Preoperative patient optimization for endourological procedures: the current best clinical practice

Abstract

Purpose of review 

Despite technological advancements in endourological surgery, there is room for improvement in preoperative patient optimization strategies. This review updates recent best clinical practices that can be implemented for optimal surgical outcomes.

Recent findings 

Outcome and complication predictions using novel scoring systems and techniques have shown to assist clinical decision-making and patient counseling. Innovative preoperative simulation and localization methods for percutaneous nephrolithotomy have been evaluated to minimize puncture-associated adverse events. Novel antibiotic prophylaxis strategies and further recognition of risk factors that attribute to postoperative infections have shown the potential to minimize perioperative morbidity. Accumulating data on the roles of preoperative stenting and selective oral alpha-blockers adds evidence to the current paradigm of preventive measures for ureteral injury.

Summary 

Ample tools and technologies exist that can be utilized preoperatively to improve surgical outcomes. The combination of these innovations, along with validation in larger-scale studies, presents the cornerstone of future urolithiasis management.