Research and Reports in Urology (Jun 2023)
Cystine Stones: Developments in Minimally Invasive Surgery and Their Impact on Morbidity and Stone Clearance
Abstract
Thomas Hughes,1 Lazaros Tzelves,2 Bhaskar K Somani3 1Department of Urology, Warwick Hospital, Warwick, UK; 2Department of Urology, Sismanogleio Hospital, National and Kapodistrian University of Athens, Athens, Greece; 3Department of Urology, University Hospital Southampton, Southampton, UKCorrespondence: Bhaskar K Somani, University Hospital Southampton NHS Trust, Southampton, UK, Tel +44-2381206873, Email [email protected]: Cystinuria is a rare genetic condition that is responsible for cystine stones. Besides stone recurrence, patients with cystine stones have reduced health-related quality of life, increased rates of chronic kidney disease and hypertension. Although lifestyle measures, medical therapy and close follow up are essential to reduce and monitor cystine stone recurrences, surgical intervention is frequently needed for most cystinuria patients. Shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy and active surveillance all have a role, and technological advances in endourology are vital in achieving a stone-free status and to prevent recurrences. The complexity of managing cystine stones necessitates a multidisciplinary team discussion, patient involvement and an individualised approach in a specialist centre for optimum management. Thulium fibre laser and virtual reality may have an increasing role in the future of cystine stone management.Keywords: kidney calculi, ureteroscopy, percutaneous nephrolithotomy, laser, cystine, recurrence
