Association Between Randall's Plaque Stone Anchors and Renal Papillary Pits

Journal of Endourology
Michael S BorofskyJames E Lingeman

Abstract

Renal papillary pits are commonly encountered during ureteroscopy. The mechanism by which such pits arise is unclear. One hypothesis is that pits represent sites where stones overgrowing Randall's plaque (RP) were dislodged. We sought to examine this theory by using digital ureteroscopy and stone μCT. Patients undergoing endoscopic stone removal had procedures recorded and stones analyzed by using μCT. Stones with evidence of Randall's plaque anchors (RPAs) were identified in a blinded fashion. Surgical videos were reviewed independently by two urologists. Twenty-eight patients had μCT-confirmed stones with RPA. Among them, 93% were recurrent stone formers and 75% had had prior stone procedures. Metabolic abnormalities were present in 87%, with 79% classified as idiopathic calcium oxalate stone formers. A mean of 7.6 stones with RPA were identified per procedure. In each case, papillary pits were visualized before any stone manipulation and in several cases the active dislodgement of an attached stone led to immediate identification of an underlying pit. Such stones routinely demonstrated an RPA on μCT. The average depth of RPA was 302 ± 172 μm, consistent with the corresponding shallow pits visualized on the papillary surface....Continue Reading

References

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Nov 9, 2016·Journal of Endourology·Andrew J CohenJames E Lingeman

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Citations

Feb 11, 2020·Healthcare Technology Letters·Katrina FernandezDavid Holmes
Jul 3, 2021·Journal of Clinical Medicine·Christophe Almeras On Behalf Of The Lithiasis Committee Of The French Urological Association
Dec 18, 2021·Journal of Endourology·James C WilliamsElaine M Worcester

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Methods Mentioned

BETA
infrared spectroscopy
X-ray
scanning electron microscopy

Software Mentioned

JMP

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