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Resumen Introduccion y objetivos Evaluar la capacidad del endourologo para evaluar la composicion del calculo mediante la observacion de imagenes endoscopicas. Materiales y metodos Una serie de 20 videoclips de tratamientos endoscopicos de calculos urinarios que tambien estaba disponible el resultado de la espectroscopia infrarroja se cargo en un sitio de YouTube accesible solo a miembros del South Eastern Group for Urolithiasis Research (SEGUR) a quienes se les pregunto para identificar la composicion de los calculos. Resultados Un total de 32 endourologos de 9 paises diferentes participaron en el estudio. El numero promedio de detecciones correctas de participantes fue de 7.81 ± 2.68 (1–12). La precision general fue del 39% (250 de 640 predicciones). Calculos de dihidrato de oxalato de calcio se han detectado correctamente en el 69.8%, monohidrato de oxalato de calcio en el 41.8%, acido urico en el 33.3%, oxalato de calcio / acido urico en el 34.3% y cistina en el 78.1%. Las tasas de precision para estruvita (15.6%), fosfato de calcio (0%) y oxalato de calcio / fosfato de calcio (9.3%) fueron bastante bajas. Conclusiones La observacion del calculo durante el procedimiento endoscopico no fue confiable para identificar la composicion de la mayoria de los calculos, aunque los calculos de oxalato de calcio dihidrato y cistina pueden identificarse con buena precision. Sin embargo, se debe alentar la presentacion de fotos o videos de calculo intacto y su estructura interna para implementar los resultados del analisis de calculo despues de la cirugia. Los endourologos deben mejorar su capacidad de identificacion visual de los diferentes tipos de calculos.

Background An increase of the frequency of uric acid urinary stones compared to calcium-containing ones has been recently described. This study was aimed at assessing the frequency of different types of urinary stones in the population of northern Italy in the period 2016–18 compared to 2001–2003. Methods Analyses by infrared spectroscopy of 1007 stones endoscopically removed at two institutions in the area of Milan (Northern Italy) were retrospectively considered. Stones were classified as calcium oxalate monohydrate (COM) and dihydrate (COD), mixed uric acid/calcium oxalate (UC); uric acid (UA), struvite (ST); apatite (CAP); mixed calcium oxalate / apatite (CAPOX); others. The patients were divided into two groups: 2001–2003 and 2016–2018. The average temperature values of the region over the two time periods were obtained by the national statistical institute. Results The average age of the 2001–2003 group (45.8+/− 15.4 years) was significantly lower than the average age of the 2016–18 group (57.9+/− 14.8) (0.000). M / F ratio was similar in the two groups: 119 / 69 (1,0.58) in 2001–2003 and 527 / 292 (1,0.55) in 2016–18 (p = 0.862). COM stones tended to more frequent in 2016–18 group than in 2001–03. COD stones were significantly more frequent in 2001–03 than in 2016–18. ST stone frequency was increased from 2001 to 03 to 2016–18. No increase of uric acid containing stones was observed in 2016–18. Results were confirmed after adjustment by age. Averages annual regional temperatures increased from 14 °C to 15.4 °C during the two observation periods. Conclusions No increase of UA stones was observed, probably due to the limited impact of the global warming in our temperate climate.

Background: An increase of the frequency of uric acid urinary stones compared to calcium-containing ones has been recently described. This study was aimed at assessing the frequency of different types of urinary stones in the population of northern Italy in the period 2016-18 compared to 2001-2003.Methods: Analyses by infrared spectroscopy of 1007 stones endoscopically removed at two institutions in the area of Milan (Northern Italy) were retrospectively considered. Stones were classified as calcium oxalate monohydrate (COM) and dihydrate (COD), mixed uric acid/calcium oxalate (UC); uric acid (UA), struvite (ST); apatite (CAP); mixed calcium oxalate / apatite (CAPOX); others. The patients were divided into two groups: 2001-2003 and 2016-2018. The average temperature values of the region over the two time periods were obtained by the national statistical institute.Results: The average age of the 2001-2003 group (45.8+/-15.4 years) was significantly lower than the average age of the 2016-18 group (57.9+/-14.8) (0.000). M / F ratio was similar in the two groups: 119 / 69 (1:0.58) in 2001-2003 and 527 / 292 (1:0.55) in 2016-18 (p = 0.862). COM stones tended to more frequent in 2016-18 group than in 2001-03. COD stones were significantly more frequent in 2001-03 than in 2016-18. ST stone frequency was increased from 2001-03 to 2016-18. No increase of uric acid containing stones was observed in 2016-18. Results were confirmed after adjustment by age. Averages annual regional temperatures increased from 14° C to 15.4° C during the two observation periods.Conclusions: No increase of UA stones was observed, probably due to the limited impact of the global warming in our temperate climate.

Objective: To investigate some epidemiological aspects of kidney stones in the South- Eastern European area. Materials and methods: From September 2015 to December 2015, 538 consecutive patients were treated and evaluated for reno-ureteral stones in eight departments in Bulgaria, Greece, Italy, FYR Macedonia, Romania, Serbia and Turkey. Results: The age of onset was lower in Turkey and higher in Italy. The rate of recurrent patients was higher in Romania and Serbia, while first renal stone formers were more frequent in Italy. The previous history of kidney stones, the characteristics of the stones and the dietary habits of the patients were different in different countries. In Bulgaria, Greece and Romania larger calculi from recurrent patients were more frequent. In Italy and Turkey smaller calculi from first renal stone formers were more frequent. Conclusions: The previous history of kidney stones, the characteristics of the stones and the dietary habits of the patients were different in different countries. A common dietary pattern associated with the formation of kidney stones was not observed, but each country showed different risk factors.

The potential renal acid load (PRAL) in diet may have a key role in renal stone formation through its effect on calcium and citrate metabolism. We examined the association between calcium renal stone formation and the PRAL in a population-based case–control study. A group of 123 calcium renal stone formers was compared with an equal number of age- and sex-matched controls. Dietary history was obtained by 24-h recall. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated across quartiles of dietary intakes of PRAL. Compared with those in the lowest quartiles of PRAL, we found an increased risk of renal stone formation for those in the highest quartile (Q4 OR=2.51, 95% CI 1.218–5.172). Regarding individual food patterns, we found a significant protection for a high consumption of vegetables (two or more servings/day; OR=0.526, 95% CI 0.288–0.962). A PRAL in diet and a reduced consumption of vegetables are associated with an increased risk of calcium renal stone formation. In renal stone formers consumption of plant foods should be encouraged in order to counterbalance the acid load derived from animal-derived foods.

Introduction: The relationship between ejaculatory frequency and ejaculatory latency time is under-investigated. Subjects and Methods: 120 healthy subjects were enrolled in a prospective randomized trial. Patients in group A engaged in sexual intercourse after a 10-day abstinence period for 3 months. Patients in group B engaged in sexual intercourse twice a week for 3 months. Ejaculation function was evaluated through the measurement of the intravaginal ejaculatory latency time (IELT) and through the premature ejaculation diagnostic tool (PEDT) at baseline and at the end of the study. Results: At the end of the study, mean IELT values in group A were significantly lower compared to baseline values. Results from the PEDT questionnaire at the end of the study demonstrated a significantly worse ejaculatory control and ability to delay ejaculation by patients in group A. Conclusions: Reduced ejaculatory frequency impairs ejaculation control.