Urolithiasis

Jamsheer J. Talati • Hans-Göran Tiselius David M. Albala • Zhangqun Ye Editors

Farhat Abbas • M. Hammad AtherSyed Raziuddin Biyabani • Mahesh DesaiTyler Luthringer • Amanullah MemonKemal Sarica • Ahmed A. ShokeirKhurram M. SiddiquiAssociate Editors

Urolithiasis

Basic Science and Clinical Practice

ISBN 978-1-4471-4383-3 ISBN 978-1-4471-4387-1 (eBook) DOI 10.1007/978-1-4471-4387-1 Springer London Heidelberg New York Dordrecht

Library of Congress Control Number: 2012954241

© Springer-Verlag London 2012 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied speci fi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.

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Editors Jamsheer J. Talati, MBBS, FRCS Professor EmeritusAga Khan UniversityDepartment of Surgery Section of Urology Karachi , Pakistan

David M. Albala, MD Associated Medical Professionals Syracuse New York , USA

Hans-Göran Tiselius, MD, PhD Professor EmeritusDivision of UrologyDepartment of Clinical ScienceIntervention and Technology Karolinska Institutet Stockholm , Sweden

Zhangqun Ye, MD, PhD Urology Division Tongji HospitalTongji Medical College, Shanghai, China. Huazhong University of Science and Technology Wuhan, Hubei, China

This book is dedicated to our wives and families to whom we are indebted for their understanding during the preparation of the book…

And to the urological residents, young consultants, faculty, and stone patients of our entire, rapidly evolving world.

Jamsheer Jehangir Talati Hans-Göran Tiselius

David Mois Albala Zhangqun Ye

vii

Foreword

The World Health Report of 2010, the biennial fl agship publication of the World Health Organization, was devoted to the link between the way health systems are fi nanced and their ability to move closer to the goal of universal coverage [1]. Universal coverage requires all people to have access to quality health services (prevention, promotion, treatment and rehabili-tation) when they need them without the risk of incurring severe fi nancial problems linked to paying for care [2, 3]. It is an ambitious goal.

Three inter-related actions to help countries move closer to this goal can be taken in the area of health fi nancing. Countries could raise additional funds for health. They could reduce fi nancial barriers to accessing health services associated with direct out of pocket payments such as user-fees through forms of prepayment with subsequent pooling of resources to spread the fi nancial risks of ill health. They could use the resources they raise as ef fi ciently and equi-tably as possible. Many countries, rich and poor, have taken steps in one or more of these areas and the World Health Report showed that all countries could take steps to move more rapidly towards the goal of universal coverage.

Clearly the pace at which they can do this varies by country and the resource constraints are particularly severe in low-income countries where the health needs are greatest. Recent work suggests that the low income countries would need immediately an average of US $44 per capita to spend on health, rising to just over $60 in 2015, to have any chance of reaching the health millennium development goals by 2015 [4]. Only $35 is available from domestic and donor funding combined despite a rapid scale up in external assistance for health since the Millennium Declaration was signed in 2000 [5, 6].

These estimates were made based on the costs of ensuring access to a limited range of health services aimed largely at communicable diseases and child and maternal health. Little attention was paid to non-communicable diseases, yet the goal of achieving universal coverage must extend to non-communicable diseases as well. This is increasingly important now that the problems associated with an aging population, the epidemiological transition and chronic diseases are increasing to the extent that the burden of disease associated with them outweighs that of non-communicable diseases even in the low-income countries [7, 8]. The goal of uni-versal coverage must extend to preventing and treating stone disease.

More money for health in poorer countries is critical to achieving this goal, and the gaps between the fi nancial needs and their domestic capacities to raise funds, even with reasonable levels of economic growth, remain large. Although most low-income countries could take steps to increase the availability of their own domestic resources for health, increased external donor support remains critical, something that may be dif fi cult to maintain in the current eco-nomic climate of rich countries trying to reduce their budget de fi cits and their own levels of indebtedness.

More money, however, will not be suf fi cient by itself. Many countries also need to reduce the fi nancial barriers facing patients when they contemplate seeking and then continuing care it. For example, almost a third of the countries in sub-Saharan Africa raise more than 50 % of their total health resources through direct charges levied on patients at the time they seek care. In India, it is more than 60 % [5]. These direct payments not only ensure that millions of

viii Foreword

people are not treated, including for stone disease, but they also ensure that millions of those that are treated suffer severe fi nancial problems simply because they became ill and needed to pay for care [9]. Each year, approximately 100 million people are pushed under the poverty line in this way [10].

This can be addressed only by reducing reliance on direct payments levied at the time people obtain care by moving to forms of prepayment and pooling. Various forms of insurance and tax-based funding are the solution and they are being implemented even in lower income countries in the search to reduce the fi nancial barriers to care.

Health fi nancing systems are fundamental to attaining universal coverage, helping to ensure that all people who suffer from stone disease can be identi fi ed and treated, and ensuring that appropriate prevention is in place. On the other hand, if there are no health workers with the appropriate training, or no medicines, or no equipment for diagnosis, for example, universal coverage is not possible. That is why this book is so vital. It is about the science of stone dis-ease. It describes the epidemiology, showing how the prevalence, incidence and severity differ substantially across the different parts of the world necessitating different approaches to case fi nding and treatment.

It describes the causes and natural history of the disease, and then the latest developments in diagnosis, treatment and rehabilitation. As such it is also a practical guide for urologists treating the disease as well as trying to prevent recurrence and limit the impact of illness on the subsequent lives of patients. It helps us to understand what can be done to prevent the disease in the fi rst place.

It also places the science in the context of society and resource constraints. At times it takes the perspective of the health professional, re fl ecting on how to understand the patient’s needs and expectations, and how to practice ethical medicine when the patient or country might not be able to afford the optimal treatment. The clinician’s task is to provide exemplary care to as large a population as possible. If the treatment is too expensive, they have to fi nd alternatives. These hard choices can be made only if the urologist is knowledgeable, technically competent, and professional. The book provides a basis for helping clinicians make rational choices in the deployment of technology, including those which are expensive. There are also chapters taking the broader planning or social perspective on how to best fi nance and manage equipment, including how to reduce costs by sharing equipment.

The information provided in this book will interest researchers seeking to understand dis-ease patterns or the way new technologies relating are developed and disseminated. It will be vital to health professionals seeking to prevent or treat the disease. And it will be important to health planners in their deliberations about how to reduce the burden of stone disease for the resources that are available. All these perspectives are important in their own way, but it is only through the combination of these perspectives that it will be possible to move more rapidly to, and eventually attain, universal coverage everywhere.

Geneva, Switzerland David B. EvansDirector

Department of Health Systems Financing (HSF) World Health Organization

Bibliography

1. World Health Organization. WHO|The world health report – health systems fi nancing: the path to universal coverage. 2010. Retrieved from http://www.who.int/whr/2010/en/index.html .

2. World Health Organization. WHA resolution 58.33: sustainable health fi nancing, universal coverage and social health insurance. Fifty-Seventh World Health Assembly. Geneva: World Health Organization; 2005. Retrieved from http://apps.who.int/gb/ebwha/pdf_ fi les/WHA58/WHA58_33-en.pdf .

ixForeword

3. Carrin G, Mathauer I, Evans DB. Universal coverage of health services: tailoring its implementation. Bull World Health Organ. 2008;86(11):857–63.

4. World Health Organization. Constraints to scaling up the health millennium development goals: costing and fi nancial gap analysis. Background document for the taskforce on innovative international fi nancing for health systems, working group 1: constraints to scaling up and costs. 2009. Retrieved from http://www.who.int/choice/publications/d_ScalingUp_MDGs_WHO_ fi nalreport.pdf .

5. World Health Organization. WHO|National Health Accounts. WHO. 2009. Retrieved 1 Nov 2011 from http://www.who.int/nha/en/ .

6. Ravishankar N, Gubbins P, Cooley RJ, Leach-Kemon K, Michaud CM, Jamison DT, Murray CJ. Financing of global health: tracking development assistance for health from 1990 to 2007. Lancet. 2009;373:2113–24. doi: 10.1016/S0140-6736(09)60881-3 .

7. Boutayeb A, Boutayeb S. The burden of non-communicable diseases in developing countries. Int J Equity Health. 2005;4(1):2.

8. World Health Organization. WHO|The global burden of disease: 2004 update. Geneva: World Health Organization; 2008. Retrieved from http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/ .

9. Wagstaff A. The economic consequences of health shocks: evidence from Vietnam. J Health Econ. 2007;26(1):82–100. doi: 10.1016/j.jhealeco.2006.07.001 .

10. Xu K, Evans DB, Carrin G, Aguilar-Rivera AM, Musgrove P, Evans T. Protecting households from cata-strophic health spending. Health Affairs. 2007;26(4):972–83. doi: 10.1377/hlthaff.26.4.972 .

xi

Preface

Why did four urologists from America, Europe, China, and South Asia get together to edit yet another book on stone disease?

The story winds back to 1997, when one of the current editors, Jamsheer Talati, published jointly, with Roger A. L. Sutton, Farhat Moazzam, and Mushtaq Ahmed, a volume on uro-lithiasis. This was intended to capture and examine the new developments (of ESWL, laser lithotripsy, minimally invasive operative surgery to name a few) of the preceding two decades, and portray the management of vesical and upper urinary tract calculi. Methodologies were examined for their ef fi cacy and cost effectiveness.

In the foreword to that book, Professor J. E. A. Wickham hoped for a world where techno-logical advancements would be available to all… He wrote:

Endoscopic stone removal and ESWL have more than justi fi ed their place in the surgical armamentar-ium on the grounds of outstanding ef fi ciency and cost effectiveness as compared with previous methods of open surgery. Such effective new technology, saving as it does much expense, must surely be the way forward for any society, particularly where resources are radically cost contained and dif fi cult to access for the poorer members of the community. Hopefully in the next twenty years economies will have improved so that a full range of interventional therapy for urolithiasis will become available to all popu-lations in all parts of the world.

Fifteen years have passed and that vision has not materialized. Why? One would expect that as treatment methods have become “easy” on the patient, and the

technology has facilitated the surgeon, our hopes would have been achieved. On the contrary: Urinary stones are still found untreated in all corners of the globe; and the numbers are grow-ing, for various reasons. There is a greater consciousness in the lay public, easier access to services…. But there are also possibly preventable recurrences; and the populations to be served are growing so rapidly. What we see as a result is that though larger segments of popula-tion can access sophisticated care, the proportion accessing anything other than open operation in poorer countries yet remains small. Silent stones destroy the kidney. Ignorance of the true prevalence and incidence thwarts planning efforts.

As the disease is seen across the world, we crafted this book with a host of exceptional spe-cialists in each topic, in order to create a consilience of known facts in all fi elds—epidemiology, basic science, technology, management, prevention, education, ethics, fund raising. The book additionally whispers the need to study geological formations and soils, and to look beyond the urological, deep into society. The book combines all of that with a stimulation of new thinking on the management of this problem, and the need for innovation, stemming from the dif fi culties of addressing the stone problem effectively in so many parts of the world.

We hope that this book, in addition to assisting urologists in management of stone patients, will stimulate search for answers to critical questions: Are there any simple measures that will eliminate or reduce stone: Will diet and increased water intake vanquish the concreting enemy? What really is the cause of stone? And what is the meaning of the differences in distribution and composition of stones across the world?

xii Preface

To hit hard and eliminate stone disease from all parts of the world is going to be dif fi cult. It will require that the treating physician not only manage the disease effectively but that she or he (i) be cognizant of all the information available and be able to connect all of that in a way that becomes knowledge useful for asking and answering questions on prevention and treat-ment; and (ii) be creative, and willing to explore the available epidemiological base and the basic science of stone formation to see if there is a new approach to management or a different opportunity for research.

To spread treatment across all parts of the globe, to more than two billion people in India and China alone, is a daunting task. How will we tackle seven billion? But with the entire world looking anew at its fi nancial models of resourcing and spending, it is apt that this book help the readers to try and attempt to fi nd a rational solution for each patient given the resources available; and to fi nd the required resources when they are not easily visible.

How does one teach innovation? And how can one turn a tool into a piece of equipment that can be patented and sold? How does one get expensive equipment when one does not have money? Money is available; there are enough philanthropists to go all around. To engage their attention, trust and con fi dence have to be built, through exhibition of excellence in manage-ment and superlative results. That takes us back to training: It is vital that we train the next generations in concepts and techniques, and then tickle their ability to think through problems. To do so, one needs, once again, information and knowledge.

For governments too it is important that the individual executing stone management be competent and practice accepted, guideline-approved strategies, introduction ever-rising stan-dards that cannot be challenged. Hence the need for consilience and the need to learn from all corners of the world.

What is needed at the end is Equity. This can be achieved through Excellence, Effectiveness, Ef fi ciency, Innovation, Subspecialization, Evidence-based practice, and training that is certi fi ed through high-stakes assessment of superlative standards.

Today , the competent lithotomist needs to be more than a cutting edge endoscopist . Every one—patient, government, administrator, and society—demands competence.

Competence is based on professionalism, knowledge and skill. But a physician’s responsibility goes beyond that—to see that she or he eliminates the very disease that provides their bread.

Above all therefore it is hoped that this book will stimulate and instigate many urologists to take on the challenge of searching society and their environments for a path leading to the demise of stone disease.

The book attempts to address a major sector of a wide-open plateau of action that the uro-logical trainee and the practicing urologist will need to continue to survey throughout their life. Above all, the book intends to assist the development of a complete Urologist who has many skills in addition to the technical.

Karachi, Pakistan Jamsheer Talati Stockholm, Sweden Hans-Göran Tiselius Syracuse, NY, USA David Albala Wuhan, Hubei, China Zhangqun Ye

xiii

Acknowledgements

The Editors are especially grateful to all contributing authors who have dedicated time and effort despite their busy schedules. For a work of this complexity, the wealth of ideas, guid-ance, support, critique, and review that we received from our Associate Editors Ahmed Shokeir from Egypt, Kemal Sarica from Turkey, Mahesh Desai from India, Tyler Luthringer from USA, and Farhat Abbas, Hammad Ather, Syed Raziuddin Biyabani, Amanullah Memon, and Khurram Siddiqui, from Pakistan, has been most invaluable.

We are indebted to Ms. Maureen Pierce, whose patience and special expertise as develop-mental editor provided us continued and intense support in preparation of the manuscript, and in editing, advising, and bringing uniformity to language, text and formats; and to Ms. Diane Lamsback for additional support. The editorial team is also grateful to the larger team from Springer-Verlag—to Nadine Firth and Sarah Cody; to Vinitha Vipin and Stephen Muthu Raj JoeArun; and very specially to Ms. Melissa Morton whose sage advice and suggestions at the very earliest stages of formalization of the ideas for the book gave us courage to build on our earlier thoughts, and helped us develop our Editorial Team.

Our very special thanks are due to the subject expert external reviewers Danette McKinley, John Norcini, Roger A. L. Sutton, Tahira Naru, Zafar Sajjad, Razi Naqvi, and Hussein Sheashaa. Our special thanks also go to James E. Lingeman and Glen Preminger for their support and assistance.

Our thanks are due to the backbone team at the Aga Khan University, where Sean Victor superbly managed the correspondence and the dif fi cult tasks of tracking, computing, correct-ing, and communicating; Ms. Ashraf Fidai, for the secretarial tasks, Murad Bana for manage-ment issues, Aadil Inayat Ali and Aziz Hyder for IT-related and computer support, and Ajmal Rizvi for the graphics and visuals; and to the Aga Khan University (AKU) and Farhat Abbas, Dean AKU, for providing the resources, human capital and time required to make this book possible.

We are grateful to the various publishers who have given permission to use matter published in their journals and books.

Karachi, Pakistan Jamsheer Jehangir Talati Stockholm, Sweden Hans-Göran Tiselius Syracuse, NY, USA David Mois Albala Wuhan, Hubei, China Zhangqun Ye

xv

Contents

Part I Epidemiology

1 Epidemiology of Kidney Stones in the European Union . . . . . . . . . . . . . . . . . . 3Palle J.S. Osther

2 Epidemiology of Stone Disease in North America . . . . . . . . . . . . . . . . . . . . . . . 13John D. Denstedt and Andrew Fuller

3 Epidemiology of Stone Disease in Pakistan . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Amanullah Memon, Khursheed Anwar, Nasir Orakzai, M. Hammad Ather, Syed Raziuddin Biyabani, Abdul Razzaq Nasir, Jai Pal Paryani, Farooq Ghani, Khurram Mutahir Siddiqui, Farhat Abbas, Kashif Bangash, Liaqat Ali, Wajahat Aziz, and Jamsheer J. Talati

4 Epidemiology of Stone Disease in Northern India . . . . . . . . . . . . . . . . . . . . . . . 39Raguram Ganesamoni and Shrawan K. Singh

5 Epidemiology of Stone Disease in Kerala, South India . . . . . . . . . . . . . . . . . . . 47Y.M. Fazil Marickar

6 Epidemiology of Stone Disease in China . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53Deyi Luo, Hong Li, and Kunjie Wang

7 Epidemiology of Stone Disease in South America . . . . . . . . . . . . . . . . . . . . . . . 61Fernando Korkes, Nestor Schor, and Ita Pfeferman Heilberg

8 Epidemiology: South Africa and Sub-Saharan Africa . . . . . . . . . . . . . . . . . . . 67Allen Rodgers

9 Epidemiology of Stone Disease in Australia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73Ming-Chak Lee and Simon Virgil Bariol

10 Epidemiology of Stone Disease in Saudi Arabia with an Overview of the Regional Differences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77Salah R. El-Faqih

11 Epidemiology of Stone Disease in Iran . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85Gholamreza Pourmand and Bita Pourmand

12 Epidemiology of Stone Disease Over a 40-Year Period in Japan . . . . . . . . . . . 89Yoshihide Ogawa

13 Epidemiology of Stone Disease in the Russian Federation and Post-Soviet Era . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Andrei Novikov, Tair Nazarov, and Vladimir Yu. Startsev

14 Renal Stone Disease in Different Racial Groups . . . . . . . . . . . . . . . . . . . . . . . . 107Jamsheer J. Talati, Naveed Haroon, and Alberto Trinchieri

xvi Contents

Part II Etiology

15 Stone Composition and Morphology: A Window on Etiology . . . . . . . . . . . . . 113Michel Daudon and Paul Jungers

16 The Genetics of Kidney Stones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141Pietro Manuel Ferraro and Giovanni Gambaro

17 Familial Clustering of Stone Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151Jamsheer Jehangir Talati, Naveed Haroon, and Alberto Trinchieri

18 Uric Acid Nephrolithiasis: Basic and Clinical Aspects . . . . . . . . . . . . . . . . . . . 155Khashayar Sakhaee

19 Oxalate and Urolithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165Ben H. Chew, Dirk Lange, and Roger A.L. Sutton

20 Anti-inflammatory Proteins in Kidney Stone Matrix . . . . . . . . . . . . . . . . . . . . 177Anwar Ali Siddiqui and Shamim Mushtaq

21 Physiology of Renal Handling of Citrate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183Samra Bashir, Naveed Ahmed Khan, and Anwarul-Hassan Gilani

22 Urinary Citrate and Stone Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187Charles Y.C. Pak

23 Renal Tubular Acidosis and Stone Formation . . . . . . . . . . . . . . . . . . . . . . . . . . 195Somnuek Domrongkitchaiporn and Wasana Stitchantrakul

24 Nephrolithiasis and Its Interrelationship with Vitamin D, Parathyroid Hormone, and Calcium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199Aysha Habib Khan

25 Current Understanding of the Role of Randall’s Plaque . . . . . . . . . . . . . . . . . 209Jessica A. Mandeville, Ehud Gnessin, and James E. Lingeman

26 Melamine-Associated Urinary Stone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219Yao Liang Deng and Cheng Yang Li

27 Trace Elements in Urolithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227Albrecht Hesse and Roswitha Siener

28 Infection Stones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231Janet Colli and Raju Thomas

29 Epidemiological and Etiological Considerations . . . . . . . . . . . . . . . . . . . . . . . . 237Hans-Göran Tiselius

Part III Diagnosis

30 Diagnosis of Urinary Tract Stones: An Overview . . . . . . . . . . . . . . . . . . . . . . . 243Ahmed S. El-Hefnawy and Ahmed A. Shokeir

31 Diagnosis and Differential Diagnosis of Urinary Tract Stone Disease in Emergency Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251Luo Yang, Hong Li, and Kunjie Wang

32 The Utilization of Ultrasound in the Diagnosis of Urolithiasis . . . . . . . . . . . . . 255James H. Masterson, Alyson Brinker, Nathan Hawkes, Lee D. Hall, Danielle A. Taysom, Brian K. Auge, and James O. L’Esperance

xviiContents

33 The Role of Radiological Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265Zafar Sajjad

34 Radiation Exposure in Uroradiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271Maseeh uz Zaman

35 The Use of Low-Dose CT Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277Sean A. Pierre

36 The Physics of Ultrasound and X-Rays: A Primer for Urologists . . . . . . . . . . 283K. Razi Naqvi

Part IV Technology and Innovation

37 The Stone Surgeon/Lithotomists’ Armamentarium: Today and Tomorrow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293Carl Sarkissian and Manoj Monga

38 Physics and Technique of Shock Wave Lithotripsy (SWL) . . . . . . . . . . . . . . . . 301Othmar J. Wess

39 Laser Lithotripsy Physics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313Joel M.H. Teichman, Jinze Qiu, Wook Kang, Kin Foong Chan, and Thomas E. Milner

40 Bioeffects of Shock Wave Lithotripsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327Ehud Gnessin and James E. Lingeman

41 History and Development of the Ureteroscope: What Does the Future Hold? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333Demetrius H. Bagley and Kelly A. Healy

42 The Operating Room Technicians’ and Nurses’ Roles in Urologic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343Mohammad Iqbal and Khurram Mutahir Siddiqui

43 Innovation in Stone Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347Brian H. Eisner and Stephen P. Dretler

Part V Management Strategies

44 The Management of a Patient with an Acute Stone Problem . . . . . . . . . . . . . . 353Ahmed S. El-Hefnawy, Ahmed Abed, and Ahmed A. Shokeir

45 Open Surgery: Current Status and Techniques . . . . . . . . . . . . . . . . . . . . . . . . . 363Nagaraja P. Rao

46 Shock Wave Lithotripsy: Present Indications and Future Prospects . . . . . . . . 375Michael E. Lipkin and Glenn M. Preminger

47 What You Should Know About Extracorporeal Shock Wave Lithotripsy and How You Can Improve Your Performance . . . . . . . . . . 383Christian G. Chaussy and Hans-Göran Tiselius

48 Examples of Clinical Problems that Might Be Encountered in Patients Treated with Extracorporeal Shock Wave Lithotripsy . . . . . . . . . 395Hans-Göran Tiselius and Christian G. Chaussy

49 SWL of Renal and Ureteral Stones: The Chinese Experience . . . . . . . . . . . . . 401Xizhao Sun, Xiaoming Cong, and Luming Shen

xviii Contents

50 Retrograde Intrarenal Surgery (RIRS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411Andreas J. Gross and Christopher Netsch

51 Percutaneous Nephrolithotomy (PCNL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417Mahesh R. Desai and Arvind P. Ganpule

52 Tubeless Percutaneous Nephrolithotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427Chong H. Choe, James O. L’Esperance, Suzanne R. Gudeman, and Brian K. Auge

53 Minimally Invasive Percutaneous Nephrolithotomy: The Chinese Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433Guohua Zeng, Wen Zhong, and Zhaohui He

54 Percutaneous Nephrostomy, Antegrade Stent Placement, and Radiological Control of Post-PCNL Bleeding . . . . . . . . . . . . . . . . . . . . . . . 439Tanveer ul Haq and Basit Salam

55 Management Strategies for Staghorn Stones . . . . . . . . . . . . . . . . . . . . . . . . . . . 445Markus Margreiter and Michael Marberger

56 Ureteral Stone Management: An Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . 455Sutchin R. Patel and Stephen Y. Nakada

57 Ureteroscopy for Ureteric Stones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 463Gerhard J. Fuchs and Steven G. Koopman

58 Tricks for Successful Ureteroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473Zhong Wu and Chen-Chen Feng

59 Lasers in Stone Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481Anne Sophie Knipper and Andreas J. Gross

60 Ureteric Stents: Their Use and Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 487Stuart J. Graham and Simon Choong

61 Ureteric Stenting: Tips and Tricks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503Syed Muhammad Nazim, Ali Akbar Zehri, and Khurram Mutahir Siddiqui

62 Transperitoneal Laparoscopic and Retroperitoneoscopic Stone Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509Marcel Hruza and Jens J. Rassweiler

63 Role of Robotic-Assisted Surgery in the Management of Urolithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 515Tyler Luthringer, Khurram Mutahir Siddiqui, and David Mois Albala

64 Management of Urinary Bladder Calculi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 519Jai Pal Paryani and Syed Raziuddin Biyabani

65 Current Status of Medical Expulsion Therapy for Urinary Calculi . . . . . . . . 527Zhangqun Ye and Huan Yang

66 Dissolution of Stones by Oral and Irrigative Therapy . . . . . . . . . . . . . . . . . . . 533Ruslan Korets, Joseph A. Graversen, and Mantu Gupta

67 Traditional Chinese Medicine for Treatment of Urinary Stones . . . . . . . . . . . 539Xiao He

68 Patient Safety and the Importance of Informed Consent . . . . . . . . . . . . . . . . . 543Robyna Irshad Khan

xixContents

69 Anesthesia and Pain Relief for Procedures Performed to Manage Urolithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 547Gauhar Afshan and Aliya Ahmed

Part VI Management of Stones Under Special Circumstances

70 Shock Wave Lithotripsy, Endourological Intervention, and Hemostatic Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 557Bushra Moiz and Syed Raziuddin Biyabani

71 Cardiac Rhythm Management Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563Azam Shafquat

72 Stone Disease in Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 567Ahmed Mohamed Elshal and Ahmed A. Shokeir

73 Minimally Invasive Treatment of Calculi in Renal Anomalies . . . . . . . . . . . . . 575Ahmed R. El-Nahas and Ahmed A. Shokeir

74 Kidney Stones and Chronic Kidney Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . 587Absar Ali, Quratulain Khan, and Tazeen H. Jafar

75 Calculus Renal Failure in Pakistan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 595Saiyid Jaffar Ali Naqvi

76 Urolithiasis in Renal Transplant Donors and Recipients . . . . . . . . . . . . . . . . . 601Ahmed M. Harraz and Ahmed A. Shokeir

77 Primary Hyperoxaluria: The Role and Timing of Liver and Kidney Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611Harshal Rajekar and Shrawan K. Singh

Part VII Pediatric Urolithiasis

78 Metabolic Stone Disease in Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 621Kemal Sarica

79 Pediatric Urinary Stone Disease in China . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 631Gang Wang

80 Patient Evaluation and Comparison of Stone-Removing Strategies in Pediatric Patients with Urinary Tract Stones . . . . . . . . . . . . . . . 639Temuçin Şenkul

81 Pediatric Vesicle Stone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 647M.S. Ansari, Jatinder Kumar, and Priyadarshi Ranjan

82 Shock Wave Lithotripsy for Renal Stone in Children . . . . . . . . . . . . . . . . . . . . 655M. Hammad Ather

83 Endourological Approaches to Renal and Ureteric Calculi in Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 659Zafar Zaidi and Zaheer Alam

Part VIII Prevention of Recurrence

84 Biochemical Risk Evaluation in Patients with Urolithiasis . . . . . . . . . . . . . . . . 671Hans-Göran Tiselius

xx Contents

85 Application of Physical Methods to Kidney Stones and Randall’s Plaque Characterization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 683Michel Daudon and Dominique Bazin

86 General and Specific Dietary Advice for the Prevention of Stone Recurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 709William G. Robertson

87 Overview of Stone Prevention Strategies in China . . . . . . . . . . . . . . . . . . . . . . 721Zhiqiang Chen

88 Management of Hypercalciuria and Oxalates in the Prevention of Stone Recurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 727John R. Asplin

89 Citrate Therapy for Calcium and Uric Acid Stones . . . . . . . . . . . . . . . . . . . . . 735Ephrem O. Olweny and Margaret S. Pearle

90 The Importance of Water and Other Fluids in the Prevention of Stone Recurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 745Tiziana Meschi, Antonio Nouvenne, and Loris Borghi

91 Orthophosphates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 751Renata Caudarella

92 Management of Cystinuria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 757Jan Peter Jessen and Thomas Knoll

93 The Detection and Management of Primary Hyperparathyroidism in Patients with Urolithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 767Mumtaz Jamshed Khan, Syed Raziuddin Biyabani, Nuzhat Faruqui, and Jamsheer Jehangir Talati

94 Normocalcemic Hyperparathyroidism: An Illustrative Case Scenario. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 785Johar Raza, Jamsheer J. Talati, and Nasir Ud Din Yashkun

95 How to Perform a Successful Exploration of the Neck for Primary Hyperparathyroidism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 791William R. Lynn and John A. Lynn

Part IX Education, Training, Assessment, and Development

96 Professional Development and Competence of Physicians . . . . . . . . . . . . . . . . 803Camer W. Vellani

97 Assessment in Postgraduate Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 807Zareen Zaidi and John Norcini

98 Assessment of Competence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 819Edward Matsumoto and Jen Hoogenes

99 Modern Concepts on Cognito-Psychomotor Skill Development . . . . . . . . . . . 827Rebecca L. Tregunna, Matthew F. Bultitude, and Muhammad Shamim Khan

100 Integration of Competences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 837Munir Ahmed

101 Education and Training of an Academic Urologic Surgeon . . . . . . . . . . . . . . . 841Farhat Abbas and Michael Coburn

xxiContents

102 Advanced Training of a Practicing Urologist in Stone Disease Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 855Tamer El-Husseiny and Noor N.P. Buchholz

103 Across Semantic Turfs: The Need for Broader Education . . . . . . . . . . . . . . . . 863Syed Nomanul Haq

104 Stimulating Research and Innovation in Residents . . . . . . . . . . . . . . . . . . . . . . 869Scott Leslie and Mihir Desai

Part X Equitable Management of Stone Disease

105 Bringing Sophisticated High-Technology Surgical Care to the Rural Masses: What Is India Doing? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 875Tehemton E. Udwadia

106 Bringing Highly Technological Urolithiasis Care to a Billion People: What Is China Doing? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 881Guo-Min Wang and Jian-Ming Guo

107 Lithotripter Sharing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 885André van der Merwe, Nicole Ebinger Mundorff, and Rian Nieuwoudt

108 Choosing and Purchasing Expensive Medical Equipment: A Hospital Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 891Nadeem Kamal Mustafa Khan and Farhan Bhayani

109 Comparative Costs of Various Treatment Strategies and Preventive Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 897Roswitha Siener and Albrecht Hesse

110 Financial Options for Purchase, Lease, and Hire of Lithotripters . . . . . . . . . . 903Faridun K. Dadachanji

111 The Engagement of Philanthropy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 907Shamsh Kassim-Lakha

112 The Impact on Health Care of the Recent Global Epidemiological Trends in Urolithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915Alberto Trinchieri

113 Societal Changes and the Etiology of Stone Disease . . . . . . . . . . . . . . . . . . . . . 921Dorit E. Zilberman, Tyler Luthringer, Daniel Young, and David M. Albala

Part XI Case Scenarios

114 Case Scenarios and Interesting Images in Urolithiasis . . . . . . . . . . . . . . . . . . . 931M. Hammad Ather, Zafar Sajjad, Basit Salam, and M. Nasir Sulaiman

Epilogue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 959

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 961

xxiii

Contributors

Farhat Abbas , M.B.B.S., FCPS, FRCS, FRCSEd, FEBU, FACS Department of Surgery , Medical College, Aga Khan University , Karachi, Sindh , Pakistan

Ahmed Abed , M.D., M.S. Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt

Gauhar Afshan , FCPS (Pakistan) Department of Anaesthesia , Aga Khan University , Karachi, Sindh , Pakistan

Aliya Ahmed, FFARCS (Ireland) Department of Anaesthesia , Aga Khan University , Karachi, Sindh , Pakistan

Munir Ahmed , M.Sc. (Med Ed. Cardiff), MAcaMed, FRCS, FRCS (Urol) Department of Urology , Kings College of Medicine, University of London , Bromley, Kent , UK

Zaheer Alam , M.B.B.S., MCPS, FCPS Urology Department of Urology, The Indus Hospital , Karachi , Pakistan

David Mois Albala , M.D. Division of Urology, Associated Medical Professionals , Syracuse , NY , USA

Absar Ali, M.D., FACP Department of Medicine , Aga Khan University , Karachi, Sindh , Pakistan

Liaqat Ali , M.B.B.S., FCPS (Urology) Department of Urology , Institute of Kidney Diseases , Peshawar, Khyber PukhtoonKhaw , Pakistan

M. S. Ansari , M.S., MNAMS, MCh, Diplomat National Board Department of Urology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , Uttar Pradesh , India

Khursheed Anwar , M.B.B.S., FRCS, Dip (Urol) Department of Urology , PAEC General Hospital , Islamabad , Pakistan

John R. Asplin , M.D., FASN Department of Medicine , University of Chicago , Litholink Corporation , Chicago , IL , USA

M. Hammad Ather , M.B.B.S., FCPS (Urol), FEBU Department of Surgery, Division of Urology , Aga Khan University , Karachi, Sindh , Pakistan

Brian K. Auge , M.D. Mountain States Urology, St. Luke’s Health System , Boise , ID , USA

Wajahat Aziz , M.B.B.S. Department of Urology , Aga Khan University , Karachi , Pakistan

Demetrius H. Bagley , M.D., FACS Department of Urology , Jefferson Medical College, Thomas Jefferson University , Philadelphia , PA , USA

Kashif Bangash , M.B.B.S., FCPS (I) Department of Urology , PAEC General Hospital , Islamabad , Pakistan

xxiv Contributors

Simon Virgil Bariol , M.B.B.S., B.Sc., (Med) FRACS Department of Urology , Westmead Hospital , Westmead , NSW , Australia

Samra Bashir , Ph.D. Department of Biological and Biomedical Sciences , Aga Khan University , Karachi, Sindh , Pakistan

Dominique C. Bazin , Ph.D. Laboratoire de Physique des Solides UMR 8502 , Université Paris Sud , Orsay Cedex , France

Farhan Bhayani , B.E. (Mech), MBA, CPM Division of Materials Management , Aga Khan University , Karachi, Sindh , Pakistan

Syed Raziuddin Biyabani , M.B.B.S., FCPS (Urol), FEBU Section of Urology, Department of Surgery , The Aga Khan University , Karachi, Sindh , Pakistan

Loris Borghi , M.D. Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy

Alyson Brinker , B.S. Department of Internal Medicine, Uniformed Services University of the Health Sciences , Bethesda , MD , USA

Noor N. P. Buchholz , M.B.B.S. (D), M.D. (CH), FSSU (CH), FKNMG (NL) Department of Endourology and Stone services, Barts and The London School of Medicine and Dentistry, Barts and the London NHS Trust , West Smith fi eld, London , UK

Matthew F. Bultitude , M.B.B.S., MRCS, M.Sc., FRCS (Urol) Department of Urology , Guy’s and St. Thomas’ NHS Foundation Trust , London , UK

Renata Caudarella , M.D. Department of Mineral Metabolism, Fondazione Ettore Sansavini per la Ricerca Scienti fi ca (Health Science Foundation) ONLUS , Lugo, Ravenna , Italy

Kin Foong Chan , Ph.D. VP Engineering , Dermira Inc, Redwood City , CA , USA

Christian G. Chaussy , M.D. Department of Urology, Caritas Medical Center St. Josef, University of Regensburg , Regensburg, Oberpfalz , Germany

Zhiqiang Chen , M.D., Ph.D. Department of Urology , Tongji Hospital, Huazhong University of Science and Technology , Wuhan, Hubei , People’s Republic of China

Ben H. Chew , M.D., M.Sc., FRCSC Department of Urology, University of British Columbia , Vancouver , BC , Canada

Chong H. Choe , M.D. Department of Urology , Naval Medical Center , San Diego , CA , USA

Simon Choong , M.B.B.S. (Lon), FRCS (Eng), FRCSEd, MS, FRCS (Urol) The Stone Unit , University College London Hospital , London , UK

Michael Coburn , M.D., FACS Scott Department of Urology , Ben Taub General Hospital, Baylor College of Medicine , Houston , TX , USA

Janet L. Colli , M.D. Department of Urology , Tulane University , New Orleans , LA , USA

Xiaoming Cong , Ph.D. Department of Urology , Nanjing Drum Tower Hospital, The Af fi liated Nanjing Drum Tower Hospital of Nanjing University Medical School , Nanjing, Jiangsu , China

Faridun K. Dadachanji , B.A., Economics Advisory Services , Advanced Equities, First Allied Security , San Diego , CA , USA

Michel Daudon , Ph.D. Service des Explorations Fonctionnelles , Tenon Hospital, APHP , Paris , France

xxvContributors

Yao Liang Deng , M.D., Ph.D. Department of Urology , The First Af fi liated Hospital of Guangxi Medical University , Nanning, Guangxi , China

John D. Denstedt , M.D., FRCSC, FACS Department of Surgery , The University of Western Ontario , London , ON , Canada

Mahesh R. Desai , M.S., FRCS Department of Urology , Muljibhai Patel Urological Hospital , Nadiad , Gujarat , India

Mihir Desai , M.D. Robotic Urological Surgery, USC Institute of Urology, Keck School of Medicine, University of Southern California , Los Angeles , CA , USA

Somnuek Domrongkitchaiporn , M.D. Department of Medicine , Ramathibodi Hospital , Bangkok , Thailand

Stephen P. Dretler , M.D., Department of Urology , Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA

Nicole Ebinger Mundorff , M.D. Department of Urology , University Hospital Basel , Basel , Switzerland

Ahmed M. Elshal , M.Sc., FEBU Department of Urology, Mansoura Urology and Nephrology Center, Mansoura University , Mansoura , Egypt

Brian H. Eisner , M.D. Department of Urology , Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA

Salah R. El-Faqih , MBChB, FRCS (Glasgow), FRCS (England) Department of Surgery (Urology) , College of Medicine, King Saud University , Riyadh , Kingdom of Saudi Arabia

Ahmed S. El-Hefnawy, M.D. Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt

Tamer El-Husseiny , MBBCh (Hons), M.Sc. (Urol), MRCS (Ed.) Department of Urology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust , Birmingham , UK

Ahmed R. El-Nahas, M.D. Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt

Ahmed Mohamed Elshal , M.Sc., FEBU Department of Urology, Mansoura Urology and Nephrology Center, Mansoura University , Mansoura , Egypt

David B. Evans , Ph.D. Department of Health Systems Financing (HSF) , World Health Organization , Geneva , Switzerland

Nuzhat Faruqui , M.B.B.S., FRCS (Urology), FEBU Section of Urology, Department of Surgery , The Aga Khan University , Karachi, Sindh , Pakistan

Chen-Chen Feng, M.D. Department of Urology, Huashan Hospital , Fudan University , People’s Republic of China

Pietro Manuel Ferraro , M.D. Division of Nephrology and Dialysis, Renal Program, Department of Internal Medicine and Medical Specialties , Columbus-Gemelli University Hospital , Rome , Italy

Gerhard J. Fuchs , M.D., FACS Department of Surgery , Minimally Invasive Urology Institute, Cedars-Sinai Medical Center , Los Angeles , CA , USA

Andrew Fuller , M.B.B.S., FRACS Division of Urology , The University of Western Ontario , London , ON , Canada

xxvi Contributors

Giovanni Gambaro , Ph.D. Division of Nephrology and Dialysis , School of Medicine, Columbus-Gemelli University Hospital, Catholic University , Rome , Italy

Raguram Ganesamoni , M.S., MRCS, MCh (Urology) Department of Urology , Postgraduate Institute of Medical Education and Research , Chandigarh , Chandigarh , India

Arvind P. Ganpule , M.S., DNB, MNAMS Department of Urology , Muljibhai Patel Urological Hospital , Nadiad , Gujarat , India

Farooq Ghani , M.D., Ph.D. (Path) USA Department of Pathology , Aga Khan University , Karachi , Pakistan

Anwarul-Hassan Gilani , Ph.D. Department of Biological and Biomedical Sciences , The Aga Khan University Medical College , Karachi, Sindh , Pakistan

Ehud Gnessin , M.D. Department of Urology , Indiana University Health , Indianapolis , IN , USA

Stuart J. Graham , B.Sc., M.B.B.S., FRCSEd, FRCS (Urol) Department of Urology , Whipps Cross Hospital, Barts Health NHS Trust , Leytonstone, London , UK

Joseph A. Graversen , M.D. Department of Urology, Columbia University College of Physicians and Surgeons , New York Presbyterian Hospital Kidney Stone Center , NY , USA

Andreas J. Gross , M.D. Department of Urology , Asklepios Hospital Barmbek , Hamburg , Germany

Suzanne R. Gudeman , M.D. Department of Urology , Naval Medical Center , San Diego , CA , USA

Jian-Ming Guo , M.D., Ph.D. Department of Urology , Zhongshan Hospital, Fudan University , Shanghai , China

Mantu Gupta , M.D. Director of Endourology, Columbia University and NYPH Kidney Stone Center , New York , NY , USA

New York Presbyterian Hospital Kidney Stone Center , New York , NY , USA

Lee D. Hall , M.D. Department of Radiology , Naval Medical Center , San Diego , CA , USA

Syed Nomanul Haq , Ph.D. Social Sciences and Humanities , Lahore University of Management Sciences (LUMS) , Lahore , Pakistan

Tanveer ul Haq , M.B.B.S., FCPS, FRCR Department of Radiology , Aga Khan University Hospital , Karachi, Sindh , Pakistan

Naveed Haroon , M.B.B.S. Department of Urology , Aga Khan University , Karachi, Sindh , Pakistan

Ahmed M. Harraz M.D., M.S., MRCS Department of Urology and Nephrology Center, Mansoura University , Mansoura , Egypt

Nathan Hawkes , M.D. Department of Radiology , Naval Medical Center , San Diego , CA , USA

Xiao He , MB Department of Urology , Peking Union Medical College Hospital , Beijing , China

Zhaohui He, M.D. Department of Urology , Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, The First Af fi liated Hospital of Guangzhou Medical College , Guangzhou, Guangdong , China

xxviiContributors

Kelly A. Healy , M.D. Department of Urology , Jefferson Medical College, Thomas Jefferson University , Philadelphia , PA , USA

Ita Pfeferman Heilberg , M.D., Ph.D. Nephrology Division , Federal University of São Paulo , São Paulo , Brazil

Albrecht Hesse , Ph.D. Urinary Stone Analysis Centre Bonn , Bonn , Germany

Jen Hoogenes , M.S., Ph.D.(c) Department of Clinical Epidemiology and Biostatistics and Department of Surgery , St. Joseph’s Healthcare Hamilton, McMaster University , Hamilton , ON , Canada

Marcel Hruza, M.D. Department of Urology , SLK-Kliniken GmbH , Heilbronn , Germany

Mohammad Iqbal Department of Nursing, Aga Khan University , Karachi , Pakistan

Tazeen H. Jafar , M.D., MPH Department of Medicine , Aga Khan University , Karachi, Sindh , Pakistan

Jan Peter Jessen , M.D. Department of Urology , Sindel fi ngen-Boeblingen Medical Center , Sindel fi ngen, Baden-Wuerternberg , Germany

Paul Jungers , M.D. Department of Nephrology , Necker-Enfants Malades Hospital, APHP , Paris , France

Wook Kang American Medical Systems , Minnetonka , MN , USA

Shamsh Kassim-Lakha , MBA Founding President, Aga Khan University and Chairman, Board of Directors of Pakistan Centre for Philanthropy , Islamabad , Pakistan

Aga Khan University , Karachi, Sindh , Pakistan

Aysha Habib Khan , M.B.B.S., FCPS (chemical pathology) Department of Pathology and Microbiology and Medicine , Aga Khan University , Karachi, Sindh , Pakistan

Muhammad Shamim Khan , M.B.B.S., MCPS, FRCS (Urol), FEBU Department of Urology , Guy’s and St. Thomas’ NHS Foundation Trust , London , UK

Mumtaz Jamshed Khan , M.D., FACS Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic Foundation , Cleveland , OH , USA

Nadeem Kamal Mustafa Khan , B.A., B.Sc. (Econ), FCA Regional CEO, Health Services, Asia, The Aga Khan University Hospital , Karachi, Sindh , Pakistan

Naveed Ahmed Khan , Ph.D. Department of Biological and Biomedical Sciences , Aga Khan University , Karachi, Sindh , Pakistan

Robyna Irshad Khan , FCPS (anaesthesiology), M.B.B.S., MHSc (bioethics) Department of Anesthesia and Intensive Care , Aga Khan University , Karachi, Sindh , Pakistan

Quratulain Khan , M.B.B.S. Department of Medicine , Aga Khan University , Karachi, Sindh , Pakistan

Anne Sophie Knipper , M.D. Department of Urology , Asklepios Hospital Barmbek , Hamburg , Germany

Thomas Knoll , M.D., Ph.D., M.Sc. Department of Urology , Sindel fi ngen-Boeblingen Medical Center , Sindel fi ngen, Baden-Wuertternberg , Germany

Steven G. Koopman , M.D. Department of Surgery, Minimally Invasive Urology Program , Cedars-Sinai Medical Center , Los Angeles , CA , USA

xxviii Contributors

Ruslan Korets , M.D. Department of Urology, Columbia University College of Physicians and Surgeons , New York Presbyterian Hospital Kidney Stone Center , NY , USA

Fernando Korkes Division of Urology , ABC Medical School , São Paulo , Brazil

Division of Nephrology, Federal University of São Paulo , São Paulo , Brazil

Jatinder Kumar , M.S. Department of Urology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , Uttar Pradesh , India

Dirk Lange , B.Sc. (Hon), Ph.D. Department of Urologic Sciences , Jack Bell Research Centre, The Stone Centre at Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada

Ming-Chak Lee , M.B.B.S. Department of Urology , Westmead Hospital , Westmead , NSW , Australia

Scott Leslie , M.D. Robotic Urological Surgery, USC Institute of Urology, Keck School of Medicine, University of Southern California , Los Angeles , CA , USA

James O. L’Esperance , M.D. Department of Urology , Naval Medical Center , San Diego , CA , USA

Cheng Yang Li, M.D., Ph.D. Department of Urology , The First Af fi liated Hospital of Guangxi Medical University , Nanning, Guangxi , China

Hammersmith and Ealing Hospitals , London , UK

Hong Li , M.D. Department of Urology , West China Hospital of Sichuan University , Chengdu, Sichuan , China

James E. Lingeman , M.D. Department of Urology , Indiana University Health , Indianapolis , IN , USA

Michael E. Lipkin , M.D. Division of Urology, Department of Surgery, Duke University Medical Center , Durham , NC , USA

Deyi Luo , M.D. Department of Urology , West China Hospital, Sichuan University , Chengdu, Sichuan Province , China

Tyler Luthringer , B.A. Division of Urology, Associated Medical Professionals , Syracuse , NY , USA

John A. Lynn , M.S., FRCS Department of General Surgery, Barnet and Chase Farm Hospital NHS Trust, Bupa Cromwell Hospital , London , UK

Department of Endocrinology, Hammersmith and Ealing Hospitals , London , UK

William R. Lynn , M.B.B.S., B.Sc. (Hons), MRCS Department of General Surgery, Barnet and Chase Farm Hospital NHS Trust , London , UK

Jessica A. Mandeville , M.D. Department of Urology , Indiana University Health , Indianapolis , IN , USA

Amanullah Memon , M.B.B.S., FRCS (Ed) Department of Surgery , Aga Khan University , Karachi, Sindh , Pakistan

Y. M. Fazil Marickar , M.S., MAMS, Ph.D. (Urology), FAMS, FIMSA, DAS, FEMSI Department of Surgery, Azeezia Medical College , Kollam , Kerala , India

Thomas E. Milner , Ph.D. Department of Biomedical Engineering , The University of Texas at Austin , Austin , TX , USA

xxixContributors

Michael Marberger , M.D., FRCS (ed) Department of Urology , Medical University of Vienna , Vienna , Austria

Markus Margreiter , M.D., FEBU Department of Urology , Medical University Vienna , Vienna , Austria

James H. Masterson , M.D. Department of Urology , Naval Medical Center , San Diego , CA , USA

Edward Matsumoto , M.D., MEd, FRCSC Division of Urology, St. Joseph’s Healthcare, McMaster University , Hamilton , ON , Canada

Tiziana Meschi , M.D. Department of Clinical Sciences , University of Parma , Parma , Italy

Bushra Moiz , M.B.B.S., MCPS (Path), FCPS (Haem) Section of Hematology, Department of Pathology and Microbiology , The Aga Khan University , Karachi, Sindh , Pakistan

Manoj Monga , M.D. Department of Urology, Steven Streem Center for Endourology and Stone Disease, The Cleveland Clinic , Cleveland , OH , USA

Shamim Mushtaq , Ph.D. Department of Biochemistry, National Center for Proteomics, University of Karachi , Karachi, Sindh , Pakistan

Stephen Y. Nakada , M.D. Department of Urology , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA

K. Razi Naqvi , Ph.D. Department of Physics , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway

Saiyid Jaffar Ali Naqvi , F.R.C.P. Department of Nephrology, The Kidney Foundation, National Institute of Kidney and Urological Diseases (NIKUD), University of Karachi , Karachi , Pakistan

Abdul Razzaq Nasir , M.B.B.S., FCPS Department of Urology , Bolan Medical College Ouetta , Ouetta , Pakistan

Tair Nazarov , M.D. Department of Urology , Northwestern State Medical University , St. Petersburg , Russian Federation

Syed Muhammad Nazim , M.B.B.S., MCPS, MRCS (Glasgow), FCPS (Urology) Department of Surgery , The Aga Khan University and Hospital Karachi , Karachi, Sindh , Pakistan

Christopher Netsch, M.D. Department of Urology , Asklepios Hospital Barmbek , Hamburg , Germany

Rian Nieuwoudt , Pr.Eng, M.Eng, B.Eng (Stell) Managing Director at Spectra-Medic, AHG Group of Companies , Western Cape , South Africa

John Norcini , Ph.D. Foundation for Advancement of International Medical Education and Research (FAIMER) , Philadelphia , PA , USA

Antonio Nouvenne , M.D., Ph.D. Department of Clinical Sciences , University of Parma , Parma , Italy

Andrei Novikov , M.D. Department of Urology , Northwestern State Medical University , St. Petersburg , Russian Federation

Yoshihide Ogawa , M.D., Ph.D. Department of Urology , Tokyo-West Tokushukai Hospital , Akishima City, Tokyo , Japan

xxx Contributors

Ephrem O. Olweny , M.D. Department of Urology , University of Texas Southwestern Medical Center , Dallas , TX , USA

Nasir Orakzai , M.B.B.S., FRCS Department of Urology , Institute of Kidney Diseases , Peshawar, Khyber PukhtoonKhaw , Pakistan

Palle J. S. Osther , M.D., Ph.D. EAU Section of Urolithiasis (EULIS) , Urological Research Center , Fredericia , Denmark

Department of Urology , Fredericia Hospital, Part of Hospital Littlebelt, Institute of Regional Health Services Research, University of Southern Denmark , Fredericia , Denmark

Charles Y. C. Pak , M.D. Internal Medicine, Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center at Dallas , Dallas , TX , USA

Jai Pal Paryani , M.B.B.S., FCPS, FEBU Department of Urology , Liaquat University of Medical and Health Sciences , Jamshoro, Sindh , Pakistan

Sutchin R. Patel , M.D. Department of Urology , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA

Margaret S. Pearle , M.D., Ph.D. Department of Urology , University of Texas Southwestern Medical Center , Dallas , TX , USA

Sean A. Pierre , M.D., FRCS (C) Urology Department of Urology , Queen’s University , Kingston , ON , Canada

Department of Surgery , Queensway Carleton Hospital , Nepean , ON , Canada

Bita Pourmand, M.D. Department of Urology, Research Development Center, Sina University Hospital, Tehran University of Medical Sciences , Tehran , Iran

Gholamreza Pourmand , M.D. Department of Urology, Research Development Center, Sina University Hospital, Tehran University of Medical Sciences , Tehran , Iran

Glenn M. Preminger , M.D. Department of Urolgical Surgery , Duke University Medical Center , Durham , NC , USA

Duke Comprehensive Kidney Stone Center , Durham , NC , USA

Jinze Qiu , M.A. Department of Biomedical Engineering , The University of Texas at Austin , Austin , TX , USA

Harshal Rajekar , M.S., MRCS, DNB Department of General Surgery , Post Graduate Institute of Medical Education & Research , Chandigarh , Chandigarh , India

Priyadarshi Ranjan , M.S., MCh Department of Urology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , Uttar Pradesh , India

Nagaraja P. Rao , M.B.B.S., ChM, FRCS Ed Formerly Director of Total Stone Management Centre, University Hospital of South Manchester , Manchester , UK

NTR University of Health Sciences , Vijayawada , Andhra Pradesh , India

Pegeia, Paphos , Cyprus

Jens J. Rassweiler , M.D. Department of Urology , SLK Kliniken Heilbronn, University of Heidelberg , Heilbronn , Germany

Johar Raza , M.B.B.S., FCPS (Urol) Section of Urology , Aga Khan University , Karachi, Sindh , Pakistan

xxxiContributors

William G. Robertson , Ph.D., D.Sc. The Physiology Department , Centre for Nephrology, Royal Free and University College Medical School , London , UK

Allen Rodgers, M.Sc., Ph.D. Department of Chemistry , University of Cape Town , Cape Town , South Africa

Zafar Sajjad , M.B.B.S., MRCP (UK), FRCR Department of Radiology , Aga Khan University , Karachi, Sindh , Pakistan

Khashayar Sakhaee , M.D. Department of Internal Medicine , UT Southwestern Medical Center , Dallas , TX , USA

Basit Salam , M.B.B.S., FCPS Department of Radiology , Aga Khan University Hospital , Karachi, Sindh , Pakistan

Kemal Sarica , M.D., Ph.D. Department of Urology , Yeditepe University, Medical School , Kozyatagi, Istanbul , Turkey

Carl Sarkissian , B.S. Eng Department of Urology, The Cleveland Clinic , Cleveland , OH , USA

Nestor Schor Nephrology Division , Federal University of São Paulo , São Paulo , Brazil

Temuçin Şenkul , M.D. Department of Urology , GATA Haydarpasa Training Hospital Üsküdar , Istanbul , Turkey

Azam Shafquat , M.B.B.S., FHRS Department of Cardiology , King Faisal Specialist Hospital and Research Center , Riyadh , Saudi Arabia

Luming Shen , Ph.D. Department of Urology , Nanjing Drum Tower Hospital, The Af fi liated Nanjing Drum Tower Hospital of Nanjing University Medical School , Nanjing, Jiangsu , China

Ahmed A. Shokeir , M.D., Ph.D., FEBU Department of Urology , Urology and Nephrology Center, Mansoura University , Mansoura , Egypt

Anwar Ali Siddiqui , Ph.D. Department of Biological and Biomedical Sciences , Medical College, Aga Khan University , Karachi , Pakistan

Khurram Mutahir Siddiqui , FCPS, FRCS (UK), FEBU Department of Nursing, Section of Urology , The Aga Khan University , Karachi , Pakistan

Roswitha Siener , Ph.D. Department of Urology , University Stone Centre, University of Bonn , Bonn , Germany

Shrawan K. Singh , MS, MCh (Urology) Department of Urology , Postgraduate Institute of Medical Education and Research , Chandigarh , Chandigarh , India

Vladimir Yu. Startsev , M.D. Department of Urology , State Pediatric Medical Academy St. Petersburg , St. Petersburg , Russia

Wasana Stitchantrakul Department of Medicine, Research Center, Ramathibodi Hospital, Mahidol University , Bangkok , Thailand

M. Nasir Sulaiman , M.B.B.S., FRCS, FRCS (Urol) Section of Urology, Department of Surgery, Aga Khan University Hospital , Karachi , Pakistan

Xizhao Sun , M.D. Department of Urology , Nanjing Drum Tower Hospital, The Af fi liated Nanjing Drum Tower Hospital of Nanjing University Medical School , Nanjing, Jiangsu , China

xxxii Contributors

Roger A. L. Sutton , DM, FRCP, FRCPC Department of Urological Sciences and Medicine, University of British Columbia , Vancouver , BC , Canada

Jamsheer Jehangir Talati , M.B.B.S., FRCS Section of Urology, Department of Surgery , The Aga Khan University , Karachi, Sindh , Pakistan

Danielle A. Taysom , M.D. Department of Radiology , Naval Medical Center , San Diego , CA , USA

Joel M. H. Teichman , M.D. Department of Urologic Sciences , University of British Columbia , Vancouver , BC , Canada

Raju Thomas , M.D., FACS, MHA Department of Urology , Tulane University, Health Sciences Center , New Orleans , LA , USA

Hans-Göran Tiselius , M.D., Ph.D. Division of Urology, Department of Clinical Science, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden

Rebecca L. Tregunna , M.B.B.S., B.Sc. (Hons.) Department of Urology , Guy’s and St. Thomas’ NHS Foundation Trust , London , UK

Alberto Trinchieri , M.D., FEBU Department of Urology , A. Manzoni Hospital , Lecco , Italy

Tehemton E. Udwadia , M.S., FCPS, FRCS (Eng), FRCS (Edin), FAMS, FACS (Hon), FICS (Hon), FARSI (Hon) Department of Surgery , Grant Medical College & J.J. Hospital , Mumbai , Maharashtra , India

Department of M.A.S. , P.D. Hinduja National Hospital , Mumbai , Maharashtra , India

Parsee General Hospital, Breach Candy Hospital , Mumbai , Maharashtra , India

André van der Merwe , MB Ch B, MRCS (Eng), MRCS (Ed) MMed (Urology), UCT, FC (Urol)SA Department of Urology , Faculty of Health Sciences, University of Stellenbosch and Tygerberg Hospital , Tygerberg, Cape Town , South Africa

Camer W. Vellani , MD (Wales), FRCP (London) Department of Medicine, Aga Khan University , Karachi, Sindh , Pakistan

Gang Wang , M.D., Ph.D. Department of Urology , Peking University First Hospital, Institute of Urology, Peking University , Xicheng District, Beijing , China

Guo-Min Wang Department of Urology , Zhongshan Hospital, Fudan University , Shanghai , China

Kunjie Wang , M.D., Ph.D. Department of Urology , West China Hospital, Sichuan University , Chengdu, Sichuan , China

Othmar J. Wess , Ph.D. Storz Medical AG , Taegerwilen, Thurgau , Switzerland

Zhong Wu , M.D., Ph.D. Department of Urology , Huashan Hospital, Fudan University , Shanghai , People’s Republic of China

Huan Yang, M.D., Ph.D. Division of Urology , Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China

Luo Yang, M.D. Department of Urology , West China Hospital of Sichuan University , Chengdu, Sichuan , China

Nasir Ud Din Yashkun , M.B.B.S., FCPS (Histopathology) Department of Pathology , Aga Khan University , Karachi, Sindh , Pakistan

xxxiiiContributors

Zhangqun Ye , M.D., Ph.D. Division of Urology , Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China

Daniel Young , M.D. Division of Urology , Duke University Medical Center , Durham , NC , USA

Zafar Zaidi , M.B.B.S., FRCS, FEBU Department of Urology, The Indus Hospital , Karachi , Pakistan

Zareen Zaidi , M.B.B.S., M.D. Foundation for Advancement of International Medical Education and Research (FAIMER) , Philadelphia , PA , USA

Maseeh uz Zaman , M.B.B.S., M.S., FCPS, FEBNM, DCBNC, FASNC Department of Radiology , The Aga Khan University Hospital , Karachi, Sindh , Pakistan

Ali Akbar Zehri , M.B.B.S., FCPS (Urology) Section of Urology, Aga Khan Hospital , Dar Es Salaam , Tanzania

Guohua Zeng, M.D., Ph.D. Department of Urology , Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, The First Af fi liated Hospital of Guangzhou Medical College , Guangzhou, Guangdong , China

Wen Zhong, Ph.D. Department of Urology , Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, The First Af fi liated Hospital of Guangzhou Medical College , Guangzhou, Guangdong , China

Dorit E. Zilberman M.D. Department of Urology , Chaim Sheba Medical Center , Tel-Hashomaer, Ramat Gan , Israel

xxxv

Abbreviations

m CT Micro computed tomography 25(OH)D Prohormone 25-hydroxyvitamin D 7DHC 7 dehydrocholesterol ABEUR Advisory Board of European Urolithiasis Research ABMS American Board of Medical Specialties ABS American Board of Surgery ABU American Board of Urology ACCP Amorphous carbonated calcium phosphate ACE inhibitor Angiotensin-converting-enzyme inhibitor ACGME Accreditation Council for Graduate Medical Education ACS American College of Surgery ADHH Autosomal dominant hypocalcemia with hypercalciuria ADHR Autosomal dominant hypophosphatemic rickets ADPKD Autosomal dominant polycystic kidney disease AGT Alanine glyoxylate aminotransferase AHA Acetohydroxamic acid AHU Ammonium acid urate AIHW Australian Institute of Health and Welfare AKU Aga Khan University ALARA As low as reasonably achievable APDS Association of Program Directors in Surgery APTT Activated partial thromboplastin time ARB Angiotensin receptor blocker ARF Acute renal failure ARSI Association of Rural Surgeons of India ASI Association of Surgeons of India ATP Adenosine triphosphate AU Attenuation units AUA American Urological Association AUA ISE American Urology Association In-Service Examination BAUS British Association of Urological Surgeons BMD Bone mineral density BMI Body mass index BNE Bilateral neck exploration BPH Benign prostatic hyperplasia CanMEDS Canadian Medical Education Directives for Specialists

xxxvi Abbreviations

CaOx Calcium oxalate CaP Calcium phosphate CAPD Continuous ambulatory peritoneal dialysis CaSR Calcium sensitive receptor CASR Calcium-sensing receptor CbD Case-based discussion CCD Charge coupled device CCST Certi fi cate of completion of specialty training CEC Clinical encounter card CHCPE Centre for Health Care Policy and Evaluation CIRF Clinically insigni fi cant residual fragments CKD Chronic kidney disease CLDN16 Claudin-16 CLL Cystolitholapaxy CMS Centers for Medicare and Medicaid Services COD Calcium oxalate dehydrate COM Calcium oxalate monohydrate COT CaOx trihydrate CPPS Chronic pelvic pain syndrome CPSP College of Physicians and Surgeons of Pakistan CRM Crisis Resource Management CROES Clinical Research Of fi ce of the Endourological Society CRT Cardiac resynchronization therapy CT Computed tomography CTAL Cortical thick ascending limb CUA Chinese Urological Association DBP Vitamin D binding protein DCT Distal convoluted tubules DDAVP De-amino D arginine Vasopressin DOPS Direct Observation of Procedural Skills dRTA Distal renal tubular acidosis DSCR Debt to service coverage ratio DTPA Diethylenetriamine pentaacetic acid DUS Doppler ultrasonography EAU European Association of Urology ECD Extracellular domain ECF Extracellular fl uid ECG Electrocardiogram ECRI Emergency Care Research Institute EDS X-ray energy dispersive spectrometry EDTA Ethylenediaminetetraacetic acid EHL Electrohydraulic lithotriptor EMI Electromagnetic interference EPAs Entrustable Professional Activities ESRD End-stage renal disease ESSQ Endoscopic Surgical Skill Quali fi cation

xxxviiAbbreviations

ESWL Extracorporeal shockwave lithotripsy EWTD European Working Time Directive FFP Fresh frozen plasma FGF23 Fibroblast growth factor 23 FHH Familial hypocalciuric hypercalcemia FHHNC Familial hypomagnesemia with hypercalciuria

and nephrocalcinosis FLS Fundamentals of Laparoscopy Program FREDDY laser Frequency-doubled double pulse ND:YAG laser FTIR Fourier transform infrared spectroscopy FTIRM FTIR microspectroscopy F-URS Flexible uretero-renoscopy GDNF Glial-cell-derived neurotrophic factor GFR Glomerular fi ltration rate GHS rat Genetic hypercalciuric stone-forming rat GOALS Global Operative Assessment of Laparoscopic Skills GR Glyoxylate reductase HAT Heterodimeric amino acid transporters HCT Helical CT HCUP Healthcare Cost and Utilization Project HHRH Hereditary hypophosphatemic rickets with hypercalciuria Ho:YAG Holmium:yttrium-aluminum-garnet HOX Hyperoxaluria HPCS Healthcare Product Comparison System HPFS Health Professional Follow-up Study HPR Hydroxypyruvate reductase IAEA International Atomic Energy Agency IAGES Indian Association of Gastrointestinal Endoscopic Surgery ICD Internal cardiac de fi brillators ICRP International Commission on Radiological Protection ICSF Idiopathic calcium oxalate stone formers IFHH Idiopathic familial hypocalciuric hypercalcemia IGNOU Indira Gandhi National Outreach University IMCD Innermedullary collecting ducts INR International normalized ratio IPTH Intact PTH molecule IR Infrared ITP Immune-mediated thrombocytopenia IVP Intravenous pyelography IVU Intravenous urography JESS Joint Expert Speciation System KUB Kidneys, ureters, and bladder LED Light emitting diode LIBOR London Interbank Offered Rate LKT Liver-kidney transplantation LMWH Low molecular weight heparin

xxxviii Abbreviations

LNS Lesch-Nyhan syndrome LNT Linear no-threshold MAC Monitored anesthesia care MAS Minimal access surgery MAUS Melamine-associated urinary stones MCCQE Medical Council of Canada Qualifying Examination MCUG Micturating cystourethrogram MET Medical expulsive therapy mini PCL Minimally invasive percutaneous nephrolithotripsy mini perc Mini percutaneous nephrolithotomy Mini-CEX Mini-Clinical Evaluation Exercise mini-PAT Mini-Peer Assessment Tool MISTELS McGill Inanimate System for Training and Evaluation

of Laparoscopic Skills MRI Magnetic resonance imaging MRU Magnetic resonance urography MS Metabolic syndrome MSF Multi-source feedback MSK Medullary sponge kidney mSv MilliSievert NAE Net acid excretion NAMS National Hospital Ambulatory Medical Care Survey NANC Non-adrenergic non-cholinergic NASPE/BPEG North American Society of Pacing and Electrophysiology/

British Pacing and Electrophysiology Group NCCT Noncontrast computed tomography NCPHPT Normocalcemic primary hyperparathyroidism NGO Nongovernmental organization NHANES National Health and Nutrition Examination Survey NHANES National Health and Nutrition Examination Survey NHS Nurses’ Health Study NIS Nationwide Inpatient Samples NOTSS Nonoperative technical skills for surgeons NRPB National Radiological Protection Board NSAID Nonsteroidal anti-in fl ammatory drug OAT1 Organic anion transporter 000 OCP Octacalcium phosphate pentahydrate OSATS Objective Structured Assessment of Technical Skills OSCE Objective Structured Clinical Examination PCA Patient controlled analgesia PCLN1 Paracellin-1 PCNL Percutaneous nephrolithotomy PDE Phosphodiesterase PDI Percussion, inversion therapy and diuresis PGME Postgraduate medical education PH Primary hyperoxaluria

xxxixAbbreviations

PH1 Primary hyperoxaluria type I PH2 Primary hyperoxaluria type II PHEX X-linked phosphate-regulating endopeptidase PHO Primary hyperoxaluria PHPT Primary hyperparathyroidism PIXE Proton-induced X-ray emission PKC Protein kinase C PLC Phospholipase C PND Powder neutron diffraction PNL Percutaneous nephrolithotripsy PPi Inorganic pyrophosphate PTFE Polytetra fl uoroethylene PTH Parathyroid hormone PUJO Pelvi-ureteric junction obstruction PWA Patients’ Welfare Association QUEST Queen’s Urology Examination Skills Training RALP Robotic-assisted laparoscopic pyeloplasty RBF Renal blood fl ow RC Renal colic RCPSC Royal College of Physicians and Surgeons in Canada RCT Randomized controlled trial RFP Request for proposal RIRS Retrograde intra-renal surgery RRC Residency Review Committee RTA Renal tubular acidosis RXR Retinoid X receptor RYGB Roux-en-Y gastric bypass SAI Stone age index SEM Scanning electron microscopy SF Stone formers SIUT Sindh Institute of Urology and Transplantation SPECT Single photon emission computer tomography SWL Shockwave lithotripsy T2DM Type 2 diabetes mellitus TA Titratable acid TCO Total cost of ownership TDT Transmission disequilibrium test THI Tissue harmonic imaging THP Tamm-Horsfall protein TLC Thin layer chromatography TLD Thermoluminescent dosimeter TUL Transurethral ureterolithotripsy TURP Transurethral resection of the prostate UA Uric acid UEMS European Union of Medical Specialists UFH Unfractionated heparin

xl Abbreviations

UPJ Ureteropelvic junction UPTF1 Urinary prothrombin fragment 1 URS Ureteroscopy US Ultrasonography USMLE United States Medical Licensing Examination UTI Urinary tract infection UVB Ultraviolet B VCUG Voiding cystourethrogram VDR Vitamin D receptor VDRE Vitamin D response elements VUR Vesicoureteral re fl ux WHO World Health Organization XAS X-ray absorption spectroscopy XRD X-ray diffraction XRF X-ray fl uorescence ZDF Zucher diabetic fatty rats AAMC Association of American Medical Colleges