\u00bb border_width_top=\u00bb1px\u00bb border_color_top=\u00bb#bfbfbf\u00bb global_colors_info=\u00bb{}\u00bb]<\/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>Especialidad m\u00e9dica \u2014 Aplicaci\u00f3n y publicaciones.Pasos de aplicaci\u00f3n de mediNiK\u00ae<style>#sp-ea-4057 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-4057.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-4057.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-4057.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-4057.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-4057.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-4057.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-4057\" 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-40570\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40570\" aria-controls=\"collapse40570\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">Antes de utilizar mediNiK\u00ae<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse40570\" data-parent=\"#sp-ea-4057\" role=\"region\" aria-labelledby=\"ea-header-40570\"> <div class=\"ea-body\"><p><strong>A.<\/strong> Aseg\u00farese de que no hay medio de contraste, sangre u otras sustancias en el ri\u00f1\u00f3n que puedan afectar a la visualizaci\u00f3n y\/o a la formaci\u00f3n del hidrogel.<br \/><strong>B.<\/strong> Antes de retirar el capuch\u00f3n de la jeringa, se debe aflojar el punto de presi\u00f3n presionando el v\u00e1stago del \u00e9mbolo. Esto permite un vaciado f\u00e1cil y uniforme de la jeringa.<br \/><strong>C.<\/strong> Para obtener un resultads \u00f3ptimo, los c\u00e1lculos renales deben recogerse en el punto m\u00e1s bajo de un c\u00e1liz renal.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40571\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40571\" aria-controls=\"collapse40571\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">Aplicaci\u00f3n de mediNiK\u00ae<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40571\" data-parent=\"#sp-ea-4057\" role=\"region\" aria-labelledby=\"ea-header-40571\"> <div class=\"ea-body\"><p><strong>1. Utilice<\/strong> el endoscopio para navegar hasta que los fragmentos de c\u00e1lculos renales est\u00e9n a la vista. Irrigue con soluci\u00f3n salina fisiol\u00f3gica est\u00e9ril (NaCI al 0,9\u00a0%) para garantizar una buena visibilidad.<br \/><strong>2. \u00a1Detenga<\/strong> la irrigaci\u00f3n! Aplique la sustancia base azul K1 lentamente y de forma pulsada a trav\u00e9s del canal de trabajo del endoscopio hasta que los fragmentos que se van a eliminar est\u00e9n completamente rodeados por el K1 azul. Si hay m\u00e1s de un c\u00e1liz renal afectado, repita este paso para cada c\u00e1liz individualmente.<br \/><u>Consejo:<\/u> Utilice s\u00f3lo la cantidad necesaria de la sustancia base azul K1. A continuaci\u00f3n, esta se convertir\u00e1 en hidrogel mediante la administraci\u00f3n del activador amarillo K2, el segundo componente.<br \/><strong>3. Enjuague<\/strong> cuidadosamente el canal de trabajo del endoscopio con NaCI al 0,9 %.<br \/><u>\u00a1Atenci\u00f3n!<\/u> Evite la turbulencia o diluci\u00f3n del K1 azul debido a una irrigaci\u00f3n demasiado intensa del canal de trabajo. Tire ligeramente del endoscopio hacia atr\u00e1s.<br \/><strong>4. Aplique<\/strong> el K2 amarillo con cuidado y lentamente a trav\u00e9s del canal de trabajo previamente irrigado. Desplace el endoscopio lentamente en direcci\u00f3n al c\u00e1liz o c\u00e1lices renales afectados.<br \/><u>\u00a1Atenci\u00f3n!<\/u> Evite la turbulencia del K1 azul debido a una administraci\u00f3n demasiado r\u00e1pida. Independientemente de la cantidad de sustancia base azul K1 utilizada, debe aplicarse todo el contenido de la jeringa del activador amarillo K2 (11\u00a0ml).<br \/><strong>5. Inserte<\/strong> la cesta de extracci\u00f3n de c\u00e1lculos (p. ej., cesta tipo Dormia o sin punta) a trav\u00e9s del canal de trabajo del endoscopio.<br \/><strong>6. Agarre y retire<\/strong> con cuidado el co\u00e1gulo de hidrogel con el instrumento de agarre. La irrigaci\u00f3n puede reanudarse ahora con baja intensidad.<br \/><u>\u00a1Atenci\u00f3n!<\/u> La pinza puede cortar el hidrogel si se cierra con demasiada fuerza.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40572\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40572\" aria-controls=\"collapse40572\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">Tras la aplicaci\u00f3n<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40572\" data-parent=\"#sp-ea-4057\" role=\"region\" aria-labelledby=\"ea-header-40572\"> <div class=\"ea-body\"><p>Aseg\u00farese de que se han eliminado todos los co\u00e1gulos de hidrogel. Sin embargo, si quedaran co\u00e1gulos de hidrogel, \u00e9stos se disuelven -por regla general- con la diuresis. El hidrogel tambi\u00e9n puede disolverse activamente a\u00f1adiendo un quelante (p.\u00a0ej., EDTA).<\/p><p><strong>Repetici\u00f3n del procedimiento:<\/strong> Si se repite el procedimiento, debe eliminarse completamente del ri\u00f1\u00f3n todo el K2 amarillo utilizado anteriormente.<br \/><strong>Un solo uso:<\/strong> mediNiK\u00ae\u2013 est\u00e1 destinado a un solo uso y no se debe reesterilizar.<br \/><strong>Eliminaci\u00f3n de residuos:<\/strong> Las jeringas llenas de K1 azul y K2 amarillo pueden desecharse de acuerdo con las normas internas de desecho hospitalario menos estrictas. El hidrogel debe desecharse por separado, puesto que ha entrado en contacto con las mucosas y\/o la orina.<\/p><\/div><\/div><\/div><\/div><\/div>Nota Todos los incidentes graves relacionados con el producto deber\u00e1n comunicarse al fabricante y a la autoridad competente del Estado miembro donde se encuentre el usuario y\/o paciente (vigilanz@purenum.com).Preguntas frecuentes sobre el uso de mediNiK\u00ae<style>#sp-ea-4058 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-4058.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-4058.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-4058.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-4058.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-4058.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-4058.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-4058\" 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-40580\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40580\" aria-controls=\"collapse40580\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">1. \u00bfNecesito un ureterorrenoscopio especial?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse40580\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40580\"> <div class=\"ea-body\"><p>No. Cualquier ureterorrenoscopio disponible en el mercado puede utilizarse sin problemas.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40581\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40581\" aria-controls=\"collapse40581\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">2. \u00bfCu\u00e1ntas jeringas necesito por paciente\/aplicaci\u00f3n?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40581\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40581\"> <div class=\"ea-body\"><p>1 aplicaci\u00f3n = 2 puntas (1 x componente K1 + componente K2).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40582\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40582\" aria-controls=\"collapse40582\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">3. \u00bfC\u00f3mo puede saber que se ha aplicado una cantidad suficiente de la sustancia b\u00e1sica K1?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40582\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40582\"> <div class=\"ea-body\"><p>K1 es de color azul y al mismo tiempo transparente, de modo que se crea un buen contraste de color en el monitor y al mismo tiempo los fragmentos de piedra son visibles. Cuando todos los fragmentos de piedra est\u00e9n completamente mojados con el componente azul, se habr\u00e1 aplicado una cantidad suficiente.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40583\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40583\" aria-controls=\"collapse40583\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">4. \u00bfC\u00f3mo puede saber si se ha aplicado una cantidad suficiente de activador K2?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40583\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40583\"> <div class=\"ea-body\"><p>No es necesario respetar una proporci\u00f3n de mezcla exacta. Debe aplic\u00bfC\u00f3mo puede saber si se ha aplicado una cantidad suficiente de activador K2?arse al menos dos o tres veces la cantidad de K2 en comparaci\u00f3n con la sustancia base K1 introducida anteriormente. Dado que no es posible sobredosificar el activador K2, tambi\u00e9n se puede aplicar lentamente todo el contenido de la jeringa (\u00a1sin causar turbulencias!).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40584\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40584\" aria-controls=\"collapse40584\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">5. \u00bfEs posible aplicar demasiado mediNiK\u00ae (K1 o K2)?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40584\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40584\"> <div class=\"ea-body\"><p>En cuanto a la cantidad de sustancia base K1, tiene sentido aplicar s\u00f3lo la suficiente para encerrar completamente todos los fragmentos seg\u00fan el principio de \u00abtanto como sea necesario, tan poco como sea posible\u00bb. Aproximadamente de 0,3 ml a 0,5 ml de K1 deber\u00edan ser suficientes para un c\u00e1liz, por lo que se pueden llenar varios c\u00e1lices sucesivamente antes de a\u00f1adir K2. Por otra parte, no es posible aplicar \u00abdemasiado\u00bb activador K2.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40585\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40585\" aria-controls=\"collapse40585\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">6. Tras a\u00f1adir el componente K2, no se forma hidrogel s\u00f3lido o s\u00f3lo se forma una peque\u00f1a cantidad de hidrogel. \u00bfA qu\u00e9 se debe esto?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40585\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40585\"> <div class=\"ea-body\"><p>a. No se detuvo la irrigaci\u00f3n antes de la aplicaci\u00f3n de K1, lo que dio como resultado que K1 se eliminara o se diluyera.<br \/>b. El componente K2 se aplic\u00f3 tan r\u00e1pidamente que el componente K1 fue \u00abarrastrado debido a la turbulencia resultante\u00bb.<br \/>c. El componente K2 se aplic\u00f3 demasiado cerca del componente K1,lo que provoc\u00f3 que el componente K1 se eliminara.<br \/>d. Se utiliz\u00f3 una cantidad insuficiente del componente K2, por lo que no se observ\u00f3 una coloraci\u00f3n amarilla en todo el l\u00edquido en el ri\u00f1\u00f3n.<br \/>e. Si no es la primera aplicaci\u00f3n: En caso de irrigaci\u00f3n insuficiente, los residuos del componente K2 segu\u00edan presentes en el ri\u00f1\u00f3n.<br \/>f. No se esper\u00f3 suficiente tiempo para que se forme el gel.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40586\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40586\" aria-controls=\"collapse40586\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">7. \u00bfQu\u00e9 ocurre si NO se detiene la irrigaci\u00f3n antes de la aplicaci\u00f3n de mediNiK\u00ae?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40586\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40586\"> <div class=\"ea-body\"><p>La sustancia base K1 se dispersa y se elimina o se diluye debido al flujo causado por la irrigaci\u00f3n.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40587\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40587\" aria-controls=\"collapse40587\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">8. \u00bfQu\u00e9 ocurre si no aplico un componente?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40587\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40587\"> <div class=\"ea-body\"><p>Si s\u00f3lo se aplica uno de los dos componentes, no tiene lugar la formaci\u00f3n de gel. En consecuencia, los fragmentos residuales no pueden recuperarse como se esperaba.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40588\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40588\" aria-controls=\"collapse40588\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">9. \u00bfQu\u00e9 ocurre si cambio el orden de aplicaci\u00f3n?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40588\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40588\"> <div class=\"ea-body\"><p>Si se aplica primero el activador K2, la formaci\u00f3n del gel ocurre instant\u00e1neamente al aplicar posteriormente la sustancia base K1. Por lo tanto, los fragmentos residuales s\u00f3lo pueden adherirse al hidrogel de forma insuficiente o no adherirse en absoluto .<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40589\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40589\" aria-controls=\"collapse40589\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">10. \u00bfDebo ejercer presi\u00f3n sobre las jeringas para que las componentes salgan de ellas?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40589\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-40589\"> <div class=\"ea-body\"><p>El componente K1 (sustancia base), de mayor viscosidad, requiere algo m\u00e1s de fuerza que el componente K2 (activador), especialmente si la aplicaci\u00f3n se realiza a trav\u00e9s de un cat\u00e9ter (lo que puede ser \u00fatil al usar un endoscopio reutilizable, por ejemplo). Con la aplicaci\u00f3n recomendada por nosotros directamente a trav\u00e9s del canal de trabajo, ambos componentes se pueden dosificar f\u00e1cilmente. Si no es factible aplicar los componentes K1 o K2 (a trav\u00e9s de un cat\u00e9ter), es posible que:<\/p><p>1) el cat\u00e9ter seleccionado sea demasiado fino;<br \/>2) haya una obstrucci\u00f3n en el cat\u00e9ter causada por residuos del otro componente que no se eliminaron por lavado.<br \/>3) el adaptador Tuohy Borst a la entrada del canal de trabajo est\u00e9 demasiado apretado, de modo que se reduce la secci\u00f3n transversal del cat\u00e9ter.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-405810\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse405810\" aria-controls=\"collapse405810\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">11. \u00bfEs normal que las jeringas est\u00e9n m\u00e1s duras al presionarlas por primera vez?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse405810\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-405810\"> <div class=\"ea-body\"><p>S\u00ed, primero debe liberarse el punto de presi\u00f3n t\u00e9cnica. Esto se logra presionando brevemente el v\u00e1stago del \u00e9mbolo, con lo que la tapa de cierre queda fijada en su lugar, por ejemplo, colocando la jeringa sobre una superficie firme, de manera similar a otras jeringas de FARCO-PHARMA (por ejemplo, Instillagel y Endosgel).<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-405811\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse405811\" aria-controls=\"collapse405811\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">12. \u00bfSe puede utilizar mediNiK\u00ae por segunda vez durante una operaci\u00f3n?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse405811\" data-parent=\"#sp-ea-4058\" role=\"region\" aria-labelledby=\"ea-header-405811\"> <div class=\"ea-body\"><p>S\u00ed, mediNiK\u00ae puede utilizarse incluso varias veces en un mismo paciente. Para ello, el canal de trabajo del endoscopio y el ri\u00f1\u00f3n deben enjuagarse cuidadosamente con una soluci\u00f3n salina fisiol\u00f3gica para que no queden residuos del componente K2. Los residuos de K2 provocar\u00edan la formaci\u00f3n inmediata de gel cuando se volviera a aplicar K1, sin que se puedan humedecer suficientemente los fragmentos del c\u00e1lculo.<\/p><\/div><\/div><\/div><\/div><\/div>Recuperaci\u00f3n de los fragmentos del c\u00e1lculo renal<style>#sp-ea-4059 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-4059.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-4059.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-4059.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-4059.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-4059.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-4059.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-4059\" 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-40590\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40590\" aria-controls=\"collapse40590\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">13. El agarre del hidrogel con la pinza es dif\u00edcil o provoca el desgarro del hidrogel. \u00bfA qu\u00e9 se debe esto?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse40590\" data-parent=\"#sp-ea-4059\" role=\"region\" aria-labelledby=\"ea-header-40590\"> <div class=\"ea-body\"><p>Es esencial esperar al menos 3 minutos despu\u00e9s de aplicar el K2, ya que el gel estar\u00e1 demasiado blando para agarrarlo si se espera demasiado. Asimismo, cerrar completamente la cesta de captura provoca el corte del hidrogel. El agarre del hidrogel difiere fundamentalmente del agarre convencional de los fragmentos de piedra. Para poder recuperar mayores cantidades de hidrogel (con los fragmentos residuales incluidos), \u00e9ste se coloca reblandecido. De este modo, puede adaptarse a las v\u00edas urinarias o a la vaina ureteral. Por lo tanto, la cesta de recogida s\u00f3lo debe cerrarse ligeramente. El agarre del hidrogel es un punto central de la aplicaci\u00f3n y puede practicarse muy bien de antemano en un modelo de ri\u00f1\u00f3n.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40591\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40591\" aria-controls=\"collapse40591\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">14: \u00bfPor qu\u00e9 hay que extraer el co\u00e1gulo de hidrogel \u00abcon cuidado\u00bb? \u00bfY qu\u00e9 pasa si \u00abpierdo\u00bb la mitad?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40591\" data-parent=\"#sp-ea-4059\" role=\"region\" aria-labelledby=\"ea-header-40591\"> <div class=\"ea-body\"><p>El hidrogel se ajusta a una consistencia blanda para que pueda adaptarse a las v\u00edas urinarias o a la vaina ureteral. Hay una estrechamiento.justo en la transici\u00f3n de la pelvis renal al orificio ureteral. Si se tira del hidrogel con demasiada rapidez a trav\u00e9s de este punto, la parte que sobresale de la cesta de recogida puede cortarse. Esta parte debe recuperarse en un paso posterior. Gracias a la localizaci\u00f3n directa en la pelvis renal, el agarre y la posterior recuperaci\u00f3n son f\u00e1ciles de realizar.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-40592\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse40592\" aria-controls=\"collapse40592\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">15: \u00bfQu\u00e9 ocurre si quedan residuos de mediNiK\u00ae en el ri\u00f1\u00f3n despu\u00e9s del procedimiento?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse40592\" data-parent=\"#sp-ea-4059\" role=\"region\" aria-labelledby=\"ea-header-40592\"> <div class=\"ea-body\"><p>Los residuos de mediNiK\u00ae que permanecen en el ri\u00f1\u00f3n no suponen un riesgo para el paciente. La diuresis natural invierte la formaci\u00f3n del gel. Ante todo, el gel se vuelve cada vez m\u00e1s blando hasta que vuelve a convertirse completamente en l\u00edquido y el paciente lo elimina con la orina.<\/p><\/div><\/div><\/div><\/div><\/div>Tras la aplicaci\u00f3n<style>#sp-ea-4145 .spcollapsing { height: 0; overflow: hidden; transition-property: height;transition-duration: 200ms;}#sp-ea-4145.sp-easy-accordion>.sp-ea-single {margin-bottom: 10px; border: 1px solid #e2e2e2; }#sp-ea-4145.sp-easy-accordion>.sp-ea-single>.ea-header a {color: #444;}#sp-ea-4145.sp-easy-accordion>.sp-ea-single>.sp-collapse>.ea-body {background: #ffffff; color: #444;}#sp-ea-4145.sp-easy-accordion>.sp-ea-single {background: transparent;}#sp-ea-4145.sp-easy-accordion>.sp-ea-single>.ea-header a .ea-expand-icon { float: right; color: #444;font-size: 16px;}#sp-ea-4145.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-4145\" 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-41450\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse41450\" aria-controls=\"collapse41450\" href=\"#\" aria-expanded=\"true\" tabindex=\"0\">16: \u00bfC\u00f3mo elimino el hidrogel y los residuos de la jeringa?<\/a><\/h3><div class=\"sp-collapse spcollapse collapsed show\" id=\"collapse41450\" data-parent=\"#sp-ea-4145\" role=\"region\" aria-labelledby=\"ea-header-41450\"> <div class=\"ea-body\"><p>El componente K1 y el componente K2 no suponen ning\u00fan riesgo para los seres humanos. Las jeringas pueden eliminarse de acuerdo con las normas internas de eliminaci\u00f3n del hospital del nivel de seguridad m\u00e1s bajo. Los cat\u00e9teres y el hidrogel deben eliminarse por separado debido al contacto con las membranas mucosas y\/o la orina y los fragmentos de c\u00e1lculos renales.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-41451\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse41451\" aria-controls=\"collapse41451\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">17: \u00bfPuede utilizarse mediNiK\u00ae sobrante para otra operaci\u00f3n?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse41451\" data-parent=\"#sp-ea-4145\" role=\"region\" aria-labelledby=\"ea-header-41451\"> <div class=\"ea-body\"><p>No. Se aplica el principio de que las jeringas abiertas y usadas s\u00f3lo pueden utilizarse en el mismo paciente y en el mismo quir\u00f3fano.<\/p><\/div><\/div><\/div><div class=\"ea-card sp-ea-single\"><h3 class=\"ea-header\"><a class=\"collapsed\" id=\"ea-header-41452\" role=\"button\" data-sptoggle=\"spcollapse\" data-sptarget=\"#collapse41452\" aria-controls=\"collapse41452\" href=\"#\" aria-expanded=\"false\" tabindex=\"0\">18: \u00bfC\u00f3mo puedo aislar del hidrogel los fragmentos de c\u00e1lculos recuperados para poder analizarlos?<\/a><\/h3><div class=\"sp-collapse spcollapse \" id=\"collapse41452\" data-parent=\"#sp-ea-4145\" role=\"region\" aria-labelledby=\"ea-header-41452\"> <div class=\"ea-body\"><p>En principio, hay 2 posibilidades:<br \/>1) Los c\u00e1lculos pueden extraerse mec\u00e1nicamente del hidrogel y enjuagarse con agua suficiente.<br \/>2) El hidrogel se disuelve introduci\u00e9ndolo en un agente quelante (por ejemplo, EDTA), de modo que se disponga de fragmentos aislados del c\u00e1lculo para su an\u00e1lisis.<\/p><\/div><\/div><\/div><\/div><\/div>M\u00e9todo de hidrogel en quir\u00f3fanoVIDEO \u2014 V\u00eddeo de formaci\u00f3n sobre el uso de mediNiK\u00aeVIDEO \u2014 Semi Live ICE25 Rom 2025VIDEO \u2014 Semi Live EAU London 2026PublicacionesSOBRE 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 [&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-3565","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>Especialidad m\u00e9dica - 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\/es\/especialidad-medica\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Especialidad m\u00e9dica - mediNiK\u00ae\" \/>\n<meta property=\"og:description\" content=\"Especialidad m\u00e9dica \u2014 Aplicaci\u00f3n y publicaciones.Pasos de aplicaci\u00f3n de mediNiK\u00aeNota Todos los incidentes graves relacionados con el producto deber\u00e1n comunicarse al fabricante y a la autoridad competente del Estado miembro donde se encuentre el usuario y\/o paciente (vigilanz@purenum.com).Preguntas frecuentes sobre el uso de mediNiK\u00aeRecuperaci\u00f3n de los fragmentos del c\u00e1lculo renalTras la aplicaci\u00f3nM\u00e9todo de hidrogel en quir\u00f3fanoVIDEO \u2014 V\u00eddeo de formaci\u00f3n sobre el uso de mediNiK\u00aeVIDEO \u2014 Semi Live ICE25 Rom 2025VIDEO \u2014 Semi Live EAU London 2026PublicacionesSOBRE 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 [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.medinik.de\/es\/especialidad-medica\/\" \/>\n<meta property=\"og:site_name\" content=\"mediNiK\u00ae\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-01T10:16:54+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data1\" content=\"32 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/especialidad-medica\\\/\",\"url\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/especialidad-medica\\\/\",\"name\":\"Especialidad m\u00e9dica - mediNiK\u00ae\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/especialidad-medica\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/especialidad-medica\\\/#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\":\"2026-04-01T10:16:54+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/especialidad-medica\\\/#breadcrumb\"},\"inLanguage\":\"es\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.medinik.de\\\/es\\\/especialidad-medica\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/especialidad-medica\\\/#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\\\/es\\\/especialidad-medica\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Startseite\",\"item\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Especialidad m\u00e9dica\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/#website\",\"url\":\"https:\\\/\\\/www.medinik.de\\\/es\\\/\",\"name\":\"mediNiK\u00ae\",\"description\":\"Der neue Standard. 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