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Cystine stones : developments in minimally invasive surgery and their impact on morbidity and stone clearance

Hughes, Thomas
Tzelves, Lazaros
Somani, Bhaskar
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Affiliation
South Warwickshire University NHS Foundation Trust; National and Kapodistrian University of Athens, Greece; University Hospital Southampton
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Publication date
2023-06-05
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Abstract
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: cystine; kidney calculi; laser; percutaneous nephrolithotomy; recurrence; ureteroscopy.
Citation
Hughes T, Tzelves L, Somani BK. Cystine Stones: Developments in Minimally Invasive Surgery and Their Impact on Morbidity and Stone Clearance. Res Rep Urol. 2023 Jun 5;15:175-185. doi: 10.2147/RRU.S381190.
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