Vincent Estrade1, Baudouin Denis de Senneville2, Paul Meria3, Christophe Almeras4, Franck Bladou1, Jean-Christophe Bernhard1, Gregoire Robert1, Olivier Traxer5, Michel Daudon6. 1. Department of Urology, CHU Pellegrin, Place Amelie Raba, Leon, 33000, Bordeaux, France. 2. University of Bordeaux, IMB, UMR CNRS 5251, 351 Cours de la Libération, F-33405, Talence Cedex, France. 3. Department of Urology, Saint-Louis Hospital, Denis Diderot University, Paris, France. 4. Department of Urology, La Croix du Sud Clinic, 52 chemin de Ribaute, 31130, Quint Fonsegrives, France. 5. Department of Urology, Tenon Hospital, Pierre and Marie Curie University, Paris, France. 6. Unit of Functional Explorations, Tenon Hospital, Pierre and Marie Curie University, Paris, France.
Abstract
OBJECTIVE: To improve endoscopic recognition of the most frequently encountered kidney stone morphologies for a better etiological approach in lithiasis by urologists. MATERIALS AND METHODS: An expert urologist intra-operatively and prospectively (between June 2015 and June 2018) examined the surface, the section and the nucleus of all encountered kidney stones. Fragmented stones were subsequently analysed by a biologist based on both microscopic morphological (i.e. binocular magnifying glass) and infrared (i.e. FTIR) examinations (microscopists were blinded to the endoscopic data). Morphological criteria were collected and classified for the endoscopic and microscopic studies. The Wilcoxon-Mann-Whitney test was carried out to detect differences between the endoscopic and microscopic diagnoses. A diagnosis for a given urinary stone was considered "confirmed" for a non-statistically significant difference. RESULTS: A total of 399 urinary stones were included in this study: 51.4% of the stones exhibited only one morphological type while 48.6% were mixed stones (41% had at least two morphologies and 7.6% had three morphologies). The overall matching rate was 81.6%. Diagnostics were confirmed for the following morphologies: whewellite (Ia or Ib), weddellite (IIa or IIb), uric acid (IIIa or IIIb), carbapatite-struvite association (IVb), brushite (IVd). CONCLUSIONS: Our preliminary study demonstrates the feasibility of using endoscopic morphology for the most frequently encountered urinary stones and didactic boards of confirmed endoscopic images are provided. The current study constitutes the first step toward endoscopic stone recognition, which is essential in lithiasis. We provide didactic boards of confirmed endoscopic images which paves the way for automatic computer-aided in-situ recognition. This article is protected by copyright. All rights reserved.
OBJECTIVE: To improve endoscopic recognition of the most frequently encountered kidney stone morphologies for a better etiological approach in lithiasis by urologists. MATERIALS AND METHODS: An expert urologist intra-operatively and prospectively (between June 2015 and June 2018) examined the surface, the section and the nucleus of all encountered kidney stones. Fragmented stones were subsequently analysed by a biologist based on both microscopic morphological (i.e. binocular magnifying glass) and infrared (i.e. FTIR) examinations (microscopists were blinded to the endoscopic data). Morphological criteria were collected and classified for the endoscopic and microscopic studies. The Wilcoxon-Mann-Whitney test was carried out to detect differences between the endoscopic and microscopic diagnoses. A diagnosis for a given urinary stone was considered "confirmed" for a non-statistically significant difference. RESULTS: A total of 399 urinary stones were included in this study: 51.4% of the stones exhibited only one morphological type while 48.6% were mixed stones (41% had at least two morphologies and 7.6% had three morphologies). The overall matching rate was 81.6%. Diagnostics were confirmed for the following morphologies: whewellite (Ia or Ib), weddellite (IIa or IIb), uric acid (IIIa or IIIb), carbapatite-struvite association (IVb), brushite (IVd). CONCLUSIONS: Our preliminary study demonstrates the feasibility of using endoscopic morphology for the most frequently encountered urinary stones and didactic boards of confirmed endoscopic images are provided. The current study constitutes the first step toward endoscopic stone recognition, which is essential in lithiasis. We provide didactic boards of confirmed endoscopic images which paves the way for automatic computer-aided in-situ recognition. This article is protected by copyright. All rights reserved.