ArticleUrolithiasis2025
The impact of normalized energy utilization on clinical outcomes and complications in endourological stone surgery: a prospective study.
Article in Urolithiasis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This prospective study evaluated the impact of normalized energy utilization on clinical outcomes and complications in endourological stone surgery. Between January 2024 and April 2025, 478 consecutive patients undergoing holmium: YAG laser lithotripsy were enrolled. Stone characteristics, energy parameters, operative outcomes, and complications were prospectively recorded. Normalized energy values (J/mm³) were calculated as total energy divided by stone volume. The primary endpoint was complication development. Mean normalized energy was 22.5 ± 13.1 J/mm³ (range: 5.8-72.4). High-density stones (> 1000 HU) and lower calyceal locations required significantly higher energy (p < 0.001 and p = 0.012, respectively). ROC analysis identified 25 J/mm³ as the optimal threshold for predicting complications (AUC = 0.792, sensitivity 75.8%, specificity 70.5%). Energy utilization above 25 J/mm³ increased complication risk 4.25-fold (95% CI: 2.05-8.82, p < 0.001), while energy above 30 J/mm³ significantly increased severe papillary damage risk (68.5% vs. 25.3%, p < 0.001). In multivariate analysis, normalized energy > 25 J/mm³ (OR: 4.25, p < 0.001), prolonged operative time (OR: 1.02, p = 0.018), and high stone density (OR: 2.54, p = 0.017) were independent risk factors for complications. Overall stone-free rate was 83.7%. This study establishes evidence-based energy thresholds for safe laser lithotripsy, demonstrating that normalized energy monitoring can guide surgical decision-making and reduce complications in endourological stone surgery.
Indexed as
Identifiers
41165832What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.