{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T08:58:55Z","timestamp":1790499535928,"version":"4.1.0"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Ureteral stones are a common cause of emergency presentations. Definitive stone removal at the index encounter can reduce delays and repeat interventions. It is unknown whether fellowship-trained endourologists are more likely to perform definitive management than general\/other subspecialist urologists. This multicenter retrospective cohort study evaluated the influence of endourology subspecialty training on the choice between upfront definitive stone treatment and initial ureteral decompression at first presentation. Patients managed with medical expulsive therapy alone were not included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Adults (\u226518 years) presenting at 2022 to seven North American academic centers with symptomatic, noninfected, computed tomography-confirmed ureteral stones were included. Patients with infection, sepsis, positive nitrites, or intraoperative pyelonephritis were excluded from the study. Variables included demographics, stone size and location, subspecialty of the on-call urologist, and management type (definitive [ureteroscopy or shockwave lithotripsy]\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      deferred [(initial stent]). Multivariate logistic regression was used to identify the predictors of definitive treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among the 395 patients, 190 (48.0%) underwent definitive management and 205 (52.0%) underwent deferred treatment. Distal stones were treated definitively more often than proximal stones were (51.1%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      36.6%). An endourologist was on call for 150 encounters (38.0%); 64.7% of these patients received definitive treatment, compared with 38.0% under general\/other subspecialist urologists. On multivariate analysis, endourologist on-call remained independently associated with definitive management (odds ratio [OR] 3.46, 95% confidence interval [CI] 2.19\u20135.47,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001), as did distal stone location (OR: 2.46, 95% CI: 1.21\u20135.00,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.013). Severe complications are rare, and none of the patients developed sepsis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Endourologists were more than three times more likely to perform definitive interventions for symptomatic, noninfected ureteral stones at initial presentation. Subspecialty expertise and timely operative access enable safe, efficient, single-stage management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08927790261492126","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:12:11Z","timestamp":1790316731000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Are Endourologists More Likely to Definitively Treat Symptomatic Stones at Initial Presentation?"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2526-4275","authenticated-orcid":false,"given":"Mouneeb M.","family":"Choudry","sequence":"first","affiliation":[{"name":"Department of Urology, Mayo Clinic Arizona, Phoenix, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C.","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic Arizona, Phoenix, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic Arizona, Phoenix, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4133-7809","authenticated-orcid":false,"given":"Victoria S.","family":"Edmonds","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic Arizona, Phoenix, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2862-0506","authenticated-orcid":false,"given":"Jackson","family":"Cabo","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic Arizona, Phoenix, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Maciolek","sequence":"additional","affiliation":[{"name":"Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinath-Reddi","family":"Pingle","sequence":"additional","affiliation":[{"name":"Department of Urology, Columbia University Medical Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrison M.","family":"Drebin","sequence":"additional","affiliation":[{"name":"Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runhan","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Urologic Sciences, University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California San Diego, San Diego, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5981-4733","authenticated-orcid":false,"given":"Joanna","family":"Langner","sequence":"additional","affiliation":[{"name":"University of California San Diego School of Medicine, San Diego, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Franceschelli","sequence":"additional","affiliation":[{"name":"The Ohio State College of Medicine, Columbus, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Mills","sequence":"additional","affiliation":[{"name":"The Ohio State College of Medicine, Columbus, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Othmane","family":"Zekraoui","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine de L\u2019Univserit\u00e9 de Montr\u00e9al, Montreal, 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H.","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Urologic Sciences, University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Sur","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California San Diego, San Diego, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naeem","family":"Bhojani","sequence":"additional","affiliation":[{"name":"Division of Urology, Centre Hospitalier de L\u2019Universit\u00e9 de Montr\u00e9al, Montreal, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell R.","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic Arizona, Phoenix, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen L.","family":"Stern","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo 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